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If the person conceals sins or thoughts in confession or does not trust to his spiritual father, he can also fall into prelest: "Think in this wise: the Holy Spirit dwells in your confessor, and he will tell you what is right. But if you say to yourself that your confessor lives a careless life, how can the Holy Spirit dwell in him, you will suffer mightily for such thoughts, and the Lord will bring you low, and you are sure to fall into delusion".<ref>Archimandrite Sofronii. Saint Silouan the Athonite. P. 292.</ref> Also, elder Ephraim of Philotheou speaks about his teacher, elder Joseph the Hesychast, who used to say to his disciples about some people who suffered from prelest. Such people quite often committed suicide because they believed that an Angel appeared to them, whereas it was a demon. The delusion was in the thought: "Do not tell that to the Elder".<ref>{{Ru icon}} Elder Ephraim of Philotheou. My life with elder Joseph.</ref>

According to St. Ignatius Brianchaninov, St. Gregory of Sinai,<ref name="greg"/> St. Symeon the New Theologian,<ref>[http://www.myriobiblos.gr/texts/english/symeon_threeways.html Saint Symeon the New Theologian, The Three Ways of Attention and Prayer.]</ref> Valaam Elder Schema-Abbot [[John (Alexeev)]]<ref>[http://oprelesti.ru/index.php/what-is-spiritual-delusion/413-how-to-pray Letters of the Valaam Elder Schema-Abbot John (Alexeev), On Prayer]</ref> and other ascetics, the first kind of prelest (prayer with imagination) very often leads to insanity. The second kind (conceit) sometimes does not result in a mental disease, but the person cannot achieve salvation being in a state of one of the seven deadly sins - pride. St. Ignatius writes about it: "This kind of prelest - is terrible: it is equally fatal for the soul as the first one, but is less evident; it rarely ends in madness, suicide, but definitely corrupts both the mind and the heart."<ref name="ign1"/>