Primary delusional experiences in schizophrenia and the sacred: a qualitative study

Psychopathology has highlighted the pivotal role of revelation in schizophrenic primary delusions. However, empirical studies on the topic remains limited. Therefore, this research aimed to explore the basic forms of subjectivity underpinning delusions in schizophrenia and to compare the experiential structure of these delusional phenomena with the experience of the sacred. The study involved eleven participants diagnosed with schizophrenia and adopted the qualitative methodology of Interpretative Phenomenological Analysis (IPA). Participants’ accounts revealed four core experiential themes: 1) fragility of presence, 2) disposition to delusion, 3) apophany, and 4) eccentric existential reorientation. Primary delusional experiences may constitute a state-like phenomenon unfolding in four structural phases toward the formation of delusional contents: 1) a weakened bodily resonance with the world, 2) a predominance of the “physiognomic” properties, 3) an imposition of idiosyncratic and self-referential meanings, and 4) an active elaboration through delusion-like ideas. Formal similarities may be found with the “numinous” experience and with the specific articulations of the manifestation of the sacred or “hierophany.” Disembodiment may be posited as the common underlying scaffolding for both delusions in schizophrenia and the sacred, albeit persistent and forced upon the subject in the former, and transient, voluntarily sought, and socio-culturally integrated in the latter.