Delusions of Grandeur |

Delusions of Grandeur

Karen Doll, Psy.D., L.P
July 10, 2019

A delusion of grandeur refers to a person’s false belief that they are someone other than who they are or believe they have special powers. It is commonly identified by strong beliefs of their greatness. It requires a clear contradiction of reality and what is reasonably true. For example, individuals may believe they have supernatural abilities or are of celebrity status.

The delusions may be persistent or show up periodically. The strength of the delusion is typically related to how strong their belief is in the delusion. People with delusions of grandeur believe they are great, special, more important, superior, magical, or have special powers.  A key component is that the belief is not tied to the person’s actual experience in life, as is unrelated to what is really happening in the moment. Having a false belief that one is a better tennis player than they actually are would not be considered a delusion if they do actually play tennis. However, someone who believes they are an alien or second coming of Jesus Christ would qualify as a delusion of grandeur.

In identifying a delusion, consider the following key characteristics:

  • Delusions impact their daily life
  • The nature of the delusion is not possible
  • The person strongly believes it to be true, despite evidence that it is not plausible
  • The person resists input and facts that are incongruent with their belief.

The following are examples of delusions of grandeur:

  • Believing they have a special, magical power (can read minds)
  • They have a skill that is not humanly possible
  • They have a connection to the afterlife
  • They are famous
  • Believing they are someone that they aren’t, suggesting the other person is an imposter
  • Believe they are a religious leader
  • Believe they have special information or connections with important people (i.e. a spy informing military leaders)
  • Believe they are protected from harm (illness, disease)
  • Inflated belief of worldly powers (can end a war)

People who experience delusions of grandeur often have difficulty getting along with people and fitting in because their sense of reality is so distorted. They lack the ability to relate in a way that allows for connection. They can often become quite dismissive or anger at people who do not accept or endorse their belief.

Delusions are typically the result of a mental health disorder. Individuals with psychotic disorders can commonly experience delusions of grandeur. Psychotic disorders are characteristized by an inaccurate sense of reality, including: bipolar disorder, schizophrenia, dementia, depressive disorder with psychotic features, and delirium. Some individuals may experience delusions without meeting the full criteria of these disorders.

Individuals with schizophrenia often experience delusions, hallucinations, and difficulty differentiating reality from fantasy. Common symptoms include variations in mood and behavior, incongruent thinking patterns, and difficulty engaging in basic daily tasks.  Schizoaffective disorder.  Bipolar disorder is identified by swings of depression and mania. During manic episodes, it is common for individuals to experience delusions of grandeur.  People with an Axis II disorder such as narcissistic personality disorder, have a distorted sense of their own importance. These inaccurate beliefs can often lead to delusions of grandeur, placing them above others, believing they are uniquely special and deserve special privilege, in a way that is disconnected from reality. Individuals who experience dementia can slowly develop delusions, as their thinking patterns become less clear. This can also come with increased memory loss and a lack of insight about reality. Additionally, people with brain trauma can experience delusions, if there has been damage to critical neurological functions.

The treatment of delusions of grandeur can be challenging. The delusions often feel good to the person and they can often resist input contradicting their beliefs, subsequently showing resistance to treatment. There is often a disconnect with a motivation to change or seek help, because somehow the belief may be serving them, and they do not recognize the dysfunctional patterns associated. Sometimes family members need to get involved because delusions of grandeur can cause people to engage in dangerous, highly risk oriented behaviors and not understand their true human limitations. If someone believes they can fly, this can obviously present risk if they take action on it.

The research on treatments for delusional disorders is limited. There is not consistent evidence for what has a strong and consistent impact. Treatment is often oriented towards managing the symptoms rather than curing the underlying cause.  A common treatment is the use of anti-psychotic drugs, yet the individual needs to be complicit in taking the prescribed drugs. Treatment options may also include individual or group therapy, at the least to help people cope with their delusions. A group therapy setting can provide some structure to learn how to develop healthier relationships.

People who experience delusions are typically not aware of the level of dysfunction and disconnect from reality. Some interventions focus on helping them consider how their beliefs may negatively impact their lives or relationships. 

The prevalence of delusions of grandeur may be more common than you think. It is estimated that up to 10 % of people experience some level of these symptoms. There are mental health disorders that increase the likelihood that one will experience such delusions. If you are someone you know may be experiencing delusions of grandeur, seek help from a mental health professional for support and treatment.

Karen Doll, Psy.D., L.P

Karen Doll has been a Licensed Psychologist in the Twin Cities for 20 years, working in organizational consulting. She leverages her education in Clinical Psychology with her leadership assessment expertise in her practice. She is an executive coach focusing on helping people maximize their potential.

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