Q. My husband is a paranoid schizophrenic. He is medicated, but will still occasionally have “break through” episodes of paranoia. I do not know how to comfort or support him without validating his paranoid “delusions” (of cars continually driving by, helicopters following him, etc.) or without his being irritated about my lack of awareness or looking at him “like that” (which I really don’t do…) I need help knowing how to help him through these situations without becoming part of the problem, or without making it worse. I say, I see how you can make these connections, or I didn’t hear that, I don’t see that, or whatever, but there doesn’t seem to be a right answer. Just being there helps him, I know, but I want to help him get through the episodes without the associated Terror and hopefully get through them faster.

A. This is a tricky issue. One reason that this is so difficult is because you are dealing with someone who believes in things or situations that are not real. He is not dealing in reality. You are using logic and reason to battle ideas that are not based on logic and reason. Paranoia is a symptom of psychosis, and psychosis is a break from reality. It is extremely difficult to battle illogical ideas with logical facts and truth, no matter how convincing your argument.

With a rational, non-psychotic mind, you could offer reasonable evidence to prove that you are right and his ideas are wrong, but you cannot do this with someone who is experiencing paranoia. Because he is paranoid, a symptom of a psychotic mind, presenting rational and logical reasons as evidence will help him to believe that you are part of the conspiracy against him. This is an exercise that gets you nowhere and only usually serves to make a person more paranoid. This does neither of you any good.

Perhaps he needs a different medication or something new to stop these “break throughs” of paranoia. That is really the only tried and true treatment for paranoia. The best thing that you can do is to be supportive of him. Do not try to argue with him, prove him wrong or gather evidence as to why you are right. With a paranoid person, you can argue with them until you are “blue in the face”, present the most convincing proof as to why he or she was wrong in their thinking, and they, in unbelievable fashion, still manage to come up with other reasons or ideas about why they are correct and you are wrong. This battle is not worth the time because it never works. In sum, don’t try to prove him wrong, talk to him or his doctor about a medication change and remain supportive-that is about all that you can do. I hope this helps. Please write again if you have any more questions.