This study describes how certain delusional people view their world. Patients' names and delusional content have been altered slightly to protect the identity of patients and their families without changing the meaning of the participant observation. Using grounded theory techniques, the investigators discovered the meaning or kernel of the distorted truth in several delusions. Five categories of delusions were found. A recurrent aim in our nursing care was to increase the patient's self-esteem. We found that certain nursing modalities worked better than others. Thorough and continuous assessment, sometimes bordering on detective work and always incorporating hunches, was necessary to decode delusions and validate the patient's experiences. © 1986 Informa UK Ltd All rights reserved: reproduction in whole or part not permitted.