Delusion of grandeur: what does it consist of?

The delusion of grandeur or megalomania It is a type of delirium associated with power. Some historical figures to whom megalomaniacal traits have been attributed are Julius Caesar, Napoleon or Hitler, as well as narcissistic traits that drove them to conquer the world. However, we must be clear that this phenomenon is a delusion; that is, a disorder of the content of thought, considered a psychotic symptom, typical of disorders such as schizophrenia or delusional disorder, for example.

Through this delusion, the person manifests delusional ideas related to believing themselves to be God or a prophet, for example. That is to say, the sense of reality is altered, and the delusional idea is fixed in the person’s mind, being very difficult to revoke. But what else do we know about delusions? And about the delusion of grandeur? How is it usually treated in psychotherapy?

The delusions

Before delving into delusions of grandeur, let’s define what a delusion is and how this concept was understood in the world of mental health. A delusion is a disorder of the content of thought. During the 17th century, the concept of madness was fundamentally based on delirium, that is, “being crazy” was the same as “having delusions,” and vice versa.

This position was maintained for a long time afterwards, even without a clear and agreed upon definition of delirium. However, later definitions arrived, and one of the best known and cited is that of Jaspers (1975), who defined it as: “false judgments, which are characterized by the subject maintaining them with great conviction, which are not influenced either by experience or by irrefutable conclusions, and that their content is also impossible.” But what about the delusion of grandeur? What exactly?

Delusion of grandeur: what does it consist of?

According to Amparo Belloch et al. (2010), in their Manual of Psychopathology, Delusions of grandeur are a type of delusion in which the content implies an exaggerated assessment of the importance, power, knowledge or personal identity. It may be religious, corporal or other in nature. It is also called delusional idea of ​​grandeur or megalomania.

That is, the person who manifests this delusion feels that he is excessively important, powerful or harbors the idea that his knowledge, in general or in a specific field, is much greater than it is. All this, logically, to a psychopathological degree (it is not a “simple exaggeration” of abilities). Furthermore, the individual may even believe that he is God or another celestial, cosmic, religious being… as we will see.

Classification of delusions

This type of delusion is found within their classification according to their content. In fact, we can classify delusions based on their form and their content. Regarding its form, we find four types of delusions:

Delusional intuition. Delusional perception. Delusional atmosphere. Delusional memories.

On the other hand, depending on their content, we find the following types of delusions (which include delusions of grandeur):

Delusion of being controlled. Bodily delusion. Delusion of jealousy. Delusion of grandeur. Delusion of poverty. Delusion of reference. Extravagant delusion. Nihilistic delusion (Cotard syndrome). Persecutory delusion. Ekbom syndrome ( delusional parasitosis, delusion of infestation). Fregoli syndrome. Paraphrenic delusions.

Subtypes of delusions of grandeur

In relation to the delusion of grandeur, the glossary of Present State Examination (PSE) distinguishes two subtypes of it: the delusion of grandiose ability (the person believes that he or she has been chosen for a special mission) and the delusion of grandiose identity (the person believes that he or she is rich, famous, or related to a real person).

Delusion of Great Skill

Within this, we find expansive delirium, also called Caesar mania or Napoleon complex.

Delusion of grandiose identity

Regarding this subtype, we find different types of delusions, even more specific, depending on the delusional idea one has:

Theonomy or the delusion of being God. Cosmic identification or the delusion of being the universe. Uromania or delusion of having celestial origin. Mignon’s delusion or delusion of believing that one has a real relationship with someone very important. Siphomania or delusion of having a superior intelligence.

Associated with other disorders

The delusion of grandeur can be associated with other conditions, such as a superiority complex or an inferiority complex.. What does this mean? That the person can go from a state of exaltation to feeling humiliated and ashamed; Thus, in moments of vulnerability, that hidden part that coincides with low self-esteem or a strong feeling of personal insecurity can flourish.

The person with this delusion, according to experts, lives with a dichotomythat of his own person and that of the person (or celestial, cosmic, religious being…) that he believes he is.

Treatment

According to the psychologist José Serrano, the intervention in the delusion of grandeur would be focused on making the person see that these beliefs of grandeur are false“trying to break down the wall of what she perceives in what she believes to make her see that it is false.”

On the other hand, Pérez et al. (2010), in their Guide to effective psychological treatments, talk about the cognitive therapy of Chadwick et al. to intervene in delusions and hallucinations, through which two techniques are practiced with the patient: the verbal challenge and the reality test.

They also mention other therapies to intervene on delusions, such as cognitive-behavioral therapy (CBT) by Kingdon and Turkington or CBT by Fowler et al., in which cognitive-behavioral strategies and a therapist-patient conceptualization of symptoms are used. .

Finally, From psychiatry, a combined psychological and pharmacological treatment (with antipsychotics) is recommended. that helps reduce the intensity of the delusional idea.

Delusions of grandeur are a symptom that can appear within a psychotic disorder; in fact, Delusions and hallucinations make up the two prototypical symptoms of psychotic spectrum disorders, such as schizophrenia or delusional disorder.

However, this phenomenon also typically manifests itself in people who do not have a psychotic disorder, but who have a narcissistic or histrionic personality disorder, for example. In the latter cases, this symptom is related to a tireless desire for power, although under that layer, often, a great feeling of inferiority hides.

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