(Press-News.org) People experiencing delusions during an episode of psychosis may be ‘living out’ a deeply held emotion, according to new research that provides a ‘radically different perspective’ on one of the most puzzling elements of psychosis.
About 2–3% of the UK and Australian population will experience psychosis at some point in their lives, with people commonly experiencing their first psychotic episode between the ages of 16 and 30 years old. Delusions are often described as fixed or false beliefs, understood to be reasoning or cognitive deficits and usually portrayed as incomprehensible and bizarre in popular culture.
New research by the University of Birmingham, University of Melbourne, and the University of York, in collaboration with the Australian youth mental health research institute Orygen, offers the first-known study of how delusions in psychosis are shaped by emotions and language, leading those experiencing delusions to ‘live in metaphor.’
The study has been published in The Lancet Psychiatry.
Conducted with young adults receiving care from Early Intervention in Psychosis services, the research combines clinical assessment, phenomenological interviews, and life-story narratives to explore how people’s sense of self and their perception of reality change during psychosis.
Dr Rosa Ritunnano, from the Institute for Mental Health at the University of Birmingham, consultant psychiatrist and author of the study, said: “Our research provides a radically different perspective on psychotic delusions, demonstrating how they emerge from the emotional, bodily, and linguistic fabric of people’s lives.
“For a long time, clinicians have struggled to understand where delusions come from and how they take shape. Our research offers new insight by showing how delusions are grounded in emotional experiences that involve great bodily turmoil.”
Strong emotions
The findings reveal that delusions are not isolated ideas produced by ‘glitches in the brain,’ but they reflect distinctive patterns of the body reacting to strong emotions or experiences of dissociation.
Participants described alternating states of intense emotional embodiment, such as feeling exposed, powerful, or connected to God, and disembodiment, such as feeling unreal or detached from one’s body, other people, and the world.
Before the delusions started, people often went through upsetting or traumatic experiences that triggered the same intense feelings they later felt during the delusions, especially being shamed.
Repeated negative experiences such as being publicly mocked and shamed by bullies could induce the bodily perception of being surveilled by others when no one is present (so-called ‘reference delusions’). These turn into persecutory beliefs that others are out to get them, and that an audience can literally see what they are doing or hear what they are thinking at all times — leaving no space for privacy (delusions of ‘thought broadcasting’).
Importantly, delusional experiences were not always negative. For some participants, they involved powerful feelings of awe, love, and spiritual connection, fostering a positive sense of identity and a renewed sense of hope about the future.
Figurative language
A striking feature of participants’ accounts was their use of figurative and metonymic language (expressions linking bodily sensations with complex emotions or abstract ideas). This helps explain why delusional content can appear unusual or bizarre. For instance, feeling ‘exposed’ or ‘tainted’ might be expressed through the beliefs of being watched by cameras or being contaminated (as in delusions of parasitosis).
The language reflects how emotion concepts take shape in bodily experiences, establishing fundamental cognitive links between, for instance, the emotion of parental love and the physical sensation of warmth, or the emotion of shame and the physical sensation of being 'seen' by others.
Jeannette Littlemore, Professor of Linguistics and Communication at the University of Birmingham and co-author of the paper, said: “We all use metaphors and narratives to understand our experiences and make sense of our lives. But psychosis patients do so more intensely. As a result of having endured strong (often negative) emotional experiences, which are then responded to by the body, and shaped by everyday language use, people experiencing psychotic delusions really are living in metaphor. People may feel delighted and say they are so happy they can ‘touch the sky’; this could lead them to experience the delusion of thinking they can fly.”
The study argues that better insight into how delusions come about can be used to create more effective care for people experiencing psychosis. Participants felt that there was no space to talk about the meaning of their delusions in the context of their treatment and recovery from psychosis, which led to more shame and increased the sense of being dismissed and marginalised.
The researchers highlight the importance of attending to people’s bodily and emotional worlds, and how they express them, when developing compassionate and effective approaches to psychosis care.
The paper concludes that delusions are not simply beliefs gone wrong, but embodied attempts to restore meaning and emotional balance when life becomes overwhelming. The metaphors and narratives people use are keys to understanding their suffering and are not signs of irrationality.
END
John Kempen, MD, MPH, PhD, MHS, Director of Epidemiology for Ophthalmology at Mass Eye and Ear and Harvard Medical School, is the lead author of a paper published in The Lancet Global Health, “Evaluation of fluorometholone as adjunctive medical therapy for trachomatous trichiasis surgery (FLAME): a parallel, double-blind, randomised controlled field trial in the Jimma Zone, Ethiopia.”
Q: Why is trachoma important?
Trachoma is the leading cause of infectious blindness in the world, predominantly affecting low-income individuals, and women more ...
For the last two years, the cultivated meat industry has been experiencing growing pains. Many startups have shrunk, shut down, or pivoted. Their advances aren’t going to waste, though.
The Tufts University Center for Cellular Agriculture (TUCCA), which seeks to enable production of meat, milk, and eggs from cells instead of animals, has teamed up with nonprofit partner Good Food Institute to salvage the intellectual property—the inventions—of those firms and make them publicly available to help nurture the industry.
Specifically, this effort aims to obtain and broadly distribute cell lines—cells of a specific type ...
Osaka, Japan – Changes in genes have been linked to the development of different diseases for a while. However, it’s not exactly clear what the mechanisms, or the causes behind those specific genetic changes, are. Recent studies using fission yeast, which can act as an ideal model for human cells, have highlighted one possible mechanism linked to disease onset.
In a study recently published in Nucleic Acids Research, researchers from The University of Osaka discovered that the loss of heterochromatin ...
To launch a successful research career in the health sciences, junior faculty need to write persuasive, high-quality grant proposals that get funded. However, the skill is not widely taught in medical schools or graduate programs. In a new study, University of California San Diego researchers report that early career faculty who completed the institution’s innovative Health Sciences Grant Writing Course demonstrated significant increases in grant submission rates and funding success — especially among women and faculty ...
MIAMI, FLORIDA (Jan. 12, 2026) – Head and neck cancer trials are frequently derailed before they can deliver answers. A new analysis suggests that the most common reasons are sponsor decisions related to safety or effectiveness and poor patient recruitment.
Researchers from Sylvester Comprehensive Cancer Center, part of the University of Miami Miller School of Medicine, and collaborators analyzed 692 clinical trials launched between 2000 and 2024. Alex Reznik, M.D./Ph.D. student at the University of Miami and co-author, described the study as “A retrospective query of head and neck cancer clinical trials in which we compared ...
Bernard Arulanandam, vice provost for research at Tufts University and professor of immunology at Tufts University School of Medicine, has been named a foreign fellow of the Indian National Science Academy. This honor recognizes his significant contributions to scientific research and his longstanding engagement with international scientific communities.
The Indian National Science Academy, established in 1935, is India’s premier scientific body dedicated to advancing scientific inquiry ...
Embargoed for release until 5:00 p.m. ET on Monday 12 January 2026
Follow @Annalsofim on X, Facebook, Instagram, Bluesky, and Linkedin
Below please find summaries of new articles that will be published in the next issue of Annals of Internal Medicine. The summaries are not intended to substitute for the full articles as a source of information. This information is under strict embargo and by taking it into possession, media representatives are committing ...
Seattle, WA — In a groundbreaking study published in the in Proceedings of the National Academy of Sciences (PNAS), scientists at Pacific Northwest Research Institute (PNRI) have overturned a long-held belief in genetics: that inheriting two harmful variants in the same gene always worsens disease. Instead, the team found that, in many cases, two harmful variants can actually restore normal protein function.
The research focused on a human enzyme called argininosuccinate lyase (ASL), ...
For decades, researchers have focused on the problem of overgrazing, in which expanding herds of cattle and other livestock degrade grasslands, steppes and desert plains. But a new global study reveals that in large regions of the world, livestock numbers are substantially declining, not growing — a process the authors call destocking.
“We often assume that rangelands are being degraded because we overgraze them, but the data show that it's not the whole story: nearly half of livestock production occurs in areas that have experienced destocking over the past 25 years,” said study co-author Osvaldo Sala, an ecologist and professor ...
Kyoto, Japan -- While investigating the FGF21-oxytocin-dopamine system, a mechanism that regulates sugar appetite, a team of researchers at Kyoto University noticed reports suggesting that the protein FGF21 may regulate alcohol ingestion. The team's original aim had been to address sugar appetite in lifestyle-related diseases, but since alcohol is a fermented product of sugar, they speculated that perhaps the body contains a system that recognizes both alcohol and sugar as the same entity.
Excessive alcohol consumption is a major global health issue, and ...
