Psychobabble 101 for Law Enforcement

You certainly learned quite a bit of information about mentally ill citizens and suspects in the academy. A couple months in a jail or in the field provided a lot more. APS, CPS, physicians, therapists, schools, concerned family members and friends call 911 regularly to request welfare checks on individuals who may have a mental illness. The lingo is very different from every caller. Let’s make this clear: psychiatric terms are confusing even to seasoned professionals. They are written by physicians, researchers and scholars. But, who writes the penal codes; lawyers; you get my point.

Police jargon isn’t easy either my friends. I remember my first day out with my Oceanside police officer. Ken took me to get some gear: a radio and holster, flashlight, cheat sheet for dispatch calls, and a spit sock. I understood the use of everything, except the spit sock. I asked Ken, “So I just put this over my head if someone is spitting at me”? He just shook his head; it was the running joke at the station for a good two weeks.

Distinguishing Between Illusions and Delusions

Even psychology students have a hard time recognizing the difference between illusions and delusions. You may ask yourself, “Who cares”? The truth is that understanding these symptoms should affect your interaction with individuals who suffer from these disorders; possibly preventing a violent encounter.

Illusions

Quite simply an illusion is simply a misleading perception. Illusions are essentially seeing (most common), hearing, tasting, feeling, or smelling something that is there, but perceiving or interpreting it incorrectly. Optical illusions like this one from Müller-Lyer, is a perfect example. Which horizontal line is the longest?

Illusions deal with stimuli that are actually present, but they are misinterpreted or hard to interpret. Illusions are also what entertain us at magic shows. They are a perfect venue for con artists with sidewalk stands. A practical example of an illusion: You hang your spare uniform over the door jamb to air out; you come home late; as you walk down the hall you see a shadow and perceive it to be an intruder; your pulse races; only to discover your intruder is a hanger wearing pants and a shirt. Another example of an illusion is hearing one's name called when the radio is playing. Illusions can happen to anyone and everyone. They are not a sign of a mental illness, unless they become constant and interfere with your life.

Delusions

Delusions are deeply fixed beliefs, which can be either false or fanciful. These beliefs are maintained by an individual despite contradictory information or evidence. In extreme forms, delusions are symptoms of psychosis. Delusional individuals cannot clearly distinguish what is real from what is not. Schizophrenics are particularly susceptible to the development of delusions. Delusions are also the hallmark of another psychiatric disorder called “delusional disorder”.

Delusions are categorized as either bizarre or non-bizarre. A bizarre delusion is a delusion that is very strange and completely implausible. For example, aliens have removed all of a person’s organs, or brain, and have replaced them with someone else’s. A non-bizarre delusion is where the content of the belief is mistaken, but it is at least possible. For example, it is possible for someone to be under constant police surveillance.

Delusions are also categorized according to their theme. Delusions of control, nihilistic delusions, and thought broadcasting/ insertion/withdrawal are generally considered bizarre delusions. Whereas, persecutory, somatic, grandiose, religious, jealousy, and mind being read delusions are considered non-bizarre.

10 of the Most Common Themed Delusions

1. Persecutory Delusions: This the most common type of delusions which involves the belief of being followed, harassed, cheated, poisoned or drugged, conspired against, spied on, tormented, attacked, etc. Delusions of persecution are suggestive of the paranoid type of schizophrenia.

2. Referential Delusions : Another common delusion in which the person believes that certain gestures, comments, passages from books, television, newspapers, song lyrics, or cues are specifically directed at the individual.

3. Delusions of Control: This is a false belief that another person, group of people, or other external force has control over the individual’s thoughts, feelings, impulses, or behavior. Individuals with delusions of control believe that their thoughts have been involuntarily taken from their mind and that their thoughts are not their own.

4. Religious Delusions: Religious delusions center on misguided beliefs about one's relationship with God. Schizophrenic individuals with this type of delusion may believe they have a special relationship with God, that God has given them special powers, or that they are God/saint/disciple. They may report an ability to speak directly to God or a responsibility to carry out God's plans. Beliefs that would be considered normal for an individual's religious or cultural background are not delusions.

5. Jealousy Delusions: False beliefs that a spouse or lover is having an affair.

6. Erotomania: A delusion in which one believes that another person is in love with them. It is common for individuals with this type of delusion to attempt to contact the other person and sometimes stalk them.

7. Delusions of Being Mind Read: The false belief that other people can know and read your thoughts.

8. Delusions of Grandeur: Grandiose delusions are mistaken beliefs that the individual is better than others. A grandiose individual exaggerates his/her sense of self-importance, and is usually convinced that he/she has special powers/talents/abilities. People with this type of delusion may believe they are a popular powerful political figure or a celebrity.

9. Somatic Delusions: Somatic delusions involve a preoccupation with the individual’s body. Most typically they consist of false beliefs that they are suffering from a severe physical condition, such as a tumor. The perceived source of the disease is usually bizarre, such as having a foreign substance in one's body, or believing that his/her body is infested with parasites.

10. Nihilistic Delusions: A delusion related to the belief centered on the nonexistence of self, others, or the world. Individuals with this type of delusion commonly believe that the world is ending.

Tips for Law Enforcement

Bear in mind that delusions are deeply fixed beliefs; you will not be able to convince a delusional individual that what he/she believes is not true. Don’t even try; you will probably just agitate him/her further, potentially escalate the situation, and increase the risk for violence.

People with persecutory delusions are not sure who is plotting against them, they may believe that it is you. They are also not likely to share their suspicions with others; they tend to isolate. Additionally, any individual who has a delusion that someone is trying to harm or kill them can be dangerous to others, including you. Do what you do best, protect and serve. If the suspect presents with the criteria for an involuntary psychiatric petition, take him/her to the hospital. There are treatments for schizophrenia and delusional disorders.

Okay---Back to the Original Question: What is the Difference between an Illusion and a Delusion?

Although both illusions and delusions are false; illusions pertain to the mind and delusions pertain to a belief. Illusions can be said to be what fools the mind; delusions are things that an individual perceives to be truth contrary to all evidence.

About The Author:

Pamela Kulbarsh, RN, BSW has been a psychiatric nurse for over 25 years. She has worked with law enforcement in crisis intervention for the past ten years. She has worked in patrol with officers and deputies as a member of San Diego's Psychiatric Emergency Response Team (PERT) and at the Pima County Detention Center in Tucson. Pam has been a frequent guest speaker related to psychiatric emergencies and has published articles in both law enforcement and nursing magazines.