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Ideas of reference

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Ideas of reference or delusions of reference involve a person having a belief or perception that irrelevant, unrelated or innocuous things in the world are referring to them directly or have special personal significance. The two are clearly distinguished in psychological literature. People suffering from ideas of reference experience intrusive thoughts of this nature, but crucially, they realize that these ideas are not real. Those suffering from delusions of reference believe that these ideas are true.

In their strongest form, they are considered to be a sign of mental illness and form part of a delusional, paranoid or psychotic illness (such as schizophrenia or delusional disorder).

They may include experiences such as:

  • feeling that people on television or radio are talking about, or talking directly to them
  • believing that headlines or stories in newspapers are written especially for them
  • having the experience that people (often strangers) drop hints or say things about them behind their back
  • believing that events (even world events) have been deliberately contrived for them, or have special personal significance
  • seeing objects or events as being deliberately set-up to convey a special or particular meaning

In psychiatry, delusions of reference form part of the diagnostic criteria for psychotic illnesses such as schizophrenia,[1] delusional disorder, or bipolar disorder during the elevated stages of mania. To a lesser extent, it can be a hallmark of paranoid personality disorder. Such symptoms can also be caused by intoxication, especially with hallucinogens or stimulants like methamphetamine.

Freudian viewsEdit

Sigmund Freud considered that ideas of reference illuminated the concept of the superego: 'Delusions of being watched present this power in a regressive form, thus revealing its genesis...voices, as well as the undefined multitude, are brought into the foreground again by the [paranoid] disease, and so the evolution of conscience is reproduced regressively'.[2]

In his wake, Otto Fenichel concluded that 'the projection of the superego is most clearly seen in ideas of reference and of being influenced....Delusions of this kind merely bring to the patient from the outside what his self-observing and self-critical conscience actually tells him'.[3]

Lacan similarly saw ideas of reference as linked to 'the unbalancing of the relation to the capital Other and the radical anomaly that it involves, qualified, improperly, but not without some approximation to the truth, in old clinical medecine, as partial delusion'[4] - the 'big other, that is, the other of language, the Names-of-the-Father, signifiers or words',[5]in short, the realm of the superego.

Anti-psychiatryEdit

Main article: Anti-psychiatry

For the antipsychiatrists, validation rather than clinical condemnation of ideas of reference frequently took place, on the grounds for example that 'the patient's ideas of reference and influence and delusions of persecution were merely descriptions of her parents' behavior toward her'.[6] Whilst accepting that 'there is certainly confusion between persecutory fantasies and persecutory realities', figures like David Cooper considered that 'ideas of connection with apparently remote people, or ideas of being influenced by others equally remote, are in fact stating their experience' of social influence - albeit in a distorted form by 'including in their network of influence institutions as absurd as Scotland Yard, the Queen of England, the President of the United States, or the B. B. C.'[7]

R. D. Laing took a similar view of the person who was 'saying that his brains have been taken from him, that his actions are controlled from outer space, etc. Such delusions are partially achieved derealization-realizations '.[8]

Laing also considered of the way 'in typical paranoid ideas of reference, the person feels that the murmurings and mutterings he hears as he walks past a street crowd are about him. In a bar, a burst of laughter behind his back is at some joke cracked about him' that deeper acquaintance with the patient reveals in fact that 'what tortures him is not so much his delusions of reference, but his harrowing suspicion that he is of no importance to anyone, that no one is referring to him at all'.[9]

Delusions of referenceEdit

'Ideas of reference must be distinguished from delusions of reference, which may be similar in content but are held with greater conviction'.[10] With the former, but not the latter, the person holding them may have 'the feeling that strangers are talking about him/her, but if challenged, acknowledges that the people may be talking about something else'.[11]

At the same time, there may be 'transitions...to delusions' from ideas of reference: whereas 'abortive ideas of reference, in the beginning of their development or, in Schizotypal personalities, continuously, may remain subject to the patient's criticism...under adverse circumstances, by minimal economic shifts, however, reality testing may be lost and daydreams of this kind turn into delusions'.[12]

It has been noted that the character 'rigidly controlled by his superego...readily forms sensitive ideas of reference. A key experience may occur in his life circumstances and quite suddenly these ideas become structured as delusions of reference'.[13] Within the 'focus of paranoia...that man crossing his legs, that woman wearing that blouse - it can't just be accidental. It has a particular meaning, is intended to convey something'.[14]

See alsoEdit

See alsoEdit

  1. Andreasen, Nancy C. (1984). "Scale for the assessment of positive symptoms"; The Movement Disorder Society.
  2. Sigmund Freud, On Metapsychology (PFL 11) p. 90
  3. Otto Fenichel, The Psychoanalytic Theory of Neurosis (London 1946) p. 430-1
  4. Jacques Lacan, Ecrits: A Selection (London 1996) p. 214
  5. Philip Hill, Lacan for Beginners (London 1997) p. 160
  6. Thomas J. Scheff, Being Mentally Ill (1999) p. 180
  7. David Cooper, The Death of the Family (Penguin 1974) p. 14 and p. 82
  8. R. D. Laing, Self and Others (Penguin 1969) p. 39
  9. Laing, p. 136
  10. P. B. Sutker/H. E. Adams, Comprehensive Handbook of Psychopathology (2001) p. 540
  11. Sutker/Adams, p. 540
  12. Fenichel, p. 444
  13. A. C. P. Sims, Symptoms in the Mind (2003) p. 129
  14. Iain McGilchrist, The Master and His Emissary (London 2010) p. 399
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