[tptacek]

I don't think reinforcement is generally the recommended approach for people with delusional or obsessive pathological parasocial fixations. I think generally the idea is to get those people into talk therapy and to cut off all contact with the object of their fixation.

[fullmoon]

Mere talk therapy is infamously useless for attachment trauma, which is relational and somatic

[tptacek]

Begs the question of whether the underlying pathology is attachment trauma or some other delusional fixation! I don't doubt most of the people in this predicament are vulnerable for one reason or another. I made a much more specific claim, about delusional obsessive fixation; I did not claim that their underlying mental health issues could be fixed straightforwardly.

[fullmoon]

It’s a great question, and I think it’s not exclusive.

Obsessive limerent obsession can be driven by reward circuits, and those _can_ be extinquished by more straight-forward therapy, but if it’s driven by unmet emotional needs, it’s often quickly replaced by some other maladaptive coping mechanism (hopefully slightly less unhealthy).