Communicating with a Person Who Is Having Delusions

Todd Belok serves as a mental health technician at the Temple University Hospital Episcopal Campus in Philadelphia, Pennsylvania. Todd Belok comes to this role with seven years of experience in psychiatric care, during which time he has built an in-depth knowledge of delusions and other symptoms of mental illness.

A symptom of many different mental disorders, including schizophrenia and bipolar disorders, a delusion manifests as an irrational and often strange belief. The most common involve believing that one is a person of grand importance, that one is being tracked or persecuted by the government, or that extraneous events specifically relate to the individual’s personal life. 

The individual with a delusion holds onto his or her belief with extreme conviction and cannot easily dismiss it, even in the face of objective evidence. One cannot eliminate the delusions by challenging them, as doing so is likely to cause the person to become defensive and hold more tightly to their convictions. Unfortunately, it is also unwise to play along with the delusion, as the person then feels that the delusion has been confirmed as true.

According to experts, the more effective and therapeutic alternative is to be empathetic but inquisitive. It is possible to say that one understands why an individual with delusions would be upset given a certain set of thoughts, even if the person speaking must honestly admit that he or she does not fully understand the thought process. 

This empathetic expression can lead into non-judgmental questions about how a person came to his or her beliefs and how he or she will respond to them. This requires the individual with the delusion to explain it, which can help him or her to begin to realize the lack of logic in the situation. It is important not to jump on this moment and force an admission of irrationality or dismiss the delusion, but rather allow the person to process his or her own thoughts at his or her own pace.