Paranoia is not pretty.
January 4, 2007 9:49 AM Subscribe
How can I talk rationally to someone amazingly paranoid without further agitating them?
posted by anonymous to Human Relations (28 answers total) 7 users marked this as a favorite
My brother is currently having classic paranoid delusions. He has a history of this, but I speculate that this specific episode is the result of several months of stress. He's convinced that someone is out to kill or harm him: he has accused various people of monitoring the phone and internet, bribing him, snooping around his yard, stalking him while he's out and so on. His theory as to why all of this is occurring continually morphs, but he insists that some sort of shadowy organization is behind it all. His paranoia directly relates to the reason behind the stress he's experienced in the past months. The most important thing is: he truly believes that all of this is happening and absolutely refuses to consider otherwise.
Living with him recently has been hectic, and his little conspiracy theory is getting more elaborate and absurd every day. He's able to warp nearly anything - completely explainable, mundane occurrences such as getting a stomach ache after overeating - to fit in with it. He is having enormous difficulty functioning like he did before all of this. He's having difficulty functioning at all, for that matter.
His paranoia has started to encompass anyone who is even mildly critical of his theory; he's beginning to craft special parts in all this for each family member. I am the only one left who he vaguely trusts. However, conflict between us is eroding that. I am losing patience with him; these past few weeks have been some of the most surreal and agonizing of my life. I hate watching him hang himself like this and I'm losing the ability to remain calm while talking to him. Consequently, I've been being more vocal in my criticism of his theory. When he presents me with yet another aspect of it, I make the mistake of trying to discount it and he gets ferocious. Due to a lack of control on my part, conversations between us frequently degenerate into yelling at each other.
I feel like I'm walking a fine line here. Playing along with his paranoia is surely dangerous, but it's extremely difficult to rationalize with him without making him angry. I initially tried to be tactful and meek in my attempts at logic, but as this situation gets more insane it's getting hard to stay calm. Alternatively, I have also tried rationalizing normal behavior within his bizarre worldview - in a "don't let them get the best of you" sort of way. I realize that his paranoia is at the level that it cannot be resolved without some sort of intervention. Regardless of what I say, he is not going to snap out of it. I know that I can’t fix this, but I certainly don’t want to inadvertently contribute to it.
I don't want to break the trust he has in me. I imagine he's feeling pretty lonely right now. My goal is to provide comfort without giving credit to his delusions. What I’m asking is: How can one talk to someone paranoid without furthering their delusions, or buying into them? What is the appropriate approach here? Is there a certain way psychologists/psychiatrists/nurses communicate with patients of this kind? Is this completely impossible?