An elderly gentleman in La Mancha reads too many books. Chivalric romances, mostly — knights, giants, enchanters, impossible quests undertaken for impossible ladies. He reads through the night and into the day, sleeps too little, and somewhere in that accumulation of pages the boundary between the world on them and the world around him gives way. He renames himself Don Quixote de la Mancha. He recruits a labourer as his squire, promising him an island to govern. He rides out to find adventure, and finds windmills, which he takes for giants, and charges.
Cervantes published the first half of that story in 1605 (Cervantes, 1605, 1615). Four centuries on, "quixotic" survives in ordinary English as a word for chasing impractical ideals (Encyclopaedia Britannica) — proof, if any were needed, of how deep the archetype sits in the culture, long before anyone had a clinical name for what was happening to the old man in the story. Don Quixote is not merely eccentric or mistaken. He is convinced. The windmills are giants because he has organised the whole of reality around the conviction that he is a knight-errant, and no amount of bruising contradicts it for long. That is the shape of the thing this essay is about: not simple overconfidence, not an inflated ego in the everyday sense, but a settled, resistant belief that one's importance, power, or destiny exceeds anything the evidence supports — and that persists regardless.
The term for it, "delusions of grandeur," did not exist in Cervantes' time. It would take the better part of three centuries, and an entirely different discipline, for that to arrive.
Naming the thing
Grandiosity itself is ancient — Hippocrates and Galen both described states recognisable as it, without a word for the state as a category. The specific phrase belongs to nineteenth-century psychiatry, and its arrival tracks almost exactly with the professionalisation of the asylum system. In 1852, the French psychiatrist Jean-Pierre Falret used délire de grandeur — delusion of grandeur — to describe a symptom cluster in what would now be recognised as bipolar disorder (Falret, 1852). Falret trained under Philippe Pinel, the reformer who had struck the chains from the inmates of the Bicêtre asylum in 1793 — an act of "moral treatment" born directly of the same revolutionary conviction then remaking France, that even the mad retained a claim to dignity and reason. By the time his student came to name grandeur as a diagnosable delusion, the driving impulse had shifted from liberty to classification — but the lineage from one to the other holds, even if it runs unannounced. Later in the century, Emil Kraepelin folded grandiose delusion into his account of dementia praecox, the condition later renamed schizophrenia (Kraepelin). The English phrase followed the French by a few decades; the earliest citation the Oxford English Dictionary can offer comes from John Russell Reynolds' A System of Medicine in 1880, in a passage on delusional insanity (Reynolds, 1880).
The timing is not incidental. This was the era in which psychiatry was building its case-note apparatus — standardised observation, classification, diagnosis by criteria rather than impression. A phrase that had existed as literary shorthand for centuries — the deluded knight, the man who believes himself greater than he is — was being formalised into something a doctor could write in a chart. The first person recorded as publicly accused of the condition in these terms was, fittingly, not a king or a general but an ordinary New York tailor. Henry Prouse Cooper was the subject of a judicial insanity inquiry in 1882, brought by his own brother and business partner, after Cooper claimed to have opened a department store in Paris and drawn up wildly implausible property developments in New York (Phrase Finder, 1882). Cooper made no defence. He insisted on the diagnosis himself — "Take me away at once," he is recorded as saying, "don't you see I am a slave to women and rum!" He was, in the event, judged sane. What the case shows is the phrase mid-transition: no longer only a literary observation about ambition and hubris, not yet fully the clinical category it would become, sitting for a moment somewhere between the two.
But naming a thing is not the same as explaining it. Why does a mind do this at all — construct a settled conviction of its own exceptional importance and hold to it against contrary evidence? Three root mechanisms exist, operating at different levels, none of them cancelling the others out — and, as the essay will come back to, the second of the three turns out to have a long reach, showing up again in places that look at first like separate phenomena entirely.
Why the capacity exists at all
The first answer comes from evolutionary psychology, and it does not start with delusion — it starts with something entirely ordinary: status.
Every social species that lives in groups needs some means of tracking where it stands relative to others. Access to food, mates, safety, and cooperation all depend on it. Paul Gilbert's social rank theory proposes that humans, like other social mammals, carry an evolved system for monitoring rank — not simply actual rank, but perceived rank, which turns out to matter just as much to behaviour and mood (Gilbert, 1992, 2000, 2005). This system is thought to draw on limbic, prefrontal, and striatal brain structures working together, tuned by hundreds of millions of years of social evolution, to answer one recurring question: relative to everyone around me, how much attention, admiration, and investment can I expect? (Frontiers in Human Neuroscience, 2012)
The theory's best-evidenced territory is the low end. When perceived rank collapses — when a person reads themselves as defeated, subordinate, unable to compete — the system appears to produce exactly the responses associated with depression: withdrawal, submission, reduced effort, a kind of protective de-escalation. This is well established. Not every response to a rank deficit is withdrawal, though — a companion essay on the borrowed self traces a different route entirely, in which status is recovered not by inflating one's own but by attaching to someone else's, admiration curdling gradually into a kind of assimilation. Grandiosity proper takes the more direct route. The high end of the same system is less studied, but the logic runs the same direction. If perceived rank can be miscalibrated downward, producing depressive collapse, there is no obvious reason the same system could not miscalibrate upward — producing a settled sense of rank far in excess of anything the social evidence supports. Seen this way, grandiosity is not an alien intrusion into an otherwise sound mind. It is the same ancient status-tracking machinery every socially living creature carries, reading the signal wrong.
This is what might be called the ultimate explanation — why the capacity for this kind of miscalibration exists in the species at all. It says nothing yet about why one particular person develops it and another does not. For that, the story has to move from evolutionary history into a single childhood.
Why one life produces it
Heinz Kohut's self psychology makes a claim that sits slightly outside where most people expect a discussion of grandiosity to start: everyone begins here.
Kohut proposed that a normal, healthy line of infant development includes what he called the grandiose-exhibitionistic self — a stage in which the infant genuinely experiences itself as the omnipotent centre of its world, requiring what he termed "mirroring" from a caregiver: delighted, attentive reflection back of the infant's sense of its own magnificence (Kohut, 1971). This is not itself pathological. It is, in Kohut's account, an "innate grandiose" starting position that every developing self must pass through. What matters is what happens next. A good-enough caregiver cannot, and should not, provide unlimited mirroring — small, tolerable frustrations are inevitable and, crucially, necessary. It is precisely through manageable disappointment — being handed to someone else, waiting a moment too long for a response, discovering the world does not reorganise instantly around every need — that the infant's grandiosity is gradually, gently tempered into something more durable: realistic ambition, a self-esteem the adult can regulate from the inside rather than needing constantly refreshed from outside.
Where this process is disrupted — where empathic mirroring is chronically absent, inconsistent, or overwhelming rather than attuned — the theory holds that the grandiose-exhibitionistic self does not get tempered. It gets walled off, defended, carried forward largely unmodified into adulthood, because the alternative was never made survivable. The adult who results does not simply have high self-esteem. They depend on a continuous external supply of admiration to hold a sense of worth that was never allowed to become internally regulated in the first place (Kohut, 1977). Otto Kernberg's later object-relations account of narcissism — a term YFL treats elsewhere as a developmental position rather than a fixed pathology — sharpened this into what researchers now call the "mask model" of grandiosity: an outward presentation of superiority and entitlement sitting over — and defending — a much more fragile, uncertain sense of self underneath (Kernberg, 1975, 1985; Zeigler-Hill & Jordan, 2011; Kuchynka & Bosson, 2018). The mask is not dishonesty in any simple sense. It is closer to structural necessity. Take it away and there is, by this account, very little holding the person up.
Something worth pausing on here: the psychiatrist Elsa Ronningstam and colleagues increasingly describe grandiose and vulnerable presentations not as two separate types of narcissism but as states that oscillate, or even co-occur, within the same person (Ronningstam et al.) — the vulnerability sometimes fully concealed behind the grandiosity, sometimes breaking through it. The mask, in other words, is not always convincing even to the person wearing it.
There is a small joke that captures something of this distinction rather well, and readers of a certain temperament will already know it. A dog is fed, sheltered, and cared for by its owner every day, and concludes: this creature must be a god. A cat receives exactly the same food, shelter, and care, and concludes: I must be a god. The line has been circulating in something like this form since at least the mid-1990s — Reader's Digest printed a version credited to a reader in 1994, and it has been misattributed to Christopher Hitchens and others ever since, though no one can trace it to a single origin with any confidence (Quote Investigator, 2026). It is worth noting, if you have read the companion essay on quiet confidence and the cat that rules the dog, that this is the same animal put to almost the opposite use. There, the cat's stillness stood for something earned and genuine. Here, the cat's godhood is the joke version of the same posture — a flattering misreading of ordinary dependency as sovereignty, arrived at with precisely no more evidence than the dog had for its own, rather humbler conclusion. Same circumstances. Different reading. The difference is not in what happened to either animal. It is in what each one made of it.
The institution learns the word
By the time Ken Kesey published One Flew Over the Cuckoo's Nest in 1962 (Kesey, 1962), "delusions of grandeur" had travelled a long way from Falret's clinical French. It had become part of the ordinary vocabulary of institutions — the asylums and psychiatric wards that the nineteenth century had built to house exactly the population the term was coined to describe. Kesey's narrator observes, of the novel's disruptive, magnetic protagonist, that "McMurphy had no more than ordinary delusions of grandeur." The line works because it plays the phrase for understatement rather than diagnosis. McMurphy is not convinced he is Napoleon. He is loud, self-assured, contemptuous of the ward's petty authority, and entirely willing to present himself as larger than life if it serves him — which is closer to what psychiatrists distinguish as megalomania: a self-important preoccupation with power and control that is not necessarily delusional at all. Fascist dictators are the textbook comparison — showing clear megalomania while remaining, in the clinical sense, entirely undeluded about what they were doing.
Kesey's line is doing something pointed but understated: using the institution's own diagnostic language ironically, about a character whose real offence is refusing to be small in a place designed to make everyone small. It is worth holding this distinction clearly, because the next register genuinely is the thing itself.
Where the delusion is real
Somewhere past megalomania, past the mask, past the evolved status system reading its signal wrong, sits a smaller population for whom "delusion" is not a loose figure of speech but a precise clinical fact: a fixed false belief, persisting despite direct and unambiguous contrary evidence, meeting the diagnostic criteria of delusional disorder, grandiose type, or occurring as a symptom within a wider psychiatric or organic condition.
Here the numbers are worth having, because they show something the popular use of the phrase rarely captures — this is not any one illness's signature symptom. Grandiose delusions appear in roughly two-thirds of manic episodes in bipolar disorder, in around half of cases of schizophrenia, and in a meaningful minority of substance-induced psychoses and delusional disorder proper (Wikipedia; Medical News Today; BrightQuest Treatment Centers). The mechanism here is different in kind from either of the two already described. It is not an ancient status system misfiring, nor a childhood mirroring failure carried forward unrepaired. It is, most directly, a matter of brain chemistry — elevated dopamine and norepinephrine activity during mania; dopaminergic dysregulation alongside the hallucinations and disorganised thought of schizophrenia. Reality-testing itself is compromised, not merely biased.
And yet even here, something is worth carrying forward rather than dismissing as pure malfunction. A 2021 qualitative study interviewed patients with lived experience of grandiose delusions and found, across the accounts, that the belief was consistently described as meaningful (PMC, 2021). It provided a sense of purpose, of belonging, of identity, or made sense of otherwise bewildering and frightening experience. That meaning, the researchers noted carefully, was not the same thing as arrogance or a claim to superiority over others. Even at the most severe end of this spectrum — organically caused, resistant to argument, sometimes genuinely dangerous to the person holding it — the belief is doing psychological work. It is not simply the mind broken. It is, in some recognisable way, still trying to make sense of a life.
Why the mask reappears, staged: American Psycho
If the organic register shows grandiosity at its most involuntary, American Psycho shows the second mechanism — Kohut's mask — at its most deliberately performed.
Patrick Bateman, the narrator of Bret Easton Ellis's 1991 novel (Ellis, 1991) and Mary Harron's 2000 film (Harron, 2000), is by most clinical readings closer to the mask model than to anything organically psychotic — and closer to it, too, than to the megalomania McMurphy embodied a section ago. McMurphy performed largeness as a weapon against a diminishing institution and seemed, underneath it, entirely secure in himself. Bateman performs largeness against no institution at all, purely for an unseen audience, and the mask does not seem to be convincing him either. Analysts of the character have repeatedly noted that he is "consumed by status dread and existential panic" — the opposite of the untroubled self-belief a true psychopath, or a true megalomaniac, is supposed to feel (Zimbardo.com; Neurolaunch; Psychologus.net; ArhFoundation.org). His grandiosity — the apartment, the business cards, the reservation at Dorsia — is maintained obsessively and almost entirely for display; he rarely brings anyone into the private version of his life, which suggests the display is doing exactly the defensive work the mask model predicts. One reading calls him a "vulnerable narcissist masked by grandiosity," which could serve as a plain description of the developmental mechanism from several sections back, dressed in satire and set in 1980s Wall Street.
Ellis's target was never really Bateman alone. The novel's satire is aimed as much at the culture that produced him — one built almost entirely around status display, where the mask is not a private psychological defence but something close to a professional requirement. Which raises a question worth asking directly: how much of this mechanism is ever a purely individual matter? Kohut's account starts in a single nursery, but nothing about it stays there. A culture can reward the performance of the mask so reliably that performing it starts to look, from the outside, indistinguishable from needing it — and the next case shows that reward turned into infrastructure.
Why the mask scales: the level playing field
The word "meritocracy" is younger than most people assume, and it did not start life as praise.
The British sociologist Michael Young coined it in 1958, in a satirical dystopia called The Rise of the Meritocracy, written as a mock-historical account looking back from the year 2034 at how a supposedly fairer Britain had been built (Young, 1958). Young's argument was not that merit-based advancement was good. It was closer to a warning: replace inherited caste with achievement, and you do not remove hierarchy, you simply manufacture a new class system — one whose winners believe, more completely than any aristocrat ever could, that they have earned their position, and whose losers are left with no explanation for their place except their own inadequacy. Young himself lived to watch the word lose its warning entirely, absorbed into ordinary political language as an unqualified good — he singled out Tony Blair's Labour Party by name, in 2001, for embracing precisely the philosophy his book had been written to caution against (Wikipedia; British Journal of Educational Studies, 2011).
That history matters here because the promise underneath meritocracy — that the field is level, that ability and effort alone determine outcome — is exactly the promise a platform like YouTube appears, on the surface, to make good on. The barrier to entry genuinely is close to zero. A camera, an idea, an upload button, and in principle the same global audience is available to anyone, regardless of birth, education, or connections. Video does periodically go from nothing to millions of views. That part is not the illusion. The illusion is in what a mind does with the visible cases and the invisible ones together — a pattern researchers call survivorship bias: the tendency to notice and reason from the successes in front of us while the much larger number of attempts that went nowhere remain, by definition, unseen. The level playing field is real in its rules. It is not remotely level in its outcomes, and the gap between those two facts is where a particular, contemporary flavour of grandiosity has room to grow.
Why that gap produces grandiosity specifically, rather than simple disappointment, has a fairly direct answer, and it connects straight back to the developmental account already covered. In transactional analysis, Eric Berne described "strokes" — units of recognition, attention, or acknowledgement — as something closer to a biological necessity than a social nicety (Berne); his colleague Claude Steiner extended this into the stroke economy, describing the often-unspoken rules that govern how freely strokes are given, sought, and accepted (Steiner). Historically, accumulating enough strokes to meaningfully shift a person's sense of status took years of face-to-face relationship. A platform built around likes, views, comments, and follower counts is, in effect, an industrialised stroke-delivery system — capable of supplying, in an afternoon, more units of apparent recognition than a person might once have gathered across a working life, arriving from total strangers with no relational cost attached to either party.
For a self that developed exactly as Kohut described — the grandiose-exhibitionistic pole never fully tempered, still dependent on external supply to regulate its own worth — this is close to a perfectly matched environment. It does not need to convince someone they are exceptional. It only needs to deliver, reliably and at scale, the specific kind of recognition an unrepaired childhood left that person still hunting for. The research bears this out in outline: heavy social media use correlates specifically with grandiose narcissism rather than narcissism generally (Fegan & Bland, 2021), platforms are structurally built to reward curated self-presentation, and grandiose narcissists in particular tend to use the resulting stream of other people's ordinary lives for downward comparison — evidence, read selectively, that the exception is closer to normal than the numbers would ever support (EBSCO Research Starters; A Place of Hope).
None of which makes the 2 million views impossible. It happens. But a culture that holds up the exception as evidence of the rule, while depending on that same confusion to keep an entire attention economy running, is doing something rather more purposeful than simply reporting good news.
Three answers to one question
None of this converges on a single explanation, and it would be dishonest to pretend otherwise. An evolved status-tracking system explains why the capacity exists in the species. A dopamine system running hot explains why, in some cases, the belief becomes genuinely unreachable by argument. And a childhood account of mirroring and its failures explains why one particular life produces it — a mechanism that turned out, on inspection, not to stay confined to the nursery: the same mask reappears staged deliberately in fiction, rewarded structurally by a culture built on display, and now delivered industrially, to almost anyone, by a platform economy that has learned to manufacture the exact recognition an unrepaired self was always going to go looking for.
What connects Don Quixote, McMurphy — held apart from the rest by his megalomania rather than true delusion — the patient for whom the belief made sense of an unbearable experience, Patrick Bateman in his immaculate apartment, and the millions of uploads chasing a platform's promise of a level field, is not a shared cause. It is a shared shape: a mind, for reasons that differ in every case, reading the same ordinary evidence everyone else has access to, and arriving somewhere else entirely. Even the tailor from New York, judged sane in the end, shows the shape from its edge — a man willing to claim the diagnosis for himself before any court would grant it to him. The dog and the cat receive identical care. One concludes it has found something greater than itself. The other concludes it has found only more evidence of what it already suspected.
References
Clinical and academic
Berne, E. (n.d.). Founding work on transactional analysis and the concept of the "stroke" as a unit of recognition.
Falret, J.-P. (1852). Early use of délire de grandeur in French psychiatric description, predating the English term by several decades.
Fegan, R. B., & Bland, A. R. (2021). Social media use and vulnerable narcissism: The differential roles of oversensitivity and egocentricity. International Journal of Environmental Research and Public Health.
Frontiers in Human Neuroscience. (2012). Neuroimaging review of social rank theory, summarising the limbic, prefrontal, and striatal correlates of perceived social rank.
Gilbert, P. (1992, 2000, 2005). Foundational and subsequent papers establishing social rank theory as an evolutionary account of status perception and its relationship to mood and behaviour.
Kernberg, O. (1975, 1985). Object-relations account of pathological narcissism and the grandiose self, contributing to the "mask model."
Kohut, H. (1971). The analysis of the self. Founding text of self psychology; the grandiose-exhibitionistic self and the concept of "optimal frustration."
Kohut, H. (1977). The restoration of the self. Further development of self psychology and narcissistic injury.
Kraepelin, E. (n.d.). Foundational work on dementia praecox (later schizophrenia), identifying grandiose delusion as a recurring feature.
Phrase Finder. (n.d.). Documentation of the 1882 Henry Prouse Cooper insanity inquiry, New York — the earliest recorded public use of "delusions of grandeur" applied to a named individual. phrases.org.uk.
PMC. (2021). Qualitative study of patients with lived experience of grandiose delusions, on the meaningfulness of the belief to those who hold it.
Reynolds, J. R. (1880). A system of medicine. Earliest Oxford English Dictionary citation for "delusional insanity" in English.
Ronningstam, E., et al. (n.d.). The higher the score, the darker the core [Review]. PMC. Clinical review on the oscillation and co-occurrence of grandiose and vulnerable narcissistic states.
Steiner, C. (n.d.). Development of the "stroke economy" concept within transactional analysis.
Wikipedia; Medical News Today; BrightQuest Treatment Centers. (n.d.). Summary prevalence data on grandiose delusions across bipolar disorder, schizophrenia, and delusional disorder.
Zeigler-Hill, V., & Jordan, C. H. (2011); Kuchynka, S., & Bosson, J. K. (2018). Empirical studies developing and testing the mask model of narcissistic grandiosity against implicit/explicit self-esteem discrepancy.
EBSCO Research Starters; A Place of Hope. (n.d.). Summary reviews of the social media–narcissism research literature, including findings on grandiose narcissism, downward social comparison, and self-presentation.
Literary and cultural analysis
Cervantes, M. de. (1605, 1615). Don Quixote.
Ellis, B. E. (1991). American Psycho.
Encyclopaedia Britannica. (n.d.). Entry on Don Quixote as a literary character, and the origin of "quixotic" in English usage.
Grokipedia. (n.d.). Entry on Quixotism as a literary and philosophical concept.
Harron, M. (Director). (2000). American Psycho [Film].
Kesey, K. (1962). One Flew Over the Cuckoo's Nest.
Quote Investigator. (2026). Research into the provenance of the dog/cat "god" comparison, tracing it to a 1994 Reader's Digest reader submission and noting its frequent, unreliable attribution to others.
Wikipedia; British Journal of Educational Studies. (2011). Secondary analysis of Young's text and its subsequent, largely inverted, adoption into political language.
Young, M. (1958). The rise of the meritocracy, 1870–2033.
Zimbardo.com; Neurolaunch; Psychologus.net; ArhFoundation.org. (n.d.). Clinical and critical analyses of the character Patrick Bateman, including the "vulnerable narcissist masked by grandiosity" reading.
Topics: #WhyDelusionsOfGrandeur #IndependentEnquiry #Grandiosity #Narcissism #Psychiatry #SelfPsychology #Megalomania #DonQuixote #AmericanPsycho #Meritocracy #SocialMedia #YoungFamilyLife #InformationWithoutInstruction