Delusion formation as an inevitable consequence of a radical alteration in lived experience

The definition of delusion is usually couched in terms of false beliefs held with conviction despite evidence to the contrary. Such beliefs are usually seen as impossible or implausible by others. In order to be classed as clinically significant, a delusion would lead a person to be distressed or to have significant problems with functioning. We note that a person ordinarily understands and negotiates the world based on familiar patterns derived from her cultural and historical experience. Thus, when her lived experience is altered, these assumptions about how the world works may be called in to question. Drawing on interviews conducted with people experiencing clinically significant delusions, we show how this alteration in lived experience manifests as emotional, affective and/or perceptual anomalies. We adopt the framework of the Enactive Approach which posits that a person interacts with her environment in terms of sense-making and we argue that radical alterations in lived experience can demand a renegotiating of how a person makes sense of this new world. We suggest that if the alteration in lived experience is sufficiently radical, then delusion formation is inevitable.