Will talking about someone’s delusions make them sicker?

Watching someone you care about experience delusions is scary. You want to help, but you’re not really sure how. How can you talk about what they’re going through without making things worse?

Don’t try to convince them it’s not real

From the outside, it seems obvious that what the person is seeing, hearing, or thinking isn’t real. You might think that if only you can convince them it’s a delusion, everything will go back to normal.

But when someone is experiencing a psychotic episode, their delusions become fixed. This means that the person has absolutely no doubt that what they think, feel, see, or hear is real. There’s nothing you can do or say to convince them otherwise… But you also won’t make the delusions more fixed if you talk about them. Talking about the delusions in the right way can actually be helpful!

Rolling with the delusions

If your friend or family member is constantly talking about delusions, it’s best to “roll with it” until you can figure out what will help.

Rolling with delusions means talking to your family or friend about what other changes can help reduce stress. So for example, if they believe someone is watching them, what changes can you make in the house to help them feel safe? A conversation might look like, “Ok, so you feel like ____, what do you think will make it better?” Identify behaviors, supports, or environmental changes that will help them to feel calm.

Remember that your goal is to get through this period with minimal stress, not to convince them that their delusions aren’t real. (If anything, arguing with them about their delusions can stress them out—and stress can make a psychotic episode worse.)

Meanwhile, you can work with medical professionals to identify what can be done. Often this will involve medication, and possibly hospitalization.

Learning from psychosis

Once the person recovers—they become stable and realize that what they experienced wasn’t real—your instinct might be to avoid talking about their delusions. It’s natural to want to just go back to “normal.” But if you just pretend it didn’t happen, you’re missing out on an opportunity to gain lessons from their psychotic episode.

Understand that delusions and hallucinations are also reflections of real fears and trauma. There’s a reason why they’re having this particular delusion, and why it’s affecting them this way. Once the psychotic episode is over and the person realizes it wasn’t real, understanding the symbolism behind the delusion can help them recover.

Instead of ignoring the delusion, ask them what they think their delusions or hallucinations were about. It’s good to review your crisis plan (or make one if you don’t have one), and talk about their options for medications or support. And talk about your own feelings and experiences. Having open, safe, and constant communication is key to a successful recovery.

In her TED Talk, Eleonor Longden talks about how looking for the symbolism in her hallucinations helped her recover from psychosis:

The Hearing Voices Network is a great resource to help you understand how to listen to delusions and hallucinations rather than fight them.