Every person with psychosis and every problem is different. It’s not possible to give advice on how to deal with every problem and every eventuality.
There are some basic principles, however, that usually apply. They often underpin the techniques that professionals use when they talk to people about their problems.
1. Avoid argument (or extended discussions) about voices or delusions where possible.
Why? This can back the person into a corner and make them work even harder to prove it’s true.
Say “I can’t understand why you feel that people are against you. Maybe you should discuss it with your doctor.”
2. Avoid getting angry if you can.
Why? You’ll feel worse. Your relationship may suffer and it usually does not work.
Do/Say Take a break/time for yourself. Think “It’s the illness, not the person talking.”
3. Don’t agree with delusions or beliefs about the voices.
Why? Your relative could interpret this as evidence that their thinking is correct.
Say “From what I’ve learned over the years I’m sure that radio waves could not be controlling your thoughts.”
4. State what you believe about the delusion or voices very clearly.
Why? Reduces the chance that they will misinterpret what you say.
Say “I am 100% sure that I am not putting voices in your head deliberately.”
5. Recognise and sympathise with distress and boost self esteem.
Why? Everyone feels a tiny bit better when they know someone cares and getting a positive response encourages people to come back for more.
Say “That must be horrible for you. I don’t know how you’re coping with this? You’re very strong/brave/determined.”
6. Acknowledge that it’s his choice/right to believe what he believes (even though you know it’s wrong).
Why? Reduces conflict. Prevents them having to justify their belief.
Say “I understand that’s what you believe and you have a right to that. I just can’t work out how it might be happening, it doesn’t seem real to me.”
7. Give people time and space to express themselves.
Why? When under pressure, it is harder to communicate effectively.
Say “Can I just check I have got this right…(offer a simple summary of what they have said).”
8. Encourage talk/discussion of alternative theories/ideas.
Why? The illness makes odd beliefs “feel right”. Recovery often involves the gradual exploration of new explanations.
Say “When the voices first started, what else did you think they might be?” “Have you spoken to anyone else who hears voices? What explanation did they have?”
When John started telling me that his voices wouldn’t let him go out of the house, I found myself arguing with him. I think this made John believe I was in some way blaming him for his illness. I knew that I wasn’t helping John or myself but I just didn’t know what else to say to him.
After a while, I found that by accepting that John had these voices no matter what I thought about them, helped me and I started to be less irritated at John. John started to talk with me a bit more about what they were saying, and some of the things they said to him were really awful. He does so well to deal with that every day.
Which of the Top Tips do you already use?
Are there any you would like to try?