Do you know someone who struggles with delusional thoughts? A delusion is defined as a belief, that is strongly held to be true, despite evidence to the contrary. It is a fixed and pervasive way of thinking that is not easily derailed by logic. For many people attempting to cope with loved ones who have delusional thoughts, it can be extremely difficult to communicate with the person or live peaceably with them. Another component that results in much stress in families is that the person with delusions does not always seem to be ill. In other words, the individual may go in and out of “consciousness” and show moments of insight, emotional awareness, and engagement. However, this only lasts for a short duration. Are you experiencing a situation like this or know someone who is? If so, this article is for you. This article will discuss the things we can do to make communication slightly better with those who struggle with delusional thoughts.
Living with a loved one (spouse, child, adult child, extended family, or parent) who is suffering from delusional thought patterns can literally flip a life upside down. Everything that was once very logical to the person becomes questionable and the delusions begin to take over. When delusions take over, there is nothing or no one who can stop it. Delusional disorder or other mental illnesses where delusional thoughts may be present (i.e., schizophrenia, psychotic disorder, major depression with psychotic features, etc), results in the individual becoming suspicious, hypervigilant, angry or hostile, confused, and paranoid. For many individuals suffering from delusions, it can be very easy for the person to become confused and paranoid which often leads them to make accusations, easily lose perspective, and maybe even change in temperament. For example, a wifewho isstruggling with delusional thoughts may believe that her husband is out everyday after work taking his female co-worker to dinner (i.e., paranoia), although there may be no proof of this, and that their marriage should end immediately (i.e., confusion and hostility). Many of my client’s have reported the challenge and deep seeded fear that can result from having a parent with delusional thoughts and paranoia. Delusions, paranoid thoughts, and other psychotic symptoms that are not being managed with medication and therapy can continue to cause deterioration in the suffering person.
As a result, it is important that we learn how to cope with someone who is suffering. A few tips I often provide to clients struggling with family members is that we must
- Pay attention to the emotions of the person: Delusions and paranoia can be very difficult to understand. What is logical to us may not be logical to the person suffering from paranoia or firmly help, yet inaccurate thoughts. Because of this, you want to train yourself to avoid arguing your point or arguing over the reality of a situation. You want to pay attention to the emotions of the person and how the person is feeling in regards to their inaccurate beliefs. If you try to argue facts or logic, the person will shut down. Try to stay focused on consoling the person, offering support in ways that you can, or just listening in a nonjudgmental fashion.
- Discuss the way you see the delusion: Although you do not want to argue facts and logical, you can express that you see the situation in a particular way and while you want to understand the situation to the best of your ability, you cannot. Sometimes it might be wise to say something like “I understand this is hard for you. I would feel the same way. I’m sorry I cannot understand this 100%, but I certainly get why you feel the way you do.” You are not trying to be correct. You are not trying to be right. You are trying to be understanding while also expressing how you see the situation.
- Express that you are concerned about the person: There may come a time when you simply have to tell the person that you are concerned about them. You certainly do not want to express this in a condescending manner. You want the person to believe that you care and are concerned about how their thoughts and feelings are affecting them. You can say something like “it is obvious that you are stressed and overwhelmed. Have you thought about seeking a therapist, someone who can hear you out and provide unbiased support?”
- Offer to pursue therapy together but be strategic: You can offer to attend a few therapy sessions or to receive therapy with different therapists on the same day. This strategy gives the impression that you are not only supporting the person in their own recovery but also seeking insight into your own needs. You can also truly benefit from therapy if you find a good therapist to see. A good therapist will teach you how to respond, interact with, and cope with the person who is suffering from delusions or paranoia. Seeking therapy together also helps the individual see that you too are in need of support in some way.
- Ask the person why they believe as they do and be open-minded: It is okay to ask the person why they believe as they do. You can also ask the person to explain when their beliefs began and why. The person may try to explain it but will often seem unable to. The persona may also become suspicious and paranoid as to why you are asking about their beliefs. But some people will simply explain their side of things. Either way, you don’t want to make the person feel defensive. You just want to get “inside their head” and see how far into their beliefs/paranoia they are. This can be helpful information for when/if the person seeks therapeutic intervention.
- Avoid getting frustrated and expressing that to the person: It is important to remember that the person is ill and in need of compassion. This can be extremely difficult, especially if the individual suffering begins to attack loved ones or a spouse. When you are the target and trigger of the suffering person, you may not feel as if you can avoid getting frustrated or defensive. That is understandable. But it is well worth it to try. You want to learn how to derail inaccurate thoughts and beliefs by downplaying them with your own responses. If you get frustrated or angry in response to a paranoid belief, you will likely inflame the situation more.
- Learn about Cognitive Distortions or Thinking Errors: We all engage in thinking errors at some point in our lives. We can exaggerate details, we can look at only the negatives in a situation, we can be judgmental without appreciating imperfection, we can become defensive if things don’t go our way, etc. We all struggle with thinking errors. It’s inevitable. I encourage you to learn more about cognitive distortions and how they may influence your reactions to the sufferer.
- Do model engaging in reality testing: Weigh the evidence for or against the delusions can be helpful not only to you but the person suffering from delusions/paranoia. The person may argue with you or find ways to defend their point of view, but it may be helpful to model weighing the evidence for a belief. When you show that you are able to consider various points of view and question things, you are modeling normal thought processes. This may or may not be helpful but it is worth a try.
As difficult as it may be, there are some situations in which separation or divorce is the only way to cope with a loved one who is suffering from delusional thoughts and beliefs. If the individual is refusing to seek psychiatric treatment (medication or therapy), it will be important to determine what is worth salvaging in the relationship and what is not. Safety is important. Emotional health is important. If both safety and emotional health is in jeopardy, you may have to make some very tough decisions, especially if the person refuses help.
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As always, I wish you well