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How Can I Support Someone with Persecution Delusions

Recently, a reader asked how to support, or what to say to someone who has persecutory delusions and confides in them. I thought this question was profound. By investigating this question it could help so many people maintain or develop a trusting relationship with their relative, friend, or client, etc. I asked the opinion of my therapist, and she gave some pointers and asked me to remember a time when I was psychotic and what could someone have said to me to make me feel more comfortable...

When I was at my peak of psychosis everything was a sign from God- that truck making a U-turn meant go back, that taxi cab driver telling me to stay out of trouble meant he was in on it too. While I was psychotic I heard conflicting voices. When I would ask someone a question on the phone the voices would give different information. I was extremely paranoid. And almost everyone was a threat. I couldn't confide in relatives because they would tell my secrets, I couldn't trust friends because they wouldn't believe me. I couldn't keep a journal because someone would find it and read it. I was mentally trapped. I remember trying to escape from family, for reasons that I cannot make sense out of, but the belief was that they were after me, and I was scared.

Wondering about the city I spotted a man with a bike, (I thought to myself I could take his bike and escape from everyone), I asked this man questions about his bike. It was early in the morning and I wore a short sleeve top, he asked me if I was cold and gave me his sweater. I took the sweater then eye-balled his newspaper, I was anxious to know what day it was. He asked me if I wanted it and I said no (I don't know why I didn't take the newspaper). By this time I re-evaluated taking his bike, (this man must be an angel- he gave me his sweater because he knew I was cold, and offered his newspaper when I really wanted it, to know the date). We talked about nothing, I asked him random questions like if he was married with children. He told me he was divorced. I asked why didn't he have children, and he replied because his wife was on birth control. I felt at peace with this man. Finally, I told him I had to go and went my separate way.

If he had known I was psychotic and offered support I would have wanted him to say what my therapist suggested: "What can I do to let you feel more safe?" My therapist also suggested that an individual ask the person experiencing psychosis if there was another explanation for their situation, such as why the FBI would be following them or why their family or anyone would try to harm them.

It is important to show empathy by telling the person with psychosis that "I understand you feel like everyone is after you (or whatever the scenario)..." DO NOT PROMISE to keep information confidential because if that individual who confides in you is a danger to them self or to others I would strongly recommend that you contact a professional ASAP.

My therapist also said to try to maintain neutral facial expressions and tone of voice to not come off as threatening. The man that spoke to me was very kind, warm, and concerned for my well being. Also, do not encourage the delusions. Instead, remind them that it must be scary for whatever they are experiencing, but just show your concern for them and how you are there to support them.

I hope this post gave you some insight into how someone feels when psychosis takes over and what you can do to support them. I appreciate you for reading my posts and would love to hear from you- whether it be a question, comment, or simple "hello".

If you would like to learn more information about schizophrenia visit the National Alliance on Mental Illness (NAMI), or Schizophrenia Society of Novia Scotia (Canada).

Comments

K.C. Jones said…
Very well written and good advice! When I used to have hallucinations, I was taught to do "reality checks," where you ask yourself how what you're experiencing could be real. This was when I was at Skyland Trail-a long term mental health center in Atlanta. Since it takes a while to learn how to do this on your own, I was expected to tell someone when I was having a hallucination and then people could ask me questions about it, which helped me realize that what I was experiencing wasn't real.
Schizophrenia said…
A new-fangled drug, Saphris, has received the approval of the FDA for treatment of adult schizophrenia and bipolar disorder I. Bipolar I disorder is an unremitting, vicious, intermittent psychiatric disorder that leads to sporadic episodes of despair, agitation and reduced sleeping patterns. The general side effects in schizophrenics are restlessness or staying totally stock-still, reduced oral sensation and sleepiness.
Chris said…
What an important and extraordinarily helpful and generous posting, Ashley.

Hope you don't mind that I post a link to your site via a sharepost at the Schizophrenia Connection so that it reaches an even wider'audience'?
Hopefully it can help give confidence to friends and family trying to 'be there'for their loved one but of course themselves scared of 'doing /saying' the wrong thing and aggravating matters??
Your article on denial was also very helpful to those living alongside..
You are doing a wonderful job.Thank you.
Wishing you good health,
Chris, UK
PS If you posted again on the Connection I am sure it would be much appreciated!!
Laura said…
I remember when I slipped into psychosis in '07 and I became extremely paranoid, my parents were the only people I trusted. I think it was probably because they were basically housebound. It was a very scary experience.
Ashley Smith said…
Thank you all for your feedback, I am glad this post was beneficial to you.

Christine, please do post a link to this blog on Schizophrenia Connection.

Thank you,

Ashley
The Medcalfs said…
This is very good stuff. I wish many others would connect with your blog. My son and I use some of this and the new ideas are great for any future experiences.
Thanks!
Lisa said…
Thank you for all of your honest and open advise / information / insight. I recently began dating a man with schizophrenia and although he is open and honest with me it really helps to have other insights so that I do not overreact or misunderstand quite as often or as much.

Hello.
Manda said…
Valash,

I found this information very insightful. I think the key is not to support someone's delusions! When I was first diganosed before they found the right medicine, I was very dillusional. At first my parents would support the deluisons. At that time I was seeing eye balls in the walls and they told me to hit them so they would go away. This only fed my delusion. The doctor told my parents not too. And slowly with the right medicine I got better! I don't want to say I don't get delusion anymore, but they are fewer and farther between.

Thanks for the advice,
LA
Anonymous said…
Hi ashley, not sure if u are still using this site or even checking post but I need some information. I feel into really really bad psychosis in 2o10. I have always been paranoid since I was teen..I am a college graduate and have had great jobs. I have always tried to keep the voices at bay not the paranoid tendency at bay. I been put away 4 times. Currently I am starting to get sacred again. I have 4 beautiful angels (grandkids) I don't want my family to know what goes on in my head. These angels are the reason I have been able to function but each month it is getting harder for me to not get up and run away. How did u get better. I was seeing a pych n on medal but left me loopy could not concentrate. Please respond tx
Unknown said…
This is great! Thank you for the information! Can someone contact me personally and message with me? My father has schizophrenia, and I have hit a road block with him....He can now take care of his basic needs, but he is too delusional to be independent. He is now going to court with my uncle, so that guardianship can be taken over him. We wish to put him in a nursing hime because he is delusional, he will not take his medication unless the nurse at the facility he is in temporarily gives it to him. He is also very paranoid and believes that he cannot die, he is immortal...if ANY of you could give me some support or advice..I would thank you forever. He had been undiagnosed for about 22 years...:( without meds. HE has now been on meds since June..please message me! I really am desperate for any advice about how to talk to him about his delusions, how to help him be complaint with his meds.........I already knows the basics about not going along with his delusions and what not. I do have some understanding.....but it would be good to talk to someone who maybe has been dx with schizophrenia and can give me insight:( I love my father and cannot bare the thought of him living in a nursing home forever :( HE can take care of himself now bc of the meds...but is very limited still because of his delusions.. please help!
Unknown said…
This is great! Thank you for the information! Can someone contact me personally and message with me? My father has schizophrenia, and I have hit a road block with him....He can now take care of his basic needs, but he is too delusional to be independent. He is now going to court with my uncle, so that guardianship can be taken over him. We wish to put him in a nursing hime because he is delusional, he will not take his medication unless the nurse at the facility he is in temporarily gives it to him. He is also very paranoid and believes that he cannot die, he is immortal...if ANY of you could give me some support or advice..I would thank you forever. He had been undiagnosed for about 22 years...:( without meds. HE has now been on meds since June..please message me! I really am desperate for any advice about how to talk to him about his delusions, how to help him be complaint with his meds.........I already knows the basics about not going along with his delusions and what not. I do have some understanding.....but it would be good to talk to someone who maybe has been dx with schizophrenia and can give me insight:( I love my father and cannot bare the thought of him living in a nursing home forever :( HE can take care of himself now bc of the meds...but is very limited still because of his delusions.. please help!

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