Reality and discourse: a critical analysis of the category of 'delusions'.

Abstract

Delusions are seen in psychiatric research and practice as central indicators of the psychotic loss of contact with reality. In this paper the psychiatric concept of 'delusions' is critically examined both theoretically and through the analysis of extracts from interviews with individuals diagnosed as 'delusional'. The diagnostic criteria for delusions, implausibility, idiosyncrasy, conviction and incorrigibility, are scrutinized, and the notion of reality that underlies the concept of delusions is deconstructed through the use of social constructionist approaches. The main arguments pursued in the paper are: first, that delusions are meaningful, not because they express something about the world or the speaker, but rather because they employ culturally available discourses and discursive strategies for their construction; second, that delusions are claims which are argued and negotiated in speech with similar strategies to those used by 'non-delusional' individuals; and third, that delusions are statements about the self and the world whose truth and falsity cannot be definitely settled in speech. All three claims are discussed through the analysis of extracts from two interviews with 'delusional' individuals, which focuses on the assumptions underlying the negotiation of claims on reality, the discursive strategies adopted in this negotiation and the way disputes on reality are conversationally produced and settled.