Understanding your loved one: Coping with delusions

Maintaining a relationship with a loved one who may be experiencing delusions is like walking on shaky ground. Every step you take could land you in an argument or adversarial position. Whether you intend to argue your points or attempt to bring reality to the attention of your loved one, you will always be on the opposing side. Delusions are strong beliefs held to be true despite evidence to the contrary.

Here is a listing of types of delusions to be watchful of:

1. Grandiose type: Delusions involve inflated worth, power, knowledge, or identity. This is not the same as narcissistic thinking. Grandiose delusions might sound like this: “I am usually more intelligent than most, so I must rid the world of people not as smart as me.”
2. Erotomanic type: Strong belief that another person of higher status (celebrity, congressman, etc.) is in love with them. This can occur even when there has been no relational ties with the person.
3. Jealous type: Strong belief that an intimate partner is being unfaithful, despite evidence to the contrary.
4. Persecutory type: Delusions or strong beliefs that the person is being persecuted or malevolently treated.
5. Somatic type: Delusion that the person has a physical defect or medical condition. This is different from hypochondria.
6. Mixed type: Delusions that may entail all of the above.

There are a few things you can do to cope with this behavior:

1. Don’t argue: It is going to be very difficult to unravel the entanglement of delusions that your loved one is entertaining. Keep in mind that they truly believe what they believe and they have a “deficit” in deciphering truth from fiction. This person needs a certain level of compassion.
2. Don’t directly reject the delusion: I’ve learned from experience that delusions are strongly connected to emotions, so it will be difficult to reject that person’s belief without becoming confrontational. You want to take a neutral stance. You can do something simple such as getting off the topic or redirecting the conversation in a subtle manner.
3. Don’t jump to pathologize: Don’t label your loved one’s delusion(s) as psychiatric just yet. There are cases in which delusions are part of medical or neurological conditions and also what I call “conditions of human nature.”

This is a very difficult situation to live with. It is difficult to view reality from your loved one’s perspective when you know their perspective is skewed. It may be helpful for families and caregivers to discuss this situation with a therapist and ask for a consultation. In any event, make sure to take care of yourself and remember: do not argue with them. You won’t win.

I wish you all the best

For information on how to distinguish what type of delusions your loved one may be experiencing, visit my “sister site” at Caregivers, Family, and Friends.