Persecutory Delusions: A False, Meaningless Pathology? A critique of the use of psychopathological conceptualisations of paranoia in Counselling Psychology practice
DOI:
https://doi.org/10.65828/fd6nx106Keywords:
Psychopathology, paranoia, persecutory delusions, existential phenomenological approach, counselling psychologyAbstract
This article critically explores the assumptive frameworks underpinning current psychopathological conceptualisations of paranoid/persecutory delusions, which position such experiences as false and meaningless phenomena. An existential-phenomenological reconceptualisation is provided as an alternative formulation that allows for recapturing the contextual, relational and subjective nuances in theoretical understanding and therapeutic practice.
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References
Aho, K. (2008). Medicalising mental health: A phenomenological alternative. Journal of Medical Humanities, 29: 243–259. DOI: https://doi.org/10.1007/s10912-008-9065-1
American Psychiatric Association. (2013). Diagnostic and Statistical Manual of Mental Disorders (5th ed.). Washington, DC: Author. DOI: https://doi.org/10.1176/appi.books.9780890425596
Bentall, R. P. (2003). Madness Explained: Psychosis and Human Nature. London: Penguin.
Bentall, R. P. (2014). What are we to believe about how we believe? Philosophy, Psychiatry and Psychology, 21(1): 39–41. DOI: https://doi.org/10.1353/ppp.2014.0004
Berrios, G. E. (1991). Delusions as 'wrong beliefs': A conceptual history. British Journal of Psychiatry, 159(14): 6–13. DOI: https://doi.org/10.1192/s0007125000296414
Boucher, T. A. (2010). Cognitive-behavioural contributions to pluralistic practice. In Milton, M. (ed) Therapy and Beyond: Counselling Psychology contributions to therapeutic and social issues. Chichester: Wiley-Blackwell. DOI: https://doi.org/10.1002/9780470667279
Boyle, M. (2011). Making the world go away and how psychology and psychiatry can benefit. In Rapley, M., Moncrieff, J. and Dillon, J. (eds) De-medicalising Misery: Psychiatry, psychology and the human condition. Basingstoke: Palgrave Macmillan. DOI: https://doi.org/10.1057/9780230342507.0007
British Psychological Society. (2014). Division of counselling psychology: Professional practice guidelines. Leicester. DOI: https://doi.org/10.53841/bpsrep.2005.rep75
Burr, V. & Butt, T. (1999). Psychological Distress and Postmodern Thought. In Dwight, F. (ed) Inquiries in Social Construction: Pathology and the postmodern: Mental Illness as Discourse and Experience. London: Sage Publications DOI: https://doi.org/10.4135/9781446217252.n9
Chadwick, P., Birchwood, M. J. & Trower, P. (1999). Cognitive therapy for delusions, voices and paranoia (Wiley series in clinical psychology). New York: John Wiley and Sons.
Cohn, H. W. (1997). Existential Thought and Therapeutic Practice: An introduction to Existential Psychotherapy. London: Sage Publications. DOI: https://doi.org/10.4135/9781446279878
Cooper, M. (2003). Existential Therapies. London: Sage Publications. DOI: https://doi.org/10.4135/9781036234898
Cromby, J., & Harper, D.J. (2009). Paranoia: A social account. Theory and Psychology, 19: 335–361.
Davidson, L., O'Connell, M., Tondora, J., Staeheli, M. R., & Evans, A. C. (2004). Recovery in serious mental illness: Paradigm shift or shibboleth? In Davidson, L., Harding, C. M. and Spaniol, L. (eds) Recovery From Severe Mental Illnesses: Research evidence and implications for practice. Boston: Center for Psychiatric Rehabilitation, Boston University.
Dowbiggin, I. (2000). Delusions and the rise of psychiatric diagnosis as a disease concept in the modern era. History of Psychiatry, xi: 37–69. DOI: https://doi.org/10.1177/0957154x0001104103
Freeman, D. & Garety, P. (2004). Paranoia: The psychology of persecutory delusions. Hove: Psychology Press. DOI: https://doi.org/10.1093/med:psych/9780199206315.001.0001
Harper, D. J. (1994). The professional construction of 'paranoia' and the discursive use of diagnostic criteria. British Journal of Medical Psychology, 67: 131–143.
Harper, D. J. (2004). Delusions and discourse: Moving beyond the constraints of the modernist paradigm. Philosophy, Psychiatry & Psychology, 11(1): 55–64.
Harper, D. J. (2011). The social context of paranoia. In Rapley, M., Moncrieff, J. and Dillon, J. (eds) Demedicalizing Misery: Psychiatry, Psychology and the Human Condition. London: Palgrave Macmillan. DOI: https://doi.org/10.1057/9780230342507
Harper, D. J. (2013). On the persistence of psychiatric diagnosis: Moving beyond a zombie classification system. Feminism & Psychology, 23(1): 78–85.
Heise, D. R. (1988). Delusions and the construction of reality. In Oltmanns, T. F., and Maher, B. A. (eds) Delusional Beliefs. New York: Wiley.
Ivey, A. E., & Ivey, M. B. (1998). Reframing DSM-IV: Positive strategies from developmental counselling and therapy. Journal of Counselling and Development, 76: 334–350. DOI: https://doi.org/10.1002/j.1556-6676.1998.tb02550.x
Jaspers, K. (1963). General Psychopathology. Trans. Hoenig, J. and Hamilton, M. W. Manchester: University Press. DOI: https://doi.org/10.56021/9780801858154
Kiser, S. (2004). An existential case study of madness: Encounters with divine affliction. Journal of Humanistic Psychology, 44(4): 431–454. DOI: https://doi.org/10.1177/0022167804269043
Laing, R. D. (1960). The Divided Self: A study of sanity and madness. London: Tavistock Press
Larsson, P., Brooks, O. & Loewenthal, D. (2012). Counselling psychology and diagnostic categories: A critical literature review. Counselling Psychology Review, 27(3): 55–67. DOI: https://doi.org/10.53841/bpscpr.2012.27.3.55
Maher, B. (1974). Delusional thinking and perceptual disorder. Journal of Individual Psychology, 30: 98–113.
McAteer, D. (2010). Philosophical pluralism: Navigating the sea of diversity in psychotherapeutic and counselling psychology practice. In Milton, M. (ed) Therapy and beyond: Counselling psychology contributions to therapeutic and social issues. Chichester: Wiley-Blackwell. DOI: https://doi.org/10.1002/9780470667279.ch1
McCabe, R., Heath, C., Burns, T., & Priebe, S. (2002). Engagement of patients with psychosis in the consultation: Conversation analytic study. British Medical Journal, 325: 1148–1151. DOI: https://doi.org/10.1136/bmj.325.7373.1148
Milton, M., Craven, M., & Coyle, A. (2010). Understanding Human Distress: Moving beyond the concept of 'psychopathology'. In Milton, M. (ed) Therapy and Beyond: Counselling psychology contributions to therapeutic and social issues. Chichester: Wiley-Blackwell. DOI: https://doi.org/10.1002/9780470667279.ch4
Mullen, R., & Gillett, G. (2014). Delusions: A different kind of belief? Philosophy, Psychiatry and Psychology, 21(1): 27–37. DOI: https://doi.org/10.1353/ppp.2014.0002
Munro, A. (1999). Delusional Disorder: Paranoia & Related Illnesses. Cambridge: Cambridge University Press. DOI: https://doi.org/10.1017/cbo9780511544095
National Institute for Health and Clinical Excellence. (2014). Psychosis and schizophrenia in adults: Treatment and management [CG178]. London. DOI: https://doi.org/10.1017/cbo9780511762246.024
Orlans, V., & Van Scoyoc, S. (2009). A Short Introduction to Counselling Psychology. London: Sage Publications DOI: https://doi.org/10.4135/9781446216118
Parker, I., Georgaca, E., Harper, D., McLaughlin, T., & Stowell-Smith, M. (1999). Deconstructing Pathology. London: Sage Publications.
Parpottas, P. (2012). A critique on the use of standard psychopathological classifications in understanding human distress: The example of 'schizoid personality disorder'. Counselling Psychology Review, 27(1): 44–52. DOI: https://doi.org/10.53841/bpscpr.2012.27.1.44
Pilgrim, D. (2000). Psychiatric diagnosis: More questions than answers. The Psychologist, 13: 302–305. DOI: https://doi.org/10.5194/hess-2019-230-rc1
Pilgrim, D. (2007). The survival of psychiatric diagnosis. Social Science & Medicine, 65: 536–547. DOI: https://doi.org/10.1016/j.socscimed.2007.03.054
Ponterotto, J. G. (2005). Qualitative research in counselling psychology: A primer on research paradigms and the philosophy of science. Journal of Counseling Psychology, 52(2): 126–136. DOI: https://doi.org/10.1037/0022-0167.52.2.126
Sartre, J. P. (1956). Being and Nothingness. New York, DC: Philosophical Library. DOI: https://doi.org/10.2307/2182625
Schlimme, J.E. (2009). Paranoid atmospheres: Psychiatric knowledge and delusional realities. Philosophy, Ethics, and Humanities in Medicine, 4(14):. DOI: https://doi.org/10.1186/1747-5341-4-14
Stanghellini, G., Bolton, D. & Fulford, W. K. M. (2013). Person-centred psychopathology of schizophrenia: Building on Karl Jaspers' understanding of patient's attitude toward his illness. Schizophrenia Bulletin, 39(2): 287–294. DOI: https://doi.org/10.1093/schbul/sbs154
Szasz, T. S. (1974). The Myth of Mental Illness. New York: Harper and Row.
Van den Berg, J. H. (1972). A Different Existence: Principles of Phenomenological Psychopathology. Pittsburgh: Duquesne University Press.
van Deurzen, E. & Arnold-Baker, C. (2005). Existential Perspectives on Human Issues. Basingstoke: Palgrave Macmillan. DOI: https://doi.org/10.1007/978-0-230-21624-2
Williams, D. J., & Irving, J. A. (1996). Counselling Psychology: A conflation of paradigms. Counselling Psychology Review, 11(2): 137–156. DOI: https://doi.org/10.53841/bpscpr.1996.11.2.4
Williams, P. (2012). Rethinking Madness: Towards a paradigm shift in our understanding and treatment of psychosis. San Francisco: Sky's Edge Publishing. DOI: https://doi.org/10.4324/9780429479199
Yalom, I. D. (1981). Existential Psychotherapy. New York, DC: Basic Books.
