Delusions in Psychosis May Be Lived Emotional Body Experiences, Not Just Beliefs

Study suggests emotions tied to past trauma fuel delusions during psychotic episodes.

Psychosis researchers have long focused on delusions as faulty thinking patterns, but a study of first-episode psychosis patients suggests something different: delusions are deeply physical experiences rooted in powerful emotions felt throughout the body.

The study, published in The Lancet Psychiatry, interviewed 10 adults in early intervention services across three UK locations. Researchers used an approach that combined standard clinical assessments with detailed phenomenological interviews and life-story narratives, building a picture of how delusions emerge not just in the mind, but in the lived experience of the whole person.

“The emergence and evolution of delusions reflected a temporally extended, embodied, and cognitive-linguistic process characterised by an emotional transformation of the self and the world as a unified conscious experience,” the researchers wrote.

Childhood Shame and Bullying Linked to Later Delusions

Participants often traced their experiences back to childhood and adolescence. Many described relentless bullying and social rejection during their school years that appeared to leave lasting emotional sensitivities. One participant, Adam, recalled how classmates criticized “anything and everything” about him, which later connected to his feeling that others could literally read his thoughts.

“I feel like I’m sort of being sent a mission,” Adam told researchers, describing intrusive thoughts about harming others that he believed were implanted by unseen agents running a simulation. “I haven’t like figured out what it is yet though. But it doesn’t feel like a good one.” These experiences were described within the context of ongoing clinical care in early intervention services.

When participants faced later-life stressors like relationship breakups, job losses, or moves away from home, similar intense emotions resurfaced in overwhelming ways. Unlike previous research that separated delusion themes into distinct categories, this study found that different delusional ideas were woven together within deeply personal emotional narratives about the self in relation to others.

Bodies Experienced as “Translucent” or “God-Like” During Delusions

Participants described their bodies feeling “translucent” or “broadcasting” their inner thoughts to others. One woman, Sandra, explained that it felt like her thoughts “were painted on like a picture that I was holding” for everyone to see.

Others described experiences of feeling invincible. Isla described rapid mood shifts where she went from feeling “really on top of the world, like I could do anything” to crushing despair. “I really felt I was a god,” she said. “I could do anything. All I had to do was think about what I wanted, and everything would work out, and I could control anything.”

The research team found that delusions reflected three main experiential patterns: feeling exposed and vulnerable with a hostile world watching, feeling connected and loved as part of something bigger, or feeling disconnected and numb as if living in a simulation.

Past Emotions Reactivate in the Body Without Present Triggers

Another key finding was how emotions from earlier experiences could reactivate in the body without clear triggers in the present environment. Adam described getting “really hot and sweaty” and feeling pushed toward violence, but the feeling appeared without an obvious cause in his current surroundings. The researchers interpreted these as partial reactivations of earlier relational emotions like shame or anger.

Sally described turning to spiritual beliefs after a painful breakup. “I started to believe that I was like a vessel of God,” she said. She described feeling “a strong loving feeling” and intense bodily connection to spiritual entities that guided her actions, which led her to walk around barefoot feeling happy but eventually became dangerous.

For some, the body became numb and disconnected. Adam described feeling “completely like empty and numb,” unable to genuinely connect with friends. “I find myself faking emotions a lot,” he explained. In this state, other people appeared fake or like actors “put there for a reason.”

How Body Sensations Shape Delusional Beliefs

The researchers identified a linguistic pattern called “metonymic thinking” that helped explain seemingly incomprehensible delusional beliefs. This type of thinking links concrete bodily experiences to abstract concepts through association.

Participants who felt exposed and vulnerable (the bodily sensation) thought of themselves as bad people or even “pedophiles” (the abstract concept). Those feeling powerful and energized (bodily) conceived of themselves as god-like (abstract). This thinking pattern helped explain why delusional beliefs seemed so fixed: they were anchored in persistent bodily feelings.

The findings suggest treatment strategies should target the emotional and bodily aspects of delusions, not just try to correct faulty beliefs. The research team recommends creating emotionally relaxing therapeutic environments, using movement-based therapies, and helping patients identify how emotions manifest in their bodies.

“Prevention and intervention models for psychosis should consider the role of the lived body for the regulation of emotions, and the effect of the surrounding material and social environments as central affective-regulatory mechanisms,” the researchers wrote.

The study included three men, six women, and one non-binary person with a median age of 24.5 years. Eight participants were White, and two were White and Black Caribbean. All had past or current significant delusions as part of first-episode psychosis across various diagnoses including schizophrenia, bipolar disorder, and brief psychotic disorder.

Researchers conducted lengthy interviews totaling 31 to 75 minutes for life story sessions and up to 218 minutes across multiple sessions for phenomenological assessments. The depth of these conversations allowed the study to comprehensively assess how delusions developed within each person’s life context.

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