Have you ever met someone who is totally convinced that what they believe is true despite the lack of evidence? The person has what is called a delusion. For example, I had a patient who really believed bugs were crawling in her skin. There was no evidence of this being true but she heartily believed it. She had what is called a fixed delusion. A delusion is something you believe but is not true. It is a false belief.

A person with a delusion might believe the government is watching our every move, or that their neighbor wants to steal something from him. Sometimes people believe someone is in love with them when they are not. A person may think she has an extraordinary talent when there is no evidence of this (Think music audition shows!). No matter the type of delusion, something can happen and the person misinterpret that event to reinforce their belief. Then, they hold that belief with conviction.

The question is, how do you help someone with a delusionf? Here are a few guidelines:

Establish a trusting relationship. You won’t be able to talk the person out of a delusion. So focus first on developing a strong  and trusting relationship with the person. Then consider this: Delusions can be reflections of real fears or trauma. The false belief may be protective or adaptive related to deeper issues. Sometimes delusions can be a sane reaction to insane circumstances.

Listen for the content. Then try to understand the purpose behind such a belief. What is the feeling or tone of the delusion? Again, don’t try to convince the person the delusion isn’t real. It won’t work, but you won’t make it worse by talking about it. And you can try and understand what is important in that delusion. Why does the person need it and how does it protect the person? Is it functioning like an emergency response system for the person?

Determine if the delusion is interfering with the person’s life. How frequent is the delusion? Does it lead to fear or paranoia? If the delusion is harmful to the person, that is more of a problem. Consider if there is anything you can do to lessen the stress around the delusion. For example, if someone believes they are being watched, you might say, “What do you think would make that feel better?” Try to decrease stress around safety as that might help the person’s thinking. Let the person know that it must be difficult to believe what they do and feel safe.

Manage the environment. If the person is concerned about the neighbor being the FBI, suggest they avoid that neighbor for awhile. Or if they think, the government is listening to them through the TV, then suggest they don’t turn the TV on when they feel unsafe. The idea is to manage the environment as much as you can to reduce stress. If the delusion causes any self-harm, the person needs to be hospitalized.

Redirect or distract the person from the delusion. Listen but you don’t have to respond to what they are saying. Instead, try distracting them to other activities or things.

Overall, express your concern fo the person. Tell them how you see things differently and express concern as to how this belief is impacting their life. Maybe suggest talking to a therapist because of the distress involved. Professional help is probably needed. Delusions can be treated even though they might not be cured.