It’s simply mental illness no matter what they “feel” or “desire”......Twisted thinking that they dwell on.
It is mental illness and in the past doctors would attempt to force the patient to see their thoughts and desires do not match with reality. Now many mental health “experts” think giving into the delusion is healthier in the long run. Most people with mental illness recognize on a rational level their thinking is wrong and it is these people who can be treated. However we have a whole new generation of experts who now try to convince even this group that their mind is correct and it is reality or nature that messed up.