If 'sane' is accepting the consensus reality and 'insane' is denying it then a psychotic delusion is no less real to the person experiencing it then anything else they experience.
Imagine you've never heard a cow 'mooing' (those of you who haven't don't need to imagine.)
You still know that cows 'moo' because other people have told you. It is genereally accepted.
Imagine you then go out into the countryside and hear cows go 'baa.' Your opinion changes you think that cows, or at least the cows you heard, go 'baa.' To everyone else you are insane, particularly to those who heard the same cows go 'moo,' but your experience of the cows going 'baa' was as vivid as any other experience. Who is to say it wasn't 'real'?
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