When you think a person has a delusional idea, it is so important to remember that they often have amassed a significant amount of evidence to convince them they are correct. They likely know what they used to think, it is just that what they currently think seems to be more accurate. In fact, we consider ways the persons’ course of study might make some of their ideas more accurate than mainstream ideas on some occasions!
Ask Yourself: How Did You Get So Lucky to Witness a Delusion!
In many cases, the delusional person has experience in the mental health system has had other people tell them they are delusional in the past. Thus, the fact that they have let you know their thoughts is significant. To know how to respond, it can be important to know why they have told you their thought in the first place.
Maybe they have told you because:
- You have spent time with them so that they trust you,
- They have hope that you can help them,
- They presume you and everyone else have had the same experiences that they have,
- They are desperate and endangered in their emergency,
- or perhaps they are just testing you out to see where you stand in the conspiracy.
It is a good idea to understand why they have shared the idea and be delighted that they did.
In group therapy, I have found countering with your own experience with delusions and stories about what happened to you, and encouraging others to do the same, helps invite exploration. More on this later.
Don’t Presume Delusions are Wrong, Explore and Confirm Ways They Are Right:
In dealing with people in a mental health setting who are labeled as delusional, across the board, I think the worst thing that you can do is confront them and tell them you think they are wrong! They historically don’t have enough support in the world to be able to agree to disagree and it can really hurt them to hear that you too don’t believe or care about what they are going through.
Ultimately, more and more we are finding that voices and other experiences that make them delusional have value! The hearing voices movement has helped emphasize the importance of this. Often, the delusional person will need to know that you believe this before they will let you be of assistance to them.
Even if a delusional person asks you your opinion and says it will help, I believe you will be far more valuable to them if you are willing to spend a little time getting to know the journey of what they are experiencing without having an agenda.
Believe me they will be testing you to see if you have an agenda.
How can it hurt them or you to listen for a while? We often entertain ideas from distinct ideologies and look for common ground to make relationships. Instead of looking for ways they are wrong, confirm ways that they are right.
Join in and Contribute Conspiracy Ideas:
It is far more effective to share conspiracy ideas that you have yourself to normalize their experience. Do you think JFK was really killed by Lee Harvey Oswald? Clearly there is some degree of conspiracy that you can buy into! In group therapy that I have run over the past eleven years, it is helpful to normalize conspiracy topics and collaborate with them.
When “delusional” people get together and get invited to share, they often help each other by working together to excavate these ideas or experiences. Often, they will not volunteer their thoughts unless other conspiracies are on the table. Expounding on conspiracy with peers is a great way to tease them out.
I have learned to respect conspiracy ideas as bearing the potential of being more correct than mainstream ideas; but also bearing the possibility of being wrong when examined over time. I find that most delusional people can accept this with reflection. A group is often effective if it just lets the conspiracies rip and gets people talking.
The Importance of Finding Out How the Idea Came into Being:
As I suggested above, conspiracy ideas don’t come from nowhere. They come from a long string of experiences that get put together. I call these experiences special messages. A lot can be achieved when a delusional person is willing to identify what experiences they have had that help them think this way.
When experiences can be uncovered and identified, I believe the delusional person will feel a sense of relief and will be more mindful of those experiences. I don’t believe that identifying experiences only serves to reinforce them,
Think of it this way: being more mindful means, they judge them less and accept them more. Instead of racing to solve the conspiracy that may threaten their existence, they can reflect on the one experience with someone else. As if each experience was traumatic, uncovering it and clearly explaining is more likely to help the person let go of it.
Identifying These Underlying Experiences in a Group Context:
In group therapy with other delusional people, defining the different kinds of experiences that can lead to delusions (or what I prefer to term divergent views) can help facilitate associated stories that highlight certain kinds of special messages. A group facilitator can share their own experience with an experience and others can relate to it. This way individuals become more aware of their experiences.
Examples of special message experiences are things like:
Sensing the thoughts of another,
Having others be able to sense your thoughts
Seeing clues of conspiracy in media,
Seeing clues in words,
Seeing clues in numbers,
Seeing clues in the world that surround you
Not Moving too Fast:
Often, before a delusional person is willing to disclose their underlying experience, they may need to have a corrective experience of making sure they will not be punished or incarcerated again for sharing their ideas. There is a tendency in mainstream treatment to impose reality on delusional people that often comes with loss of rights, unwanted medications, and, most commonly, by being ignored or called “crazy” or “delusional.”
Additionally, many have experienced severe poverty, like homelessness, as a result of their delusional ideas and these kinds of depravations can be perceived as an even worse form of punishment.
Thus, a facilitator is wise to recognize when a delusional person just needs to tell their shocking stories and beliefs without connecting with others or disclosing underlying experiences. This story, while it may raise eyebrows, may be getting told to establish safety and freedom from punishment. It needs to be encouraged and valued by the facilitator even if other delusional people don’t get it.
What About Reality Testing?
Someone who is delusional for some years likely feels oppressed in the mental health. Reality testing often leads to an end in the exploration or relationship.
It is important to remember that, in most cases, the person who is looking for reality testing would prefer being in control of the test. They may ask you questions and trick you to get authentic answers.
For best outcomes, anticipate this and provide persistent authenticity. Thus, all questions need to be answered with honesty, without defensiveness, and with congruent non-verbal and verbal responses.
Rarely will your feedback resolve the issue and experiences they are having. It is possible that the experiences they are having will continue to some extent for a while. But hopefully they can get to the point where they trust you through it all.
I work with delusional people a long time before I try to provide reality feedback. I generally do this when the person is testing me to see if I am the mastermind of their problems. When I am aware of this happening, I believe correcting them via non-verbal cues, and communicating about the feedback they are receiving from me can help.
In general, I will support what I think they believe to the best of my ability. Indeed, I still believe that often delusional people are correct in ways that are surprising.
Teaching the Public What You Know:
In fact, delusional people are quite common. But when delusional people are treated in the mental health system, the result be very severe isolation. Too often, this isolation is totally reinforced in repressive treatment that tries to further suppress traumatic experiences, rather than heal.
A far better strategy is to try to change public opinion about underlying experiences like ESP or voices. are and how to further include people who experience an influx of them in crisis. Most people get feedback from dreams, nonverbal communication, and intuitions, which are types of underlying experiences. They can learn to relate