Maintaining Delusional Beliefs to Satisfy and Protect Psychological Needs

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Affiliation, control, and self-esteem are psychological needs that human beings attempt to satisfy and protect (Epstein, 2003; Grawe, 2004). From a motivational perspective, behaviors, attentional and cognitive biases as well as symptoms can have an instrumental function for need satisfaction and protection (Caspar, 2011). In this opinion paper, we elaborate the idea that the maintenance of delusions could be a motivated process. This approach helps to view the maintenance of delusional beliefs as a purposeful, yet mostly nonconscious, and not completely adaptive attempt to satisfy and protect psychological needs. Conclusions for case formulations, therapy planning, and therapeutic relationship building are drawn within the framework of cognitive-behavioral therapy for psychosis. In addition, limitations of the approach and future research avenues are discussed.

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