How Can I Help My Delusional Family Member? (Part 1)

There are times when it seems like others are being mean ... all the time. If others can observe and relate to that experience, then in all liklihood you might read up on how to deal with bullies. Today's discussion is a little different. There are times when people have this feeling even though others can't qualify the experience. There are people that feel persecuted and it can be a very crippling experience. They are unable to use "Reality Testing," our way of making sense of the world we live in that includes the utility of third party perspective-taking.

The presence of persecutory delusions is serious and needs to be evaluated by a doctor. These can manifest as a result of a severe urinary tract infection, neurocognitive degeneration, schizophrenia, or other serious condition. Any medical explanation needs to be explored and treated before considering psychological conditions. The content of this article presumes this has been done and you are trying your best to be helpful.

Imagine being Sandra Bullock and for some reason your life has been completely erased. Try telling the policeman parked at the coffee shop that people are after you and you have been chosen to save the world with an encrypted data disc that was stolen from your office. I can't really remember how that movie played out, but the fictitious character she played had reason to fear for her life. People suffering from persecutory delusions are living in fear, beleaguered by mistrust, and have a reduced capacity to find solace.

If your loved one is turning to you for help, this is good. This means that in a very scary world, you are the ONE person that can offer a sense of safety and security. It can be extremely frustrating trying to logically make sense or reason with a person who suffers from persecutory delusions.

One of the most important things is to keep a neutral tone. If you are frustrated, this can be an extremely difficult thing to do. In order to keep a neutral tone, you have to manage your frustration.

I know I'm presenting this point second; however, First and foremost, you need to adjust your expectations of this person. For this person, reality testing is like trying to solve differential equations when lacking skills to solve algebra. Try baking a cake from scratch if you've barely mastered the shake 'n' bake technique. How about building a car from the frame up if you can barely put two Lego pieces together. Yes, reality testing is THIS HARD for persons suffering from persecutory delusions. Your frustration tolerance will change commensurate with the magnitude of your adjustment of expectations. So, keep in mind that these experiences are fragmented and illogical in nature and there is no way to rationally understand why your loved one feels persecuted just because someone happened to glance in their direction, laugh among their friends, or mention that there isn't any yogurt in their refrigerator.

Now that you know Reality Testing isn't within their skill set, you can model it by asking questions out loud (in a non-confrontational manner) that challenge different aspects of the delusion. Ideally, you will have your own support resource to rehearse and decompress. The National Alliance for the Mentally Ill offers support across the country. I recommend you connect with a professional support resource to be as effective as you can be while maintaining as much of your strength as possible.