Helping friend who may be having paranoid delusions
February 8, 2019 9:14 AM   Subscribe

I have a friend who in recent times has experienced very rough, life-changing experiences, and is suffering quite a lot from it. They need a lot of support right now, and I can give some - but what do I do when they *may* be expressing paranoid delusions about non-existent risks to their safety?

Basically, a friend of mine's life sort of blew up in recent months - their long term relationship spectacularly ended, reports of emotional abuse and physical threats were made, legal interventions, etc. The details are not too important, I don't think, other than my friend is now in a very unstable situation, regularly moving around, dealing with PTSD and mental health issues, and not working. Amongst other challenges, they are concerned for their safety b/c they believe their previous partner is a threat to them, physically.

So I can provide help a bit - some material, helping out with rides, talking and listening - but one thing I really don't know what to do with is what appear to be paranoid delusions about their safety.

From my perspective, its not clear that they are under any physical threat from their former partner, or how they even could be; they have not seen their former partner in months, have totally blocked them on social media and otherwise. But, they claim the former partner is making death threats via social media (they know this b/c other friends are monitoring the feeds). This doesn't seem true when I've looked at the social media accounts I can see; they also claim a friend of the former partner is in cahoots and participating in these threats via social media, and that seems unfounded.

Now, I don't doubt my friend has been through trauma and abuse, feels threatened, has PTSD, and is having a hard time managing. But what is the best way as a non-expert friend to deal with claims that seem very distanced from reality, like that they are being actively pursued to be attacked or murdered by their former partner?

Do I just listen and provide support; or does that negatively encourage paranoid delusions? Or maybe I don't have the full picture and should be supportive? Any thoughts, especially from those in mental health fields would be so appreciative.

(PS in a previous question, I asked about supporting a friend with a substance abuse problem - not the same person, and in this question I don't believe there are any substance abuse issues.)
posted by RajahKing to Health & Fitness (14 answers total) 1 user marked this as a favorite
 
If you knew for sure that they were paranoid delusions, best practice is to accept it as their experience, don't argue and don't engage - refocus the discussion on other topics. Arguing about delusions doesn't help make them go away. Validating the emotional experience is OK.

In this case, since you can't be sure, I would suggest that your friend ask the people who are telling about the threats to document them. If something does happen it would be important to have a record. Beyond that, whether true or not, it is not something you can help with so focus your relationship on the places where you can support them. If they want to talk about it, you can validate the feelings (It must be scary) and then, since they have done what they can and/or it's not a problem you can help with, you would rather talk about more productive topics.
posted by metahawk at 9:39 AM on February 8 [10 favorites]


You can contact the National Alliance on Mental Illness (NAMI) HelpLine at 1-800-950-NAMI (6264), which offers information, referrals and support for people living with a mental health condition, family members and caregivers, mental health providers and the public.

The NAMI website also offers information about supporting someone with PTSD, including a link to this PTSD Help Guide: "Helping Someone with PTSD - Helping a Loved One While Taking Care of Yourself."

Additional resources and collected AskMes are available at the MeFi Wiki ThereIsHelp page.
posted by Little Dawn at 10:35 AM on February 8 [1 favorite]


Just in case it's NOT a delusion- it actually is possible for the ex to create FB posts that only specific people can see, so you might be excluded from seeing their posts, at the same time as the friend who's reporting to your traumatized friend might be seeing something real.
posted by nouvelle-personne at 10:55 AM on February 8 [10 favorites]


they claim the former partner is making death threats via social media (they know this b/c other friends are monitoring the feeds). This doesn't seem true when I've looked at the social media accounts I can see; they also claim a friend of the former partner is in cahoots and participating in these threats via social media, and that seems unfounded.

People are threatened and harassed by abusive ex-partners all the time. I think before you decide that your friend is delusional it would be prudent to investigate further.

Is your friend saying that they've seen these hostile social media posts themselves or just that other friends have told them they exist? Have you spoken to these other friends about it? Do you know these other friends and do you consider them trustworthy? How easy would it be for the abusive ex to be making social media posts that you personally aren't able to view (on Facebook it's super easy, I'm not as familiar with other social media platforms)?
posted by Secret Sparrow at 10:59 AM on February 8 [3 favorites]


Yeah I was going to say that you should treat these threats as real unless there is solid evidence that they are not *and also* the fact that they aren't real is harmful in some way. Violence against women is real and very common. Document whatever you can, seek evidence, and when talking to your friend about this, treat it as real.
posted by natteringnabob at 11:03 AM on February 8 [2 favorites]


From a practical point of view if I was going to make death threats to someone on social media, the very first thing I would ensure is that they were the only person who could see it. So the fact that it’s not visible to you doesn’t mean anything, I mean of course they’re not going to publish it to the world.

The most dangerous time in a relationship is when you leave so in my mind, it’s far more likely that your friend is actually telling the truth than that they’re paranoid. Given that when they left there were threats of emotional and physical abuse and legal interventions, I don’t know why you think this current development is left of field, their ex partner has a history already of this kind of thing.

If they are being threatened, they need your support. If they are actually paranoid, they need your support so either way, your job is just to be there for them.
posted by Jubey at 11:23 AM on February 8 [7 favorites]


Now, I don't doubt my friend has been through trauma and abuse, feels threatened, has PTSD, and is having a hard time managing. But what is the best way as a non-expert friend to deal with claims that seem very distanced from reality,

Firstly, the best way would be to educate yourself on ptsd so you understand the symptoms and aren't relating to them as "paranoid delusions." What your friend is experiencing are symptoms of ptsd. Period.
The next best thing to do would be to understand the difference between paranoia and delusions and hypervigilance; her fears aren't irrational, they are based on the experiences she had which gave her ptsd in the first place.

I just listen and provide support; or does that negatively encourage paranoid delusions?

It's not possible to somehow externally encourage symptoms of mental illness into another person. It is possible however possible to further retraumatize your friend by denying her the reality of her real life experiences that led to having ptsd.

Lastly, stop confusing ptsd with mental illness. The two are not the same. Ptsd is psychiatric injury, not illness.
posted by OnefortheLast at 11:37 AM on February 8 [8 favorites]


Another resource that you can call is the National Domestic Violence Hotline: 1-800-799-SAFE (7233) or TTY 1-800-787-3224. Hotline advocates are available 24/7 to provide confidential crisis intervention, safety planning, information and referrals to agencies in all 50 states, Puerto Rico and the U.S. Virgin Islands.

You have serious and valid concerns, but I want to warn against any approach that tries to get your friend to produce evidence while she is in crisis - this could be a very harmful thing to do, so I encourage you to contact organizations that have training and experience with issues like these.

As noted above, your friend may be experiencing PTSD-related hypervigilance that reads threat in seemingly innocuous signals, which can be related to surviving chronic abuse, because survivors often learn to be very responsive to indications of a threat of further abuse. Similarly, abusers may learn to gaslight and engage in just-below-the-radar intimidation that the survivor understands perfectly, because the abuser thinks they can get away with it if it seems 'innocent' to a casual observer.
posted by Little Dawn at 11:39 AM on February 8 [12 favorites]


It's VERY possible to scare or threaten a partner in a way that wouldn't read as a threat to outsiders at all. For instance, an abuser could post a photo of a location where the couple once had a terrible fight. Or a photo of an object that was part of a verbal threat (like a baseball photo, when private threats of violence with a bat had been made). Or of a character from a movie that aligns with how the abuser sees themself. Or a photo near to where the abused person's loved ones live, thereby subtly threatening to harm them.

Sneaky abusers absolutely exist. Violent abusers tend to escalate the violence right after a breakup. Abusers are almost always charming to outsiders.

You should take your friend's claims seriously, and remember that your doubting their claims is not a neutral act. When you doubt the friend's story- and even if you only doubt them in your head, they will be able to tell you don't believe them- what you're actually saying is that you believe the ex more than the friend.

Essentially, doubting their abuse claims is a sign that you're on the ex's "side", and that you think the friend is "crazy". Your doubt is likely also weakening their own trust in their instincts, which could lead them to not trust their gut in a crucial moment, make a wrong choice, and be at further risk of violence.

If you want to be a friend to an abused person, BELIEVE THEM.
posted by nouvelle-personne at 12:11 PM on February 8 [19 favorites]


I think the main thing here is that it’s really not your role to determine whether these threats are real or not. I think a lot of times we believe that we can present our friends with logic and change their minds, or that it's somehow our job to, but a threat at this level, whether real or perceived, is not necessarily helped by figuring out what’s rational. I mean - you and I just don't have the expertise to evaluate threats or psychosis.

That said, I think you can help both your friend and yourself. With your friend, I would empathize with the feelings. “That must be so scary!”

I think you can help both of you by acknowledging that this situation is out of your depth. So that would look like “I feel confused and helpless in this situation, and I bet you do too. I think a great place to go would be…” and then maybe share some of the resources in this thread or local DV resources.

And finally, if you don’t feel like this is reality-based or that you can help, it’s just fine to say something like “I really want to be there for you but like I said, this is really out of my depth. I would love to do X (see a movie, get a meal, go bowling, go to a yoga class) together with you and hang out. But I can’t be your support and resource person for this situation. I care about you a lot, and I want you to get any help you need.
Then just keep up those boundaries and keep sharing professional resources. That’s really all you can do.
posted by warriorqueen at 1:14 PM on February 8 [6 favorites]


It's VERY possible to scare or threaten a partner in a way that wouldn't read as a threat to outsiders at all.

This. A friend of mine had an abusive ex who posted a nice picture of a sunset over a lake. What wasn’t obvious to the casual observer was that the photo was taken from the end of the dock at the cottage my friend was winterizing to be her new home so she could get out of the emergency rental accommodations she’d moved into when she left her ex.
posted by Secret Sparrow at 1:14 PM on February 8 [7 favorites]


I think you can help both of you by acknowledging that this situation is out of your depth.

I appreciate warriorqueen's eloquent response on this issue, including because it helps clarify my comment above that warns against "any approach that tries to get your friend to produce evidence while she is in crisis" - it's an untrained approach that I'm worried about. There are ways to obtain evidence from a survivor that reduces the risk of trauma, and when I worked as an attorney representing survivors of abuse, it was standard to connect clients to trained support resources in the community and to use a trauma-informed style of practice during the representation.
posted by Little Dawn at 1:44 PM on February 8 [2 favorites]


The thing is that YOU don't need evidence that these threats are actually happening. But it is in your friend's best interest to document those threats, just in case. It's not really your place to decide these "delusions" aren't reality, because they very well may be. On the flip side, it's very healthy for people in these types of situations to be EXTREMELY cautious - which is exactly why your friend's brain sees potential threats where your brain sees none.

As someone who has been through a similar situation, if the potential threats never materialize, your friend's brain will eventually (mostly) calm down and they will stop noticing every single potential threat. Don't worry yet about your friend suddenly becoming delusional. It's probably exhausting for you to hear about it, but it's more exhausting to think your life is constantly in danger.

Better safe than sorry. Help them stay safe.
posted by Penguin48 at 2:34 PM on February 8 [2 favorites]


Yeah a person I dated definitely used subtle scare tactics via social media to try to threaten me. Although it didn’t do much else except anger me, it is very possible your friend’s ex is doing the same. For example, said person would comment after every post I made on mutual friends’ walls. At one point they commented on a mutual friends’ post about phones, again, immediately after I did so. Their comment was about being so angry recently that they threw their new phone against a wall, shattering it. I had just broken up with them not very long after they purchased that phone to try to participate in my photography hobby. So to me that was an obvious display of some sort of psychological warfare, whether it was meant to be menacing or threatening or to make me feel guilty. Regardless, mutual friends wouldn’t have really gotten the jist of it since they didn’t really know our dating history or that we even split.

Psychological abuse and violence is definitely a thing that occurs and social media is one more tool. Unless your friend is delusional about something that seems highly unlikely, believe them.
posted by Young Kullervo at 3:08 PM on February 8 [5 favorites]


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