Encapsulation of Delirium

The concept of delusional encapsulation is an interesting phenomenon in the world of psychopathology and spans both theoretical approaches and practical treatments. Currently, this topic continues to be the object of numerous studies, which makes it relevant for modern clinical psychiatry.

Encapsulation is a process that involves the loss of the “delusion-reality” connection in the patient’s mental structure. The development of delusions is associated with a person’s sense of conviction, which he experiences at the current moment in time. For example, ideas of persecution or imaginary betrayal arise in a patient who is convinced of the danger of the world around him and of his own need for protection. It follows from this that the problem of delusion is directly related to the patient’s lack of understanding of real events. It should be noted that despite the fact that the appearance of delusional disorder is accompanied by experiences that determine the patient’s beliefs, fictional events and images should not be allowed to become his only reality. One of the most important aspects of the dynamics of delirium is associated with the formation of the so-called “cocoon of perception” into which the delusional patient is immersed.

So, how exactly does the process of encapsulating delusional ideas take place? The first stage in the manifestation of the disease, as a result of which the patient begins to experience fear of danger, is a conditioned reflex: the patient becomes more sensitive to external stimuli. This happens because a person’s increased readiness for protective behavior contributes to the formation of associative connections between painful attitudes and the surrounding reality. Another important factor is emotional overload. Thus, the presence of strong emotional arousal contributes to the patient’s increased attention to the world around him - already at this moment the process of disintegration of the boundaries of the field of perception and the formation of a feeling of a delusional component begins.

How does this work from the point of view of neurophysiology and psychophysics? The appearance of delusional ideas is associated with traumatic factors and negative experiences of the patient caused by external circumstances experienced previously. Jumps in the activity of physiological mechanisms of behavior are detected during the presence of a state of anxiety and fear. A distinctive feature of the formation of delusional disorder is the prolonged effect of activation of brain structures, which, in the absence of negative experience, retain their functions even in a normal state. The functional gap between healthy functioning and pathological processes defines the initial reference point created around the painful belief. Despite the lack of contact with reality, patients with delirium retain the ability to transition to a state of full awareness, against the background of which a picture of various functional disorders clearly appears.

Violation of the perception of oneself and the world around is the main characteristic of delusional disorders. Features of the course of delirium are diffuseness and concreteness of perception, determined by the mystification of one’s fears at the subconscious level of consciousness. The encapsulated object is characterized by the degree of objectification of the imaginary composition, since delusional ideas most often lack clear outlines, and the creation of a specific form is impossible due to the patient’s lack of awareness. Distortions in the perception of reality appear at the very beginning of the disease, thereby creating delusional manifestations that are inaccessible to others. Violation of connections with objective reality shapes the patient’s experiences associated with his behavior, based on the modeled picture of the world. Delusion formation is systemic in nature, since against the background of a general disturbance of the individual, the formation of a specific delusion of specific content occurs in the patient’s consciousness. Pawned