In order to understand what guilt delusions are we must first understand the concept from which it originated from, delusions. A delusion is what we use to describe the phenomenon of a person firmly holding onto an untrue belief, without any regard to contradicting proof to their belief.
Transitioning guilt into this, guilt delusions is a subcategory, or in other words, one of the various types of delusions that a patient could be experiencing. Guilt delusion is a sort of self implication to guilt of big events where there is no possible correlation to the patient feeling guilty for it. A patient experiencing this could imagine and truly believe for themselves that they are guilty and have affected things like big catastrophes in the world. When a patient carries this belief they are often severely affected by it. They often experience sadness, depression or maybe even being afraid that someone is going to discover their “imaginary”(not realizing it only exists in their mind) secret, which could impact their ability to function in their day to day life.
In order to know with certainty that the patient is experiencing guilt delusions the belief has to be impossible/certainly not true. The patient also has to absolutely believe in the guilt completely. Lastly the patient has to persevere with the belief, even after having been presented with contradicting proof.
Treating the problem can be quite complex. Firstly one has to find the origin from which the delusion arrives. Finding out whether it comes from a psychological disorder, trauma, difficulty or drug abuse can be hard. Once you know where the issues derive from the treatment process can start. Another possible issue to keep in mind is that the patient completely believes the delusion. In other words, convincing them to go to treatment can be hard seeing as though they don't know that they have a problem.
Beck, A. T. (2014). Successful outpatient psychotherapy of a chronic schizophrenic with a delusion based on borrowed guilt: A 1952 case study. In A casebook of cognitive therapy for psychosis (pp. 19-30). Routledge.
Bell, V., Halligan, P. W., & Ellis, H. D. (2006). Explaining delusions: a cognitive perspective. Trends in cognitive sciences, 10(5), 219-226.
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