An expert tells Nadia Badarudin that an over-inflated sense of worth, power, knowledge or identity may indicate an underlying physical or psychological illness
TWENTY years ago, Al-Arqam was banned by the Government following alleged malpractice by the religious sect. Its founder, Ashaari Mohammad proclaimed himself as a direct descendant of Prophet Muhammad and told followers that he had the ability to identify which follower would go to heaven. He also claimed that he possessed a special power to fight those opposing him.
Last year, businessman Noor Jan Tuah from Parit, Perak, made the headlines when he claimed to be the sultan of Malacca as he was a descendant of Parameswara, founder of the Malacca sultanate.
Stories of Ashaari and Al-Arqam, the “Malacca sultan” as well as countless tales of “healers” and “shamans” are part and parcel of our society.
Some cases shock the nation, while others leave the people amused and shaking their heads in disbelief.
Is there a logical explanation for such behaviour? Is there a reason why these people believe they are the “chosen ones”?
GRANDIOSE DELUSION
International Medical University Malaysia’s consultant psychiatrist and associate professor Dr Philip George says an over-inflated sense of worth, power, knowledge or identity is the sign of suffering grandiose delusions.
He says a delusion is a fixed false belief that is not amenable to change even after being shown the evidence against it and that it is also not consistent with an individual’s cultural and religious beliefs.
“There are many themes or types of delusions and grandiose is one theme. A person with this type of delusion has an over-inflated sense of worth, power, knowledge or identity,” he says.
“This person might believe he has a great talent or has made an important discovery. For example, someone with no medical background is convinced that he can heal people who have cancer or someone may believe he has the power to predict the future.”
He adds that s grandiose delusion may have a religious theme, such as when a person believes he is the messenger of God.
“The person might also believe he has a special relationship with a prominent person (such as being an adviser to the Prime Minister) or that he himself is a prominent figure,” he says.
GRANDIOSE DELUSIONs VS NARCISSISM
Grandiose delusions should not be mistaken with a narcissistic personality disorder although both are linked to feelings of superiority.
Dr Philip explains that narcissistic personality disorder is a mental disorder in which a person has an inflated sense of his own importance and a deep need for admiration. Such a person believes he is superior to others and has little regard for other people’s feelings.
“However, there are no delusions in personality disorders, so the person’s beliefs are not fixed and can be shaken. In addition, personality disorders like narcissistic personality disorder usually starts from adolescence whereas the grandiose delusions has a specific onset after a period of apparent normalness,” he adds.
SYMPTOM, NOT DIAGNOSIS
Grandiose delusions are a symptom and not a diagnosis, says Dr Philip. It may be a symptom of brain disorder or dysfunction such as dementia, tertiary syphilis, Huntington’s disease or other conditions that typically occur later in life.
He adds that having grandiose delusions may also be part of mental illnesses like bipolar disorder or schizophrenia. Some drug dependants also show symptoms of grandiose delusions, depending on the drugs used.
However, he says, grandiose delusions are more common in people with bipolar disorder. “Bipolar disorder is caused by a combination of psychological and environmental factors. It often occurs in upper socio-economic classes and educated people,” he says.
He explains that a person with grandiose delusions will be assessed through clinical psychiatric interviews, interviews with family members and at times work reports, in order to uncover the underlying conditions.
“Other medical conditions or substance abuse need to be ruled out through appropriate investigations. Screening questionnaires such as the Psychosis Screener can also be used,” he says.
TREATMENTS
Grandiose ideas can lead to creative and unique plans. Unfortunately, grandiose delusions can cause negative effects as this state of mind does not keep up with reality, so it must be treated.
Dr Philip says treatment is targeted at the disorder that shows the symptom of grandiose delusions.
“A person with bipolar disorder may find anti-psychotics and mood stabilisers helpful. Anti-psychotics are also important for schizophrenics,” he says.
“Treatment for drug-dependants include detoxification, followed by relapse-prevention and maintenance. As for those with brain disorders, treating the original condition is imperative.”
WHY BELIEVE?
In cases involving people with grandiose delusions, it is fascinating to take note of the behaviour of the believers and followers (often well-educated and cultured individuals).
Followers of the Al-Ma’unah militant group, for instance, believed that its leader Mohamed Amin Mohamed Razali could control one’s mind and could perform a surgery from afar and without using any instrument.
Is there a psychological explanation for this as well?
Dr Philips says vulnerable individuals can be easy prey to believing people with grandiose delusions. “For instance, a person with grandiose delusions who believes he can cure cancer is likely to attract cancer patients who are in distress and losing hope. Believing and being convinced by the delusional person is likely to boost the patients’ spirit,” he says.
“It’s just like the saying: In the land of the blind, the man with one eye is king.”