It seems like there is a continuum between being oblivious and delusional. You need to notice things, recognize their meaning, make connections and then make conclusions. Being oblivious can mean missing important signs and making bad choices due to not realizing what is happening. Being delusional can mean jumping to conclusions by "connecting the dots" in one particular way that leads to one conclusion even though that may not be the truth. A sane perspective would mean evaluating different hypotheses to come to a reasonable conclusion. Someone who is paranoid may be right about some things much earlier than others, but they may also be wrong about many other things.
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