I have been trying to find more information on this type of delusion and not finding anything from someone who has first hand experience that might be helpful. Suggestions? Thank you in advance.
@GEORGE, there’s an old joke grounded in truth (most good ones are) that may help you with the distinction: “It’s not paranoia if I KNOW people are out to get me!” If this is the case, you’ve likely transitioned from a paranoid delusion to a persecutory one. It’s a bit like the difference between suffering “free-floating anxiety” and a specific one like performance anxiety. I’m not a huge fan of being overly clinical and splitting hairs with diagnoses and categorizations, as these distinctions are generalizations and I feel sufferers as well as their symptoms should be treated as individuals. But since I tend toward paranoia and you asked, I’ll illustrate with an example from my experience:
As I first started experiencing symptoms, I got a general feeling that I was being followed or watched. It concerned me and I became increasingly anxious about it to the point that I considered hiring a private investigator to confirm my suspicions. I’m often curious what would have happened if I’d had the resources and connections to actually hire and trust someone, but instead I became my own amateur “investigator”. But since I wasn’t experienced or mentally competent enough to conduct a true investigation, what followed for months was me collecting “evidence” out of hunches and speculations and intuition that led to a very specific explanation that I was being followed by two FBI agents, a man and a woman not unlike Mulder and Scully from the X-files (this delusion predated the series by many years). I treated my conclusions as near fact and invested much time in fleshing out this story, to the point I gave them names and a timeline of how their investigation of me came to be, and why they persisted in following me. I quickly learned it wasn’t safe discussing these thoughts with most people, and they wouldn’t believe me even if I tried, so I quietly continued to build my “case” and searched for a way to make them go away while attending college classes and working part-time.
I could go on with details and specifics, but generally the defining characteristics of persecutory delusions are they are specific, treated as fact or well established theory and are perceived as limiting the freedom of the person experiencing them.
To use an analogy, the experience is a bit like being a writer of a fictional narrative, only you think you’re a journalist. Your story ideas become plot and narrative, and you create lore and establish canon, but in your mind it’s all true. To me it was a logical conclusion to my paranoia, and it’s tempting for me to say the only difference between a paranoid delusion and a persecutory one is time, but I think that misses another ingredient— the sufferer’s mind. That is, you need to have enough cognitive faculties to remember and organize paranoid thoughts into a “logical” or seemingly consistent and coherent (to yourself at least) framework. My understanding is people who suffer paranoid or persecutory delusions have better prognoses, with a hypothesis that it’s because more of their analytical and planning cognitive processes remain intact, so they are better equipped to adapt, cope with and compartmentalize delusional thoughts.
Your description and analogy is really helpful and hits a few points I hadnt considered. I have further questions and at some pount would like to PM you if you are comfortable with that.
Also, if a person is of a mindset that they are, let’s say like you have people following you or like my husband, no one can be trusted because they are going to try and financially or emotionally take advantage of him… that’s a very simple explanation of a much more complex one…how can you also recognize 1. That you may need help because your viewpoint or perspective is different than what may be reality or 2. Once you are convinced to go or have some recognition you need to go have therapy work without seeing them as someone else with a dangerous goal or agenda?
I think it comes down to a choice of trusting at least one person or a few people, or accepting the reality that if you don’t you are going to be very much alone. A paradox of persecutory complexes in my experience is deep down you crave an audience so you can air your grievances and get someone to believe, validate or acknowledge your experience. That’s why I think LEAP training is important, it takes advantage of this need and leverages it to improving your relationship with the person with anasognosia, with the possibility of guiding them into treatment.
Update: after the nightmare Thursday night with his meltdown in the truck we got a call back about his meds and…I was completely shocked…he handed the phone to me to talk to them. I don’t know what they will do or if they will do little more than juggle his meds again but that was huge. Today was bad…to much abusive words and screaming again, so much blaming me for his life and being told to just ‘take it’, maybe, just maybe there is some hope getting some help finally from the VA.