Dealing with a paranoid spouse
January 13, 2015 7:09 AM Subscribe
Does anyone have advice on how to deal with a paranoid spouse while we wait for professional help?
I am not asking for medical advice.
My wife has been getting increasingly paranoid recently. We have made an appointment with a psychologist, but that's still 2 weeks away. I need help keeping things on an even keel in the meantime.
She will get very worried/stressed about quite implausible things, usually about individuals or groups taking actions or conspiring because they have a personal grudge against her/us, and wants me to take elaborate precautions to avoid these unlikely events.
When I try to explain that X or Y happened for perfectly mundane reasons, there's no evidence that [person] or [group] actually does have a grudge (or even cares in the slightest) and [implausible scenario] is very, very unlikely to happen, and not something to worry about, she gets angry with me for not taking her concerns seriously.
Has anyone got advice for navigating this maze? I want to keep her calm, but trying to rationalise with her doesn't seem to work. Should I pretend to agree with her concerns? That seems insincere, and likely to increase her worries.
I am not asking for medical advice.
My wife has been getting increasingly paranoid recently. We have made an appointment with a psychologist, but that's still 2 weeks away. I need help keeping things on an even keel in the meantime.
She will get very worried/stressed about quite implausible things, usually about individuals or groups taking actions or conspiring because they have a personal grudge against her/us, and wants me to take elaborate precautions to avoid these unlikely events.
When I try to explain that X or Y happened for perfectly mundane reasons, there's no evidence that [person] or [group] actually does have a grudge (or even cares in the slightest) and [implausible scenario] is very, very unlikely to happen, and not something to worry about, she gets angry with me for not taking her concerns seriously.
Has anyone got advice for navigating this maze? I want to keep her calm, but trying to rationalise with her doesn't seem to work. Should I pretend to agree with her concerns? That seems insincere, and likely to increase her worries.
You're not going to reason her out of paranoid ideation. I think what I would do is try to keep her from acting on anything for the next two weeks.
Also, if this is a sudden onset thing, you may want to take her to a regular general practitioner while you're waiting for a psychologist. There are all kinds of medical conditions than can cause this.
posted by empath at 7:17 AM on January 13, 2015 [5 favorites]
Also, if this is a sudden onset thing, you may want to take her to a regular general practitioner while you're waiting for a psychologist. There are all kinds of medical conditions than can cause this.
posted by empath at 7:17 AM on January 13, 2015 [5 favorites]
Do make sure that your environment is safe. No guns. No unnecessary medications in easy reach.
How long is your wait for help? If you think she might be a danger to herself or others call your doctor right away and see what resources might be available in the near term. Does she exercise? Maybe a good daily hike to wear her out would help. Suggest she write her worries in a diary. That could be helpful to identifying patterns later.
posted by amanda at 7:18 AM on January 13, 2015 [3 favorites]
How long is your wait for help? If you think she might be a danger to herself or others call your doctor right away and see what resources might be available in the near term. Does she exercise? Maybe a good daily hike to wear her out would help. Suggest she write her worries in a diary. That could be helpful to identifying patterns later.
posted by amanda at 7:18 AM on January 13, 2015 [3 favorites]
Take her concerns as seriously as possible so that she feels your support. It sounds like reasoning with her isn't helping? At least she will feel safer if you provide unoconditional support than if she feels you are not looking out for her, which someone with paranoid tendencies may well do, and that would lead to a lot of stress for both of you. You should also consider getting counilling yourself so that you can better navigate her treatment and your role in augmenting her recovery or management.
posted by waving at 7:18 AM on January 13, 2015
posted by waving at 7:18 AM on January 13, 2015
What helps with the paranoid person in my life is to listen without refutation or helping. No explaining how implausible her theory is, no trying to solve anything. Just let her get it out and acknowledge how much it's worrying her without trying to fix the problem (either with logic or by indulging the paranoia).
That's obviously not a long-term solution, and isn't helpful if she's endangering herself or really suffering. But, if her paranoia is mostly her worrying at you, it does help maintain a more or less pleasant emotional atmosphere during an episode of paranoia since it stops you from becoming her adversary and ensures she feels like her concerns are heard.
posted by snaw at 7:20 AM on January 13, 2015 [15 favorites]
That's obviously not a long-term solution, and isn't helpful if she's endangering herself or really suffering. But, if her paranoia is mostly her worrying at you, it does help maintain a more or less pleasant emotional atmosphere during an episode of paranoia since it stops you from becoming her adversary and ensures she feels like her concerns are heard.
posted by snaw at 7:20 AM on January 13, 2015 [15 favorites]
Yeah, I second empath on taking her in to see her doctor while you're waiting for the psych eval. Does she have any other symptoms? Weight loss, difficulty sleeping, trouble swallowing, tremor, strangely warm and sweaty all the time? I would definitely mention anything out of the ordinary to her doctor, even if it's something that doesn't seem like it could possibly be connected.
For dealing with her fears -- I would go with acknowledging her feelings but not reasoning with her fears. If she thinks Sally is trying to kill her cat, don't reason with her about why Sally wouldn't do that, and don't wrap the cat in duct tape. Instead: "It must be really stressful to think that. I'm sorry you're so stressed out right now. Is there anything I can do that might help with the stress? Do you want to take a walk/nap/watch a movie/whatever?"
Beyond that, I would keep the environment as safe as possible, and also remember that you may need to pull the cord and go to the ER before the psych appointment comes.
posted by pie ninja at 7:24 AM on January 13, 2015 [7 favorites]
For dealing with her fears -- I would go with acknowledging her feelings but not reasoning with her fears. If she thinks Sally is trying to kill her cat, don't reason with her about why Sally wouldn't do that, and don't wrap the cat in duct tape. Instead: "It must be really stressful to think that. I'm sorry you're so stressed out right now. Is there anything I can do that might help with the stress? Do you want to take a walk/nap/watch a movie/whatever?"
Beyond that, I would keep the environment as safe as possible, and also remember that you may need to pull the cord and go to the ER before the psych appointment comes.
posted by pie ninja at 7:24 AM on January 13, 2015 [7 favorites]
she gets angry with me for not taking her concerns seriously.
Say calmly and firmly, "well, then, I'm sorry, but then we'll just have to agree to disagree." Repeat as necessary.
Also, what snaw said. Good luck!!
posted by Melismata at 7:25 AM on January 13, 2015
Say calmly and firmly, "well, then, I'm sorry, but then we'll just have to agree to disagree." Repeat as necessary.
Also, what snaw said. Good luck!!
posted by Melismata at 7:25 AM on January 13, 2015
You can empathize with the emotion underlying the paranoia without agreeing with the paranoia. "That sounds really stressful," "It sounds like you're really upset about that," "I can see how that would worry you," etc.
Arguing about the external facts is most likely going to cause her to dig in her heels more.
posted by jaguar at 7:26 AM on January 13, 2015 [14 favorites]
Arguing about the external facts is most likely going to cause her to dig in her heels more.
posted by jaguar at 7:26 AM on January 13, 2015 [14 favorites]
Here's a short guide to help caregivers coping with delusions and other symptoms of schizophrenia (not diagnosing your wife with schizophrenia, that's just the mental condition most commonly associated paranoid delusions).
posted by drlith at 7:27 AM on January 13, 2015 [2 favorites]
posted by drlith at 7:27 AM on January 13, 2015 [2 favorites]
If you spend too much time refuting the paranoia, you run a serious risk of appearing to be in cahoots with whoever she is paranoid about. And it will be easier to act as a caregiver if she is not paranoid about you too.
posted by emilyw at 7:31 AM on January 13, 2015 [3 favorites]
posted by emilyw at 7:31 AM on January 13, 2015 [3 favorites]
If [person] or [group] really did do a thing, acknowledge that the thing happened. Try to validate her feelings as much as you reasonably can. If there is any kind of positive action that you are willing to take, emphasize your willingness to do that. For example, if any kind of prayers or blessings are things that you believe in, you could pray out loud for or bless your wife. Or offer to do things that will help both of you take your minds of the stress, like eat popcorn and watch a movie.
posted by Bentobox Humperdinck at 7:31 AM on January 13, 2015
posted by Bentobox Humperdinck at 7:31 AM on January 13, 2015
No good comes of trying to get her to see "the truth" or egging her paranoia on by agreeing with her conclusions/delusions. Both just increase anxiety. The best thing to do while you wait for professional assistance is to listen to her concerns without judging them positively or negatively and then try a gentle redirection. Pie ninja's script is ideal.
And unless there's a danger issue, sometimes it's just easier to go along with new/odd routines until professional help is available. For instance, my ancient aunt had serious dementia with paranoia before she died and she was obsessed with putting saran wrap on all the doorways. Attempts to prevent her from doing this could end in violence. When she was allowed to just put up the saran wrap, peace prevailed.
posted by xyzzy at 7:32 AM on January 13, 2015 [1 favorite]
And unless there's a danger issue, sometimes it's just easier to go along with new/odd routines until professional help is available. For instance, my ancient aunt had serious dementia with paranoia before she died and she was obsessed with putting saran wrap on all the doorways. Attempts to prevent her from doing this could end in violence. When she was allowed to just put up the saran wrap, peace prevailed.
posted by xyzzy at 7:32 AM on January 13, 2015 [1 favorite]
I asked a question about paranoid folks coming to my workplace a while back here. Living with someone means that some of the comments are not relevant, but there were some links to readings about de-escalating. What I got out of it was to basically not engage with the literal content but the emotional content. "That sounds really stressful, no wonder you came to us for help. How long have you been worried about this? Two weeks? That's such a long time! Have you been able to get sleep at all during that time?" We've had one other person since that Ask and they were pretty amenable to being redirected in this way.
posted by tchemgrrl at 7:32 AM on January 13, 2015 [12 favorites]
posted by tchemgrrl at 7:32 AM on January 13, 2015 [12 favorites]
You don't have to agree with her concerns. You just have to emphasize that you understand. Name her emotions when she starts getting fearful, and offer support for those emotions, not the delusions themselves.
"You sound very scared/fearful/anxious. What can I do to help you feel less scared/fearful/anxious? Could I make you something to eat, or...?"
posted by Hermione Granger at 7:35 AM on January 13, 2015 [1 favorite]
"You sound very scared/fearful/anxious. What can I do to help you feel less scared/fearful/anxious? Could I make you something to eat, or...?"
posted by Hermione Granger at 7:35 AM on January 13, 2015 [1 favorite]
Do not argue with her or try to reason with her. I speak from experience.
Instead, soothe her. Get her mind off what is bothering her. Do not appear bothered yourself but try and emanate calm instead (I know this is hard when worried) Give her a hug. Gently change the subject.
The above is the only way we could deal with the person in our family who went through this.
posted by vacapinta at 7:37 AM on January 13, 2015 [2 favorites]
Instead, soothe her. Get her mind off what is bothering her. Do not appear bothered yourself but try and emanate calm instead (I know this is hard when worried) Give her a hug. Gently change the subject.
The above is the only way we could deal with the person in our family who went through this.
posted by vacapinta at 7:37 AM on January 13, 2015 [2 favorites]
this article speaks on a much more serious medical issue, but i hope it might be relevant for some readers.
posted by kinoeye at 7:45 AM on January 13, 2015 [1 favorite]
posted by kinoeye at 7:45 AM on January 13, 2015 [1 favorite]
Is this a sudden onset thing? If so I'd be taking immediate action. If this behavior has come out of nowhere, or had intensified from an existing mental health issue, you really do need to get a medical evaluation, perhaps neurological.
If your wife is under care for a mental health issue and it's getting worse, and you're comfortable that it can wait, you can acknowledge her concerns.
"Camille, I understand that you're concerned about X. I know it seems real to you. In my judgement I don't think that the situation is likely and your proposed actions are not appropriate. Since you suffer from X and it seems that your feelings may be stemming from some changes, will you agree that while you may believe these things to be true that there's also a chance that they're not?"
But I'd be insisting on an emergency appointment for evaluation. Like heading to ER if I couldn't get one.
posted by Ruthless Bunny at 8:26 AM on January 13, 2015 [1 favorite]
If your wife is under care for a mental health issue and it's getting worse, and you're comfortable that it can wait, you can acknowledge her concerns.
"Camille, I understand that you're concerned about X. I know it seems real to you. In my judgement I don't think that the situation is likely and your proposed actions are not appropriate. Since you suffer from X and it seems that your feelings may be stemming from some changes, will you agree that while you may believe these things to be true that there's also a chance that they're not?"
But I'd be insisting on an emergency appointment for evaluation. Like heading to ER if I couldn't get one.
posted by Ruthless Bunny at 8:26 AM on January 13, 2015 [1 favorite]
Definitely try to keep her distracted (but not obviously so), and comfort her, as what she experiences seems very real to her. As others have said though, try to not address the content of her paranoia, however, I think staying on her "side" is the most important thing, as you can't afford to lose her trust.
Aside from that, I strongly recommend you call or email the psychiatrist and ask for your appointment to be moved up if at all possible. PM me if you'd like, I can share some experience privately.
posted by polywomp at 8:27 AM on January 13, 2015
Aside from that, I strongly recommend you call or email the psychiatrist and ask for your appointment to be moved up if at all possible. PM me if you'd like, I can share some experience privately.
posted by polywomp at 8:27 AM on January 13, 2015
Notice what _does_ help. Pay attention to what happens when you have a nice cup of tea with her, feed her comfort food, watch sitcoms, or just hug her or hold her hand. Do any of these seem to make her more relaxed?
In other words, don't just try one thing - try different things and _observe_ the results. Notice her.
Also look for other things than just her words -- notice how she dresses, her facial expressions, her postures. Notice if she is focusing on things she enjoys, or if she's just sitting silently, or if she's exercising more than necessary, or if she hugs you or holds your hand.
posted by amtho at 9:27 AM on January 13, 2015 [4 favorites]
In other words, don't just try one thing - try different things and _observe_ the results. Notice her.
Also look for other things than just her words -- notice how she dresses, her facial expressions, her postures. Notice if she is focusing on things she enjoys, or if she's just sitting silently, or if she's exercising more than necessary, or if she hugs you or holds your hand.
posted by amtho at 9:27 AM on January 13, 2015 [4 favorites]
I want to second what vacapinta said. When I get crazy anxious, I become convinced that everyone hates me; when I tell that to my husband, what I *do not* want to hear is, "Well, everyone doesn't hate you-- Esau likes you, and Sylvia likes you, and..." It just feels like he thinks he's talking to a child, and not engaging with the real problem, which is not a rational problem and can't be solved by rational conversation. I agree that the better idea is to try to redirect your wife's attention by asking what she needs or how you can make her feel better.
posted by holborne at 10:11 AM on January 13, 2015 [2 favorites]
posted by holborne at 10:11 AM on January 13, 2015 [2 favorites]
If you have sufficient flexibility in your schedule(s), you could call the psychologist's office up and ask to be put on a waitlist for appointment cancellations.
posted by deludingmyself at 10:26 AM on January 13, 2015
posted by deludingmyself at 10:26 AM on January 13, 2015
N'thing "Acknowledge, then redirect". It's hard, especially if she's accusing *you* of something, not to argue with her, but this is what works and what will get you through. After a few times, you'll be practiced enough so it becomes routine.
Later in her treatment, you'll have more tools to deal with situations like this, and so will she.
posted by Mogur at 12:22 PM on January 13, 2015 [1 favorite]
Later in her treatment, you'll have more tools to deal with situations like this, and so will she.
posted by Mogur at 12:22 PM on January 13, 2015 [1 favorite]
Perhaps it is a regional difference, but in my area the delusions and para is you describe would be treated by a psychiatrist, not a psychologist. Is it possible to see a psychiatrist sooner? I would not wait two weeks, I would be heading to ER right now. The crappy thing with breaks from reality is that the longer and deeper you are in seems to square the time you need to get out. So two weeks of active treatment now could shorten that treatment by months
posted by saucysault at 12:35 PM on January 13, 2015
posted by saucysault at 12:35 PM on January 13, 2015
I hope this is clear from consensus, but please don't do this:
Say calmly and firmly, "well, then, I'm sorry, but then we'll just have to agree to disagree." Repeat as necessary.
This drives a wedge between you, as she's trying to tell you something she absolutely thinks is true - it's not a matter of opinion to her and it's therefore not something you can "agree to disagree" on. I guarantee this phrase will be hurtful and destabilizing to your spouse no matter how kindly it may be said. Other advice is golden. Acknowledge. Redirect.
disclosure: I have literally been driven mad by this phrase. My relationship was abusive, but I believe it can be devastating even in a trusting one.
posted by lokta at 1:02 PM on January 13, 2015 [4 favorites]
Say calmly and firmly, "well, then, I'm sorry, but then we'll just have to agree to disagree." Repeat as necessary.
This drives a wedge between you, as she's trying to tell you something she absolutely thinks is true - it's not a matter of opinion to her and it's therefore not something you can "agree to disagree" on. I guarantee this phrase will be hurtful and destabilizing to your spouse no matter how kindly it may be said. Other advice is golden. Acknowledge. Redirect.
disclosure: I have literally been driven mad by this phrase. My relationship was abusive, but I believe it can be devastating even in a trusting one.
posted by lokta at 1:02 PM on January 13, 2015 [4 favorites]
Gently suggest that she write it down to show to the professional in two weeks' time, so the professional can help her think of ways to respond.
This puts the risk of acting on paranoia on the back burner; it documents the paranoia for the professional to review, and it doesn't agree or disagree with her fixations. And the professional will help her find a way to respond, but in a healthful way about coping with her issues instead of confronting people based on paranoia.
posted by mibo at 3:34 PM on January 13, 2015 [1 favorite]
This puts the risk of acting on paranoia on the back burner; it documents the paranoia for the professional to review, and it doesn't agree or disagree with her fixations. And the professional will help her find a way to respond, but in a healthful way about coping with her issues instead of confronting people based on paranoia.
posted by mibo at 3:34 PM on January 13, 2015 [1 favorite]
While you definitely shouldn't feed into her paranoia by pretending to agree with her, I think it's a good thing to acknowledge that you believe that these things are real for her-- that she's not lying or being difficult but undergoing legitimate distress. Unless these beliefs are leading her to take actions that could harm herself or someone else, I would leave it alone and just help her take it as easy as possible for the next two weeks.
posted by fox problems at 5:29 PM on January 13, 2015 [1 favorite]
posted by fox problems at 5:29 PM on January 13, 2015 [1 favorite]
Nthing everyone saying do not try to explain how she's wrong. Everything that snaw, holborne, amtho and lockta (I really hate that approach too) is spot on.
posted by kassila at 7:52 PM on January 13, 2015 [1 favorite]
posted by kassila at 7:52 PM on January 13, 2015 [1 favorite]
This thread is closed to new comments.
Serious question, why? Does she hurt herself or anyone if she's not calm? Or does she just fret and putter about, worrying 'bout things. Because if it's the latter, they may not be a bad thing over the next two weeks.
posted by Brandon Blatcher at 7:11 AM on January 13, 2015 [2 favorites]