Psychosis can be a frightening and confusing experience for individuals and their loved ones. Most people don't really understand what's happening when someone loses contact with reality. They may not want to confront the person directly because they don't want to make things worse. Furthermore, they might feel scared for their own well-being.
Learning how to support and confront psychosis requires understanding the condition and a commitment to empathy and treatment. Let's get into what you need to know.
Understanding the Key Symptoms
Psychosis, at its core, disrupts someone's sense of reality. The concepts of fact and fiction become blurred. In a psychotic state, people cannot necessarily delineate their hallucinations or delusions from the legitimate truth. These states can last for a few hours. In more severe cases, they can persist long-term for several weeks or months.
A hallucination refers to experiencing stimuli that don't exist. A person, for instance, might hear God talking to them directly. Or, they might see shadows on the wall. They might even feel like bugs are crawling all over their skin. Hallucinations range in severity- some can be mildly distressing, whereas others feel downright debilitating.
A delusion refers to experiencing intense thought patterns that don't align with common society. For instance, someone might believe that the government is following them at all times. Or, they may believe a chef is intentionally drugging them at a particular restaurant.
Along with hallucinations and delusions, psychosis can include other disturbing symptoms like severe paranoia, catatonia, incoherent speech, extreme withdrawal, and problems with coordination.
Some people are open about their psychotic symptoms. They will share what they see and feel (and they may appear confused or agitated about why others don't share their same reality). Others may feel too paranoid or self-conscious to share what's going on. As a result, they risk being undiagnosed or misunderstood in standard treatment settings.
What Not to Do When Someone You Love Is in Psychosis
The first step in confronting psychosis is developing awareness. Recognizing psychotic symptoms- and labeling them accurately for what they are- allows you to understand the dynamic better. In addition, having this foundation helps you recognize what not to do when someone is struggling.
Avoid Direct Confrontation
Psychosis feels like truth. Trying to debunk or challenge your loved one's sense of reality will likely result in some conflict. They may become defensive or argumentative. In other cases, they might become emotionally hostile or even violent.
Avoid Labeling Psychosis
Like direct confrontation, telling someone they are in a psychotic state doesn't work. You can't convince someone how they "should" think. For example, if you know the sky is blue, but they see it as completely orange, they won't understand why you're trying to convince them otherwise.
Avoid Taking It Personally
While it's normal to feel some guilt or concern, psychosis isn't your fault. It's a result of a chemical imbalance, and you should avoid taking irrational thoughts or behaviors personally. They aren't inherently directed to you, even if your loved one has become suspicious towards you.
Avoid Confirming Their Truth
Just like you don't want to argue with their points, it isn't helpful to agree with them, either. Enabling hallucinations or delusions can reinforce a dangerous self-fulfilling prophecy. While you might now appear to be "on their side," these actions are disingenuous. Furthermore, they often worsen the situation, as your loved one might now try to "use you" to convince others to understand their reality.
What to Do Instead
Now that you know what to avoid, here are some helpful steps you can take to support your loved one. Remember, it's okay if you don't handle the situation perfectly. As mentioned, psychosis can be frightening and difficult- it's normal to feel uncertain about how to intervene.
Harness Your Empathy
Try to step into your loved one's shoes and imagine how they might be experiencing specific situations. For instance, if they feel nervous that anyone driving a delivery truck is out to kill them, do your best to envision how terrifying that may feel. Once you can sit with that feeling, it often seems natural to validate their concerns with an affirmative statement like, "It must feel so frightening to see all those trucks driving around."
Focus More on the Feelings
It's easy to lose yourself in the details of someone's story. However, if you find yourself stuck in the content, try to shift more into a feeling stance. How intense do their emotions feel right now? After all, we can all relate to fear, guilt, or confusion- try to focus on how you can use your own experiences with certain feelings to help support your loved one.
Remember Their Strengths
You might worry that your loved one will never get better. But in most cases, psychosis is treatable, and people can make significant improvements in their quality of life. If you feel overwhelmed, focus on what's working and going well in their life, even if those milestones seem small. For instance, maybe they started a new job or are showing interest in trying psychiatric medication.
Contact Their Treatment Team
If you have concerns about their safety, reach out for professional support. Even if you aren't sure what's going on, it's worth making contact to share your observations. If you don't have consent to speak with providers, you can always leave a message with a summary of what's going on.
Final Thoughts
While psychosis feels frightening, finding the right treatment can make a profound difference. At The Mental Health House, we help people struggling with psychosis and other related conditions. Contact us today to learn more about our unique, supportive approach.