Delusions – Encapsulated Delusions – Encapsulated Persecutory Delusions

Google the term “encapsulated delusion.”

Encapsulated delusion: a delusion that usually relates to one specific topic or belief but does not pervade a person’s life or level of functioning.”

Encapsulated delusion: An isolated mistaken but unshakable belief in something for which there is neither evidence nor common acceptance, occurring in the absence of other signs or symptoms of psychiatric illness.”

The American Psychiatric Association defines a persecutory delusion as:

“Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (APA; 2000)

A delusion is a fixed and false belief that is maintained despite contrary evidence.

A delusion is a psychotic pathology. At its core, the pathology we are dealing with in attachment-based “parental alienation” (not PAS) is a psychotic pathology involving an encapsulated delusion that the targeted parent represents an abusive threat to the child.

Delusions can be bizarre (such as a delusion that extraterrestrials are implanting thoughts in the patient’s head) or non-bizarre (such as a husband’s delusional belief that his wife is having an affair when she isn’t – called a “jealousy delusion”; APA, 2000).

There is no point in arguing with a delusion because, by definition, the delusion is a false belief that is maintained despite contrary evidence. No amount of contrary evidence will alter the person’s fixed belief system.

What I find so incredibly troubling from a professional standpoint is that so many mental health professionals – whose job it is to diagnose pathology – are absolutely missing the diagnosis of a psychotic pathology that’s sitting right in front of them. That’s astounding to me.

Diagnosing pathology is the job of a mental health professional. For a mental health professional to entirely miss recognizing a psychotic pathology sitting right in front of them in their office represents astounding professional incompetence. I don’t expect a lawyer to recognize psychotic pathology, or an architect, or a policeman, or an engineer. But a mental health professional? That’s exactly our job. Astounding professional incompetence.

For nearly 15 years earlier in my psychology career I worked on a clinical research project at UCLA involving schizophrenia. Every patient in this project was rated every two weeks on their symptoms using a 7-point scale from “not at all present,” through “moderate symptoms,” to “severe symptoms” (the Brief Psychiatric Rating Scale; BPRS).

This symptom rating scale included delusions, called “Unusual Thought Content” on the scale. The cutoff for a delusional belief was a rating of 4 or higher. Below a rating of 4 the patient’s thought content was considered unusual but it was not delusional. Above a rating of 4 the symptom moves into the realm of a delusion.

In order to maintain inter-rater reliability among all the clinicians who were rating patients’ symptoms, every year we had to go through “reliability training” with the Diagnostic Unit located at the VA. This involved a series of lectures from the head of the Diagnostic Unit regarding symptom features and then we each had to watch and rate 10 videos (new videos each year). Our ratings for these 10 videos were then compared with the “gold standard” ratings made by the head of the Diagnostic Unit. If we achieved 90% consistency with the head of the Diagnostic Unit then we were considered reliable symptom raters. If we did not achieve 90% consistency in our ratings with those of the head of the Diagnostic Unit, then we received additional training and rated additional videos until we achieved 90% consistency.

For 15 years I went through this yearly reliability training on rating symptoms on a 1-7 scale, learning the fine-grained analysis of what made a symptom a 3 or a 4 – what the difference was between a severity rating of a 5 or a 6. When was an unusual thought odd but normal-range, and when does it cross the line into a delusional belief… what features of a symptom elevate it from a mild delusion (a rating of 4) to a moderate delusional belief (a rating of 5) or a severe delusional belief (a rating of 6 or 7).

For fifteen years, every year, I underwent training on 10 videos comparing my ratings with the “gold standard” ratings made by the head of the Diagnostic Unit for a major longitudinal research project at UCLA on schizophrenia.

I know what a delusion looks like. The pathology of “parental alienation” (as described in Foundations, not by PAS) represents a delusion.

The professional term for this type of delusion is an encapsulated persecutory delusion. As noted above, the American Psychiatric Association defines a persecutory delusion as:

“Persecutory Type: delusions that the person (or someone to whom the person is close) is being malevolently treated in some way.” (APA; 2000)

In the case of attachment-based “parental alienation” the persecutory delusion centers around “someone to whom the person is close” – i.e., the child.

Beck & Rector (2002) describe the delusional process:

“The pathogenic belief has taken control of the information processing so that the interpretations of events show a systematic bias and appear to others to be contradictory to the evidence or to logic.” (p. 457)

“The dominant beliefs and consequently the interpretations are relatively impervious to reality-testing by the patient. The patient is unwilling or unable to consider that his ideas and interpretations might be wrong. In psychiatric terms, he lacks insight.” (p. 457)

Delusion. Encapsulated delusion. Encapsulated persecutory delusion. Psychotic.

We are dealing with a psychotic level of pathology. That’s what everyone needs to understand.

In our day-to-day lives, people don’t generally expect to run into psychotic distortions to reality. We generally assume that other people are relatively anchored in our same shared reality. But with this particular form of pathology that assumption is NOT warranted.

Delusion. Encapsulated delusion. Encapsulated persecutory delusion. Psychotic.

For 15 years I underwent yearly reliability training at UCLA in rating delusions on a 1-7 scale of severity. I know what a delusion looks like. The pathology of “parental alienation” represents the manifestation of a delusional belief system. An encapsulated persecutory delusional belief system.

Psychotic pathology.

The accurate diagnosis of this pathology using the ICD-10 diagnostic system of the World Heath Organization is F24: Shared Psychotic Disorder.

The accurate diagnosis of this pathology using the DSM-IV TR diagnostic system of the American Psychiatric Association is 297.3 Shared Psychotic Disorder.

The accurate diagnosis of this pathology using the DSM-5 diagnostic system is V995.51 Child Psychological Abuse, Confirmed.

According to the DSM-IV TR diagnostic description for a Shared Psychotic Disorder:

“Usually the primary case in Shared Psychotic Disorder is dominant in the relationship and gradually imposes the delusional system on the more passive and initially healthy second person. Individuals who come to share delusional beliefs are often related by blood or marriage and have lived together for a long time, sometimes in relative isolation. If the relationship with the primary case is interrupted, the delusional beliefs of the other individual usually diminish or disappear. Although most commonly seen in relationships of only two people, Shared Psychotic Disorder can occur in larger number of individuals, especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs.” (p. 333; empahsis added)

Let that sink in…

“…especially in family situations in which the parent is the primary case and the children, sometimes to varying degrees, adopt the parent’s delusional beliefs” – the American Psychiatric Association.

Delusion. Encapsulated delusion. Encapsulated persecutory delusion. Psychotic.

According to the DSM-IV TR diagnostic description of the course of a Shared Psychotic Disorder:

“Without intervention, the course is usually chronic, because this disorder most commonly occurs in relationships that are long-standing and resistant to change. With separation from the primary case, the individual’s delusional beliefs disappear, sometimes quickly and sometimes quite slowly.” (p. 333; emphasis added)

Diagnosis guides treatment.

The core of the delusional process in attachment-based “parental alienation” is the false trauma reenactment narrative of the psychologically decompensating narcissistic/(borderline) parent which is contained in the pattern “abusive parent”/”victimized child”/”protective parent.” 

This false trauma reenactment narrative is contained in the internal working models (Bowlby) of the parent’s attachment networks from their own childhood trauma experience.

The internal working models of attachment described by Bowlby are referred to as “schemas” by the renowned psychiatrist, Aaron Beck (2004):

“How a situation is evaluated depends in part, at least, on the relevant underlying beliefs.  These beliefs are embedded in more or less stable structures, labeled “schemas,” that select and synthesize incoming data.” (Beck et al., 2004, p. 17)

“The content of the schemas may deal with personal relationships, such as attitudes toward the self or others, or impersonal categories.” (Beck et al., 2004, p. 27)

“When schemas are latent, they are not participating in information processing; when activated they channel cognitive processing from the earliest to the final stages.” (Beck et al., 2004, p. 27)

“In personality disorders, the schemas are part of normal, everyday processing of information.” (Beck et al., 2004, p. 27)

“Arntz (1994) hypothesized that childhood traumas underlie the formation of core schemas, which in their turn, lead to the development of BPD.” (Beck et al., 2004, p 192)

“Young’s schema model… patients with BPD were characterized by higher self-reports of beliefs, emotions, and behaviors related to the four pathogenic BPD modes (detached protector, abandoned/abused child, angry child, and punitive parent mode)” (Beck et al., 2004, p. 192)

“The conceptualization of the core pathology of BPD as stemming from a highly frightened, abused child who is left alone in a malevolent world, longing for safety and help but distrustful because of fear of further abuse and abandonment, is highly related to the model developed by Young (McGinn & Young, 1996)… Young elaborated on an idea, in the 1980s introduced by Aaron Beck in clinical workshops (D.M. Clark, personal communication), that some pathological states of patients with BPD are a sort of regression into intense emotional states experienced as a child.  Young conceptualized such states as schema modes.” (Beck et al., 2004, p. 199)

“Young hypothesized that four schema modes are central to BPD: the abandoned child mode (the present author suggests to label it the abused and abandoned child); the angry/impulsive child mode; the punitive parent mode, and the detached protector mode… The abused and abandoned child mode denotes the desperate state the patient may be in related to (threatened) abandonment and abuse the patient has experienced as a child.  Typical core beliefs are that other people are malevolent, cannot be trusted, and will abandon or punish you, especially when you become intimate with them.” (Beck et al., 2004, p. 199; emphasis added)

This is not Dr. Childress making these statements, this is Aaron Beck, one of the preeminent psychiatrists in mental health making these statements.

Internal working models (schemas) of attachment trauma:

“abusive parent” – “victimized child” – “protective parent”

Current targeted parent – current child – current narcissistic/(borderline) parent.

There is a one-to-one psychological correspondence between the internal working models (schemas) in the attachment networks of the narcissistic/(borderline) parent to the current family relationships.

“Abusive parent” = targeted parent
“Victimized child” = current child
“Protective parent” = narcissistic/(borderline) parent

The trauma reenactment narrative.

Delusion. Encapsulated delusion. Encapsulated persecutory delusion. Psychotic.

That’s the pathology we’re dealing with.

Craig Childress, Psy.D.
Clinical Psychologist, PSY 18857

American Psychiatric Association. (2000). Diagnostic and statistical manual of mental disorders (Revised 4th ed.). Washington, DC: Author

Beck, A. T., & Rector, N. A. (2002). Delusions: A cognitive perspective. Journal of Cognitive Psychotherapy, 16(4), 455-468.

Beck, A.T., Freeman, A., Davis, D.D., & Associates (2004). Cognitive therapy of personality disorders. (2nd edition). New York: Guilford.

8 thoughts on “Delusions – Encapsulated Delusions – Encapsulated Persecutory Delusions”

  1. Hello,
    Have a question about MMPI that NOBODY has brought up and I BELIEVE this is not to be overlooked in custody evaluation! It wasn’t and the child is with this “person!”
    Positive impression scale moderately elevated suggesting he/she views self relatively free from common faults.
    Mild elevation on treatment rejection scale, persons with this response pattern are generally satisfied with themselves as they are and see little need for major change, they can have little motivation to enter therapy and are at risk for early termination.
    Response pattern on interpersonal scale is often indicative of someone who is generally self conscious in social situations and not skilled at asserting themselves when needed. They are generally uncomfortable if focus of attention. (Is that suggesting that these people have a fear someone may corner them as to expose their true self?)
    This response pattern is often associated with persons who see little need for close relationships and are often seen as unsympathetic and stern!
    Profile considered to be valid with possible moderate defensiveness. Response pattern did have some mild clinical elevations suggesting he/she experiences some somatic complaints when stressed. Persons with this response pattern are often unconventional, extroverted and may have superficial relationships!
    Shouldn’t this be a concern or not?

    1. The interpretation of the MMPI is a complex professional specialty. The MMPI must be interpreted within an overall context of all the data. So interpreting isolated elevations out of context from other scales and subscales, and out of context of the clinical data is problematic.

      My experience regarding the MMPI and attachment-based “parental alienation” is that the Dark Triad and Vulnerable Dark triad pathology does not readily show up on the MMPI. Once we solve the pathology of “parental alienation” I would strongly recommend additional research regarding the MMPI profile of the narcissistic/(borderline) Dark Triad and Vulnerable Dark triad personality.

      The Dark Triad personality is, however, evidenced in a low score on scale H (Honesty-Humility) on a prominent personality assessment instrument, the HEXACO (Book, Visser, & Volk, 2015; Lee, & Ashton, 2012). There are also specific measures of the Dark Triad personality, such as the Short Dark Triad (SD3) scale; Jones & Paulhus, 2014. However, all of these self-report scales are likely vulnerable to presentation bias, meaning that in conditions of a child custody evaluation the narcissistic/(borderline) parent may not report accurately on these self-report measures.

      Once we solve “parental alienation,” greater professional focus on developing specific assessment measures for the Dark Triad and Vulnerable Dark Triad personalities in the context of child custody evaluations would be warranted.

      Craig Childress, Psy.D.
      Psychologist, PSY 18857

      Book, A., Visser, B.A., and Volk, A.A. (2015). Unpacking ‘‘evil’’: Claiming the core of the Dark Triad. Personality and Individual Differences 73 (2015) 29–38

      Jones, D.N. and Paulhus, D.L. (2014). Introducing the Short Dark Triad (SD3): A Brief measure of dark personality traits. Assessment, 21, 28-41.

      Lee, K., & Ashton, M. C. (2012). The H factor of personality: Why some people are manipulative,
      self-entitled, materialistic, and exploitative — and why it matters for everyone. Wilfrid Laurier University Press: Waterloo.

      1. Okay, well I suppose the rest of the test wasn’t worth mentioning.
        The Parent Coordinators that administered this test would have at least verbalized their concerns if they had any.
        Thank you!
        I’m keeping up with your research and I KNOW you have NO CLUE who I am or the other person so we are AMAZED how you’re research has helped us understand WHAT IS REALLY HAPPENING!!
        Like you said, we’re sitting here saying, ” What????”
        “How did this happen??”
        We have hope in GOD and YOU!!
        “Your sins will find you out!” HIS WORD will not come back void!
        I do believe the Lord is working through you!
        You’re in our prayers Dr.

  2. Another great description of the bizarre thought patterns that bewildered me for so long. My daughters are smart – youngest (17) carries a 95+ average. They can’t be delusional, they must think/process just like me! But their conclusions and actions just make no sense to me.

    Just like their mother, who would perplex me with her dysphoric rages -because of insignificant or invisible triggers – angrier than if I had burned down the house with the kids and dogs in it. The emotion just never matched the conditions.

    Now my daughters treat me as virtual pond scum. Without a single explanation beyond “we are concerned he will be critical of our mother”. History rewritten to remove all that was good. Love, support and guidance blacked out of their minds. Years into it now, they are further away than ever – isolated with their protector (sic), even texts and voice mails are left unanswered.

    And this is what makes us (the targeted parent) question if we are the crazy ones – because we just can’t get our thought processes to align with their’s – we can’t make sense of the rejection because we can’t find the reason for it.

  3. I need to clear that last comment up!
    I’m not a good speaker or writer!
    I was just quoting scripture! Not meaning YOU,YOUR SINS! Haha
    Dr you’re a BLESSING!

  4. Question: is it possible that in a PA as domestic violence (revenge) situation, the disordered abusive parent knows full well that the target parent isn’t abusive, but calculatingly induces the delusion in her children as a revenge tactic?

    My ex with traits of borderline, psychopathy and machiavellianism (vulnerable dark triad) used to praise my parenting all the time (post divorce) and tell me how lucky our children are to have me for a father. Much later I discovered she was at the same time telling our children the opposite and they now have the fixed delusion that I’m inadequate and abusive.

    In other words, does pathogenic parenting allow for a non-delusional parent to instill the delusion in the children?

    1. Answer: It depends. If the personality pathology is more on the borderline side, then entering into the fluid thought process of this personality pathology is more delusional. In the mind of the borderline and narcissistic personality, truth is what they assert it to be. If you delve deep enough into this fluid assertion of truth you will find dissociative denial at the core. They simply cannot comprehend the inconsistency of their false reality from actual reality.

      Prior to reaching this core of dissociative denial, however, the primary defense against insight will be the creation of chaos through every-shifting reality compounded by hostile flurries of angry accusations. To ask if the borderline personalty actually believes the allegations is a meaningless question. The borderline personality believes the reality as it needs to be in the moment, while the concept of actual truth is not relevant. The surrounding chaos prevents the clarity necessary for insight into truth or falsehood.

      The more psychopathic and manipulative personality clearly understand that what they saying is false, but it is a convenient reality to get what they want. They are amoral, and getting what they want is the only consideration. There is no guilt or remorse. Its called Machiavellian because of the Italian Renaissance diplomat and philosopher Niccolo Machiavelli, who advocated an approach of absolute service to practicality. According to Wikipedia, he “described immoral behavior, such as dishonesty and killing innocents, as being normal and effective in politics.”

      The Machiavellian psychopath knows that they are lying and deceiving and they just doesn’t care if it gets them what they want.

      Craig Childress, Psy.D.
      Clinical Psychologist, PSY 18857

Leave a Reply

Fill in your details below or click an icon to log in: Logo

You are commenting using your account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s