Delusion as embodied emotion: a qualitatively driven, multimethod study of first-episode psychosis in the UK.
The lancet. Psychiatry February 1, 2026 Rosa Ritunnano, Jeannette Littlemore, Barnaby Nelson et al. 8 citations
Delusions in first-episode psychosis are not isolated symptoms but emerge from a global shift in how a person experiences self and world, shaped by early negative emotions like shame. In a qualitative study of ten adults, persecutory, reference, and grandiose or religious themes were common and overlapping. Narrative interviews revealed that recurrent shame, anger, and fear, along with efforts to avoid or immerse in these emotions, preceded delusions. Three emotional transformation patterns were identified: from embodied shame to invincibility, from meaninglessness to love and hope, and feeling cut off in a simulation. Delusions reflect an embodied, temporal process where bodily experiences link to extreme appraisals, such as being a bad person or connected to God. Interventions should target the lived body and social environments for emotional regulation.