Exploring the Grey Zone: A Biopsychosocial Approach to Religious Delusions and Conspiracy Beliefs

We propose to develop a novel biopsychosocial formulation of delusional beliefs which draws together complementary perspectives from social anthropology, philosophy, psychiatry, and neuroscience. It has long been acknowledged that understanding psychiatric illness demands a biopsychosocial approach, embracing and integrating not just a biological and pathological framing, but also the broader sociocultural context that drives and shapes it. This is especially relevant to delusions, which are fixed and frequently bizarre beliefs that are defined not solely by their content but by their deviation from what a person would be expected to believe given their sociocultural background. This definition – which is core to clinical practice – is accompanied by profound conceptual and practical difficulties.
Consider ‘Dorothy’ – an Aberdeenshire woman in her seventies who found hidden codes in the Scots translation of the Bible that revealed to her that she was the Virgin Mary, that her husband was Joseph, and that her son was the Christ. Her divine mission, she believed, was to hand her file of biblical codes to Benjamin Netanyahu to bring ‘born again’ revival within Israel and thereby trigger the apocalypse.
We might see Dorthy’s beliefs as bizarre and indicative of a serious mental illness, but in its local socio-religious context, steeped in millenarianism and Christian Zionism, should we see such claims as delusional? What about similarly ‘unbelievable’ worldviews adhered to by large numbers of people, such as ‘gang stalking’ of ‘targeted individuals’ as an organised government programme to stamp out dissent? Do such beliefs no longer qualify as ‘delusional’ if sufficient numbers of individuals coalesce around them to form supportive communities of fellow believers, or if they emerge from a wider cultural (and social media) context where society-at-large is grappling with similar issues?
Within clinical neuroscience, progress has been made in elucidating the cognitive operations and information-processing that may be disturbed in psychiatric illnesses characterised by delusions. But without a more comprehensive understanding of what makes a belief delusional, such efforts remain limited and incomplete.
We propose to focus on what we call the “grey zone”: the border between delusional and non-delusional beliefs. Our analysis will be drawn together through a series of case studies within this “grey zone”, with a focus on religious ideas about being divinely ‘chosen’ and conspiracist ideas about being nefariously ‘targeted’. Such cases, where defining delusions is made more complex by prevailing cultural context, offer the best opportunity to elucidate the effects of social factors on information processing and belief formation.
Shedding light on religious and conspiracist ideation by integrating philosophical, social anthropological, psychiatric, and neuroscientific lenses will offer new and important clarifications with implications for how we approach, study, and diagnose delusions. The shared notion of beliefs as “maps” or “models” – enabling people to navigate and predict their world – provides the necessary analytical common ground.
Yet, important and useful divergences also exist, allowing each discipline to reshape the others. Philosophy generally locates such models as existing within the inner thoughts of the individual, while anthropology locates these models in the space between such individuals – within culture and society. Thus, while this pivotal notion of mind-models will be the uniting concept in applying the disciplines to delusions, Exploring the Grey Zone will synthesise the tools of each discipline, including qualitative coding, semi-structured and ethnographic interviews, and philosophical model-building.