NOTE: This post is pinned to the front page because it is my most popular post. Read down for more recent work.
It’s not very often you encounter a delusional person unless you’re already a loved one or care giver of someone with a mental illness. While talking with my mother last weekend, she recounted the onset on my psychosis – a week of tumultuous delusions so compelling even my family became engaged.
Someone had broken into my apartment, multiple times. I was not mistaken about the break-ins, but was delusional about the reason for the break-ins. My mom said to me, “Why would someone be doing this?” To which I replied, “To mess with my mind.” My mother quipped, in her usual fast-response humor “And they have.” Remembering back, I can make a few suggestions to keeping everyone even-keel when delusions appear.
Don’t criticize–Criticism is disapproval based on perceived faults or mistakes. By launching into this conversation, one can automatically place the person in a position to protect him or herself. Face it — no one likes to be told they are making a mistake, and a major mistake of misperceiving all of reality is not common. For those first experiencing delusions, this will only drive the person silent, leaving her to her own devices and isolating her from the sound reasoning of others.
Don’t judge–Judgement is when condemnation from someone who takes a position of superiority, or one assumes the other is not wise or sensible. For those of us who suffer with thought disorders, our reactions to delusions is much the same to our reactions to ‘reality’ (except when there is a break from reality altogether).
When I thought someone was breaking into my apartment, I felt violated, unsafe, uncertain of my surroundings. When it continued to happen, I was alarmed, hyper-vigilant, and terrified. My delusions that a team of people were working in a clandestine fashion to drive me mad and my immediately family were not acting as though this was an urgent matter, as I had, I started acting irrationally. The non-spoken judgement that this was not a matter of safety drove me to ever increasing reckless behavior.
NOTE: You should make judgements calls, which are empowered actions to stave off reckless behavior.
Don’t argue–Both criticism and judgment can elicit strong reactions for one justifying him or herself, pushing that person toward expansive explanations, perceived evidence, and rationalism and persuasion. Arguing with me drew out the details and depths of my delusions, where I had constructed detailed accounts of the who, what, when, where and why of the events and also served to send me inward, ever seeking greater justification for what was happening, cementing my perceptions.
Emphasize doubt–Uncertainty, mistrust or distrust of what one is thinking can provide the demarcation point between suspicion and certainty. It is our nature act on hunches, regardless of our mental health status. Though those of us with thought disorders may spend an inordinate time contemplating the nature of our delusions, we also certainly grasp a thin line of doubt. For me, doubt persisted where the multiple breaks-ins seemed surreal. One step-beyond that however, and I was in the deep-end of delusion. Don’t press for stacked instances of uncertainty, but do emphasize the improbability of events (while also deferring to good judgement).
Nurture sanity–Encourage the investment of self-care aspects the person has; emphasize that one needn’t act recklessly or too quickly, and most certainly without consulting others. Suggest a doctor’s visit, offer support and even going with your loved one to a doctor jointly.
All of this could have prevented the fear, uneasiness, and disquietude I felt when delusional. Approach the personal calmly, listen, observe, and when needed, intervene to assist the person who is struggling. Though it appears we are willingly engaging in delusional thoughts, keep in mind that these thoughts can’t be turned off or ignored and are part and parcel for schizophrenia and psychosis.