Five Tips for Dealing with Delusional People

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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.

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10 responses »

  1. I’m about at my wits’ end and I’m not sure what to do. This seems like very good advice though. My wife is currently experiencing delusions. Do you think it would help if I asked her to read your post? Thank you.

    • I don’t think it could hurt and she might be able to give you some insight into what she is feeling. The feeling here is important, since being delusional isnt grounded in in reality. If she seems to have no awareness of her medical condition, you might need to intervene, since true delusion indicates a break from reality and reason. It’s not a comfortable place to be even if she seems to be “content” to be in that place.

  2. Hi, I’m 15 and my mam is suffering from delusions. She has grudges against family members and keeps accusing people of things they didn’t do. Shes actually quite nasty at times.

    Its been happening for years now but shes been on tablets which kept her fine. However shes being slowly taken off them again but as shes doing so shes gradually getting worse.

    What do I do, my family knows about it but nobody’s doing anything really because they dont know how. She won’t accept that there’s anything wrong so won’t tell the doctor. I want to do something about it but I dont know who, it’s really sad that shes taking a step back but we cant really cope with it. Who should I tell?

    • Hi, Amber.

      Unfortunately it gets really complicated fast when dealing with adults in this kind of situation. I would say really try approaching your mom and tell her you would like to do a “reality check” with her. Remind her of times past, when she was delusional, and then remind her of times when she is on medication.

      Convincing her is the shortest path, but may not be the easiest. Try to approach her without judgment and with compassion. She’s probably not very comfortable and may listen if you provide gentle grounding.

      • Hey thanks, she’s been pretty quiet lately but I’ll try that next time there’s an issue :) x

  3. My boyfriend is paranoid, and also grandiose. He has got into a cycle of telling me, again and again, about these “spiritual experiences” he has had – dreams which identified a murderer. He says he told the police, and then he saw the policeman he spoke to socializing with the killer (as identified in his dream). He is obsessed with this – that he knows who the real killer is, and that he’s in danger from the police because of it. He goes on and on, in this dark, morbid way and is angry if I don’t agree. So I listen for a while then say I can’t listen to any more of it.

    He is paranoid about everyone and everything. Every friend he has “betrays” him in the end. He is forever examining their words, even utterly innocent ones, for insults. He believes every conspiracy theory going. He goes on about the end of the world, how the rich will kill off the poor, etc.

    I am so tired of it. I can’t listen any more.

    I keep all my feelings to myself while he is going on and on.

    He has seen a psychiatrist but was only diagnosed with paranoia due to anxiety. I think you have to know him well to see how deep it really runs.

    I am making decisions as I write this.

    • I would say to him, “My experience is not yours, and my experience tells me this may not be true as you suspect.” Sometimes it does take leaving people for them to see things aren’t going well. Since it is the typical response, however, to leave people, maybe you can find a way to be a supportive friend after a while if you decide to leave him. I suggest being repetitive, short, direct, and plain with him if you do break up.

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