Realising the potential of general population research to reconceptualise the study of “delusions”: From normalising “psychosis” to defamiliarising “normality”

Abstract

Over recent decades a research programme involving nonclinical samples has provided a justification for the use of normalising practices within cognitive behaviour therapy for psychosis. These studies have found that, contrary to mainstream psychiatric assumptions, beliefs considered delusional are neither rare in the general population nor qualitatively different from “nondelusional” beliefs, whilst theories from a “normal” rather than “abnormal” psychology have shown them to be intelligible rather than un-understandable. Yet the programme’s inherent limitations have meant that the potential of nonclinical research has not been fully realised. An alternative research programme is proposed which could elucidate the diversity of belief in the general population by examining the role of social norms and lived belief narratives in unconventional belief communities. This could address the limitations of the normalising programme, provide a necessary corrective to the “clinician’s illusion” bias, and prompt a more fundamental reconceptualisation of beliefs considered delusional.