What is an Illusion?
An illusion is a distortion of one or a few of the five senses. It often gets confused with hallucinations. It is commonly confused with hallucinations and is more often than not paired with some sort of mental illness. Illusions happen to all of us. They are fairly common occurrences. The most typical illusion is that of our visual sensory system. We see an object and interpret it as something else. Walking through the woods and seeing a stick, we then interpret it as a snake. We jump and we are sure it is a slithering serpent. After further inspection, it turns out to be just a piece of dead wood.This is a classic optical illusion. Auditory illusions are not uncommon, as we may here a noise and are convinced it is someone breaking into the house, a window breaking, or a variety of beliefs without the proof until we inspect the noise. Illusionists have long toyed with our mind, they have manipulated what we see and what we have touched. In the mind of mental illness, illusions can be very debilitating. For the healthy individual we quickly assess, do the mental gymnastics and correctly see the stick is actually a stick. For others, well..not so much. The stick remains the snake the illusion can become a paranoid illusion and the individual may sense there are many snakes coming after them. Illusions are clearly deceptive however are based in some perceptual reality that is distorted.
What is a Delusion?
A delusion is a distorted belief. This belief could be based on some real entity or fact and then distorted into a false belief. In an illusion there must be a sensory impact if you will. A delusion may or may not need this sensory stimuli. Many healthy individuals who have delusions correct their false belief with educating themselves, or checking out reality with a peer. Individuals who have experienced post traumatic stress, rape, sex abuse and even the battered woman or man can have fixed delusions based on their life trauma. A spouse who observes their husband or wife e-mailing a friend or spending time on facebook with a member of the opposite sex can become jealous. They may inquire which can be healthy. If their is trust in the relationship it is over quickly, however if the individual draws an inference and then believes there is an affair going on, despite zero evidence this falls into paranoia and even paranoid delusions. The determination is based on the following: How long do they hold onto this belief? Is their ample evidence for this belief? Is their past trauma influencing their delusion?
The psychotic patient will have a fixed delusion and many times there is no shaking the belief. They can watch a program and feel a commentator is speaking directly to them, they believe they are destined for great things and this belief many times needs the direct influence of medication. A narcissistic personality disorder frequently has delusions of grandeur. They believe they are entitled to great things, and are deserving. This is more than a false sense of entitlement when the belief is based firmly in the grasp of a delusion. “I have special talents,” “Due to my ability, I am well liked, and I am deserving of great things.” Delusions as many symptoms in mental illness are on a continuum, that range from benign occurrences to severe debilitating illness.
What is “concrete thinking” versus delusions and illusions?
Have you ever been involved in a discussion on any topic and the individual would not, could not conceptualize an alternative. I am not referring to defensive posture where one defends their political view, their passion around religion, or even their belief on how to garden. I am referring to a thought process where one cannot abstract think. An individual who thinks in a concrete manner only sees the idea the topic at hand. For example, if the discussion is about giving back to the poor, by donating a coat an individual can grasp the coat is to help this person stay warm. They may or may not grasp the idea of giving, altruism and the greater good. An individual that can abstract think is able to not only understand the coat will warm someone but the act is altruistic and could possibly even carry over for others. That the “pay it forward” act is a perfect example of being able to abstract think. Individuals who see topics as good vs. bad, black and white answers, are not the best at abstract thinking.
The best examples to test one’s ability to abstract think are metaphors and proverbs:
” A rolling stone gathers no moss” an individual with concrete thinking realizes that a rock rolling does not collect moss. An abstract thinker realizes the proverb means much more, that the importance is of one to keep moving in life.
“Strike while the iron is hot.”
“A chain is only as strong as it’s weakest link”
“A leopard cannot change it’s spots”
Targeting concrete thinkers is difficult. They usually do not realize they are unable to figure out the proverb, however this is a great predictor of therapy outcome, intelligence levels, and the ability to problem solve as well as decision making. This is very important in terms of personality assessment, because it infers how one sees life as well as others. Their problem solving ability is limited. Organic brain disorders, dementia, and other illness such as chronic alcoholism will impact abstract thinking over time.