Dstinction here is usually clear-cut, but not always. Classically, delusions
are fixed false beliefs (also not shared by members of one's culture or
subculture according to the DSM, although some - myself included - disagree)
and are "ego-syntonic" - consistent with the self-concept and not recognized by
the person as irrational. Classically, obsessions are "ego-dystonic" -
inconsistent with the self-concept and recognized by the person as irrational -
and therefore repeatedly resisted (albeit almost always unsuccessfully). But
beginning at least in the 1980s (probably earlier), psychiatrists and
psychologists have recognized that this distinction, although usually clear,
becomes fuzzy around the edges - hence, the introduction of the even murker
concept of the "overvalued idea" to denote the blurry middle ground between
obsessions and delusions. The ego-dystonic nature of obsessions isn't seen in
many children, and it's become increasingly evident that it's also absent in
some adults - hence the introduction of the OCD with "poor insight" qualifer in
DSM-IV. See:
Kozak MJ, Foa EB (1994). Obsessions, overvalued ideas, and delusions in
obsessive compulsive disorder. Behaviour Research and Therapy 32:343-353.
But in the substantial majority of cases in adults, the
ego-syntonic/ego-dystonic distinction offers a fairly clear line of demarcation
between the two symptoms. People with delusions by definition are certain
their beliefs are warranted, and most people (adults, at least) with obsessions
are sure - or pretty sure - their beliefs are either unwarranted or grossly
overstated. But the middle ground remains controversial, so the bright line
that was once there has largely evaporated.
.....Scott
________________________________
From: don allen [[email protected]]
Sent: Tuesday, April 27, 2010 7:31 PM
To: Teaching in the Psychological Sciences (TIPS)
Subject: Re: [tips] Obsessions vs. delusions
Hi Rob-
An obsession is where you feel that you have to do something (e.g. repeated
hand washing in OCD). A delusion is where you have a belief that is untrue
(e.g. I am Napolean Bonepart). There can be some overlap. For example, you
might have the delusion that everything you touch is covered with highly toxic
bacteria which might lead you to be obsessive about constantly washing your
hands. Usually, however, people who are delusional do not feel compelled to
engage in unnecessary repeated actions the way some people with OCD do.
Hope that helps,
-Don.
----- Original Message -----
From: Rob Weisskirch <[email protected]>
Date: Tuesday, April 27, 2010 4:06 pm
Subject: [tips] Obsessions vs. delusions
To: "Teaching in the Psychological Sciences (TIPS)" <[email protected]>
> TIPSfolk,
>
> A student asked the difference between an obsession a la OCD and a
> delusion. I couldn't come up with a coherent distinction
> when I was further
> questioned.
>
> Can someone give me a concrete distinction?
>
> Thanks,
> Rob
>
> Rob Weisskirch, MSW. Ph.D.
> Professor 90.77% Furlough 9.23%
> Associate Professor of Human Development
> Certified Family Life Educator
> Liberal Studies Department
> California State University, Monterey Bay
> 100 Campus Center, Building 82C
> Seaside, CA 93955
> (831) 582-5079
> [email protected]
>
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