Religious delusion is a content-related delusional symptom that is often associated with schizophrenia. Often, the delusion is accompanied by a salvation order. Treatment of patients is usually difficult due to ego syntonia.
What is religious delusion?
Delusion is a symptom of psychiatric illness. In psychopathological findings, delusion is a thought disorder of content in the context of various disorders of the psyche. Delusional disorders disturb the conduct of life by beliefs in incompatibility with objective reality. The ability of the affected person to judge is disturbed. Similar thought disorders are super-valued ideas and obsessive thoughts. However, unlike delusional patients, patients of this thought disorder usually know that their thoughts are in conflict with objective reality and normality. Delusion mainly characterizes disorders such as schizophrenia. Delusions can vary in content. A relatively common content is religious themes. This religiously influenced form of delusion is called religious delusion. Patients of such a delusion suffer from false but unshakable ideas in the form of beliefs that contradict the individual’s personal level of education and cultural or social background. Patients hold their beliefs with extraordinary conviction and ego syntony. Their personal certainty withstands contrary evidence.
Causes
According to recent studies, religious themes are the content of up to 30 percent of all schizophrenic delusions. This makes religious delusions one of the most common delusional themes. In addition to schizophrenia, many other disorders are associated with delusional symptoms. This is true, for example, of affective disorders such as major depression or mania and bipolar disorder. The primary cause is often dementia or brain damage. In the context of dementias, Alzheimer’s disease in particular often causes delusional symptoms. Delusions occur almost as often in vascular dementia, Lewy body dementia, and fronto-temporal dementia. Accordingly, religious delusion is usually not caused by purely psychological phenomena, but is related to brain-organic damage in the majority of all cases. On the other hand, cases of religious delusion are also known that are not associated with brain-organic changes. Depending on the primary causative disorder, different forms of religious delusion exist. Ultimately, religious delusion should be understood as a symptom in which the aforementioned disorders find expression. Often, religious delusions do not arise from a personally religious experience. Rather, they arise in the context of human conflicts, such as marital problems or fear of death.
Symptoms, complaints and signs
People with religious delusions are often convinced that they are in direct communication with God. In some cases, they also believe themselves to have been chosen as the new messiah and sent to earth to redeem the world. In such a case, there is talk of a religious delusion with a salvation mission. The patients are completely fixated on their delusional content and feed the totality of their thinking and acting from it. In their delusion system they are completely immune to critical counterarguments. In paranoid schizophrenia, patients often experience a great need to communicate and disseminate their delusional religious ideas. In many cases, a patient with religious delusion alternates between dialogue forms and monologue structures of the same content. In most cases, the delusion results in alienation or partial alienation from the environment. The patient usually faces the environment in isolation, since no one but him represents the content of the delusion. In most cases, patients with religious delusion are not integrated even in religious communities, because their ideas are not compatible with the widespread ones. In clinical practice, religious delusion often leads to physically severe self-injury.
Diagnosis and course of the disease
Religious delusion must be distinguished from religious belief in the diagnostic process. In a delusion, knowledge is asserted instead of belief. They do not make professions of faith but communicate in objectively impossible perceptions of reality. In religious belief, realistic self-assessment is still possible. Patients with religious delusions, on the other hand, suffer from arrogant self-assessment.In religious belief, patients are also capable of distancing themselves and questioning the religious content. Patients with religious delusion are not able to distance themselves from their fixed ideas and do not see any starting point for questioning their ideas. The prognosis for patients with religious delusion depends on the causative disorder. In many cases, complete recovery cannot be achieved because of ego syntonia.
Complications
Numerous complications can occur in the course of religious mania, most of which are social in nature. However, severe self-injury is also possible. For example, in most cases, the delusional beliefs of the affected person will lead to social isolation. An insistence on the knowledge of a certain religious fact can also lead to severe conflicts, which can affect family relationships, other social contacts and the work environment, among other things. The fixation on the content of the delusion can also lead to neglect of other areas of life, which can end in inability to work and the neglect of one’s own needs. Along with the fact that even religious communities can be overwhelmed in integrating such psychotics, the conflict between what the environment believes and what the psychotic thinks he or she knows often leads to self-isolation. Self-injurious behavior may be due to the fact that the sufferer identifies or equates himself with a martyr from the religious traditions, for example, and is willing to imitate his actions accordingly. The tendency to take risks – often fed by a delusion-induced overestimation of oneself – is fueled when the affected person sees himself as a savior on behalf of God.
When should one go to the doctor?
A religious delusion is not a disease on its own. It usually occurs with other complaints that form an overall picture. It is characteristic that the affected person often shows no insight into the illness. Therefore, parents, relatives or people from the social environment are responsible for initiating a visit to the doctor. If the affected person is in a communication with imaginary entities, this alone is not a characteristic that is worrying. Actions in the name of God have also been performed for many millennia and are not interpreted as signs of illness. The borderline to a disease is crossed when the affected person reports hearing voices or self-appointed salvation orders seemingly without a cause. A fixation of the delusional content takes place, which substantially changes the thinking and acting. The affected person’s behavior is described as off the norm and should be presented to a physician. Other signs include monologues as well as an unsolicited influence on the environment. Harassment takes place, which triggers social conflicts. The expressed theses often lack a solid basis and are defended by the affected person with all vehemence. If insults, aggressive behavioral tendencies or self-injury occur, a doctor must be consulted.
Treatment and therapy
Treatment of patients with religious delusion depends on the causative disorder. For conservative drug therapy, psychotropic drugs are primarily available. In schizophrenia, electroconvulsive therapy, in which seizures are stimulated under anesthesia, has also been used since the recent past. However, the benefit of this form of therapy remains controversial. In addition, sociotherapy, occupational therapy, and work therapy are used to normalize daily routines. The same is true for exercise therapies. In psychotherapy, individual vulnerability is alleviated, external stressors are reduced, and disease management is supported. Acceptance, self-management, and problem coping are the focus of therapy. Behavioral and cognitive therapeutic elements may be integrated into the sessions. In most cases, family therapy takes place. This is due to the fact that the religious delusion not only has extreme effects on the psychotic’s relatives, but the delusion symptomatology often develops on the breeding ground of interpersonal problems in the closer circle. The real difficulty in religious delusion symptomatology is the insight of the disease.The ego syntonia of delusion must become ego dystonia for the patient to feel any suffering at all.
Prevention
Religious delusional symptomatology is merely the symptom of a superordinate disorder and therefore can be prevented only to the extent that the causative disorders can be prevented.
Follow-up
Follow-up care for religious delusion is largely dependent on the underlying cause. Schizophrenia, depression, substance abuse, and mania are the most common candidates in this regard. Accordingly, religious delusion is usually an expression of these conditions and rarely requires targeted follow-up that would be limited to this symptom alone. Follow-up care may be necessary for religious delusion, however, if it has led to actions on the part of the individual. Self-harm, delusional crimes, and similar things are sometimes carried out by people in religious delusion. Aftercare here ranges from wound care to first aid to legal assistance. The religious delusion, which is limited only to a verbally expressed delusion through monologues, messages of salvation and the like, usually leads only to social problems. Here again, the follow-up should be based on the underlying condition. Furthermore, religious delusions can also be dependent on triggers. These consist, for example, in religious symbols, certain statements and similar things. In the interest of social interaction and in case of doubt that the delusions have completely disappeared, it makes sense to avoid these triggers. Here, in the sense of social aftercare, the environment should also cooperate.
What you can do yourself
In the case of religious delusion, there is no self-help measure that could address the problem causally. Religious delusion as such is in all cases a symptom of another mental condition. However, there are possibilities for affected persons to improve the extent of and the handling of the delusion. Basically, it is useful for affected persons if they can get to know and name the triggers of their religious delusion. If it turns out (in the course of therapy) that there are certain key stimuli that are more likely to lead to delusion, these stimuli should be consistently avoided. Avoiding triggers, however, is only effective if the religious delusion is not a permanent condition but a phasic mental state. In the case where sufferers live permanently in their delusion, various measures can be taken. For example, self-help groups are useful in many cases, as coping strategies can be discussed here together with other sufferers. In addition, it is also appropriate in these cases to put things that are part of the delusion – such as religious objects – out of reach of the affected person.
