Delusions

While trying to get a deeper insight into the field of delusions and delusional patients I felt, more than once, bewildered and confused trying to imagine how I would personally deal with such a patient. In my imagination I tried to visualize an encounter with a delusional person and every time I did so, I felt frustration as I couldn’t figure out a way to come up with a method that would satisfy either me as a future psychologist or the patient. As a consequence of this confusion I have tried to gather some strategies that are valuable and might be helpful when dealing with delusional patients. 

Even though there are still a lot of unanswered questions when talking about delusional disorders, some aspects have been established and are generally recognized as true and effective. A strong foundation is crucial when working with delusional patients, this includes an insight into the history of medication, considering possible adjustments through interdisciplinary work with professionals and established trust, or even companionship between patient and therapist to secure a strong bond. Many professionals agree that a combination of psychopharmacology and psychotherapy make the perfect conditions for a successful intervention with delusional patients (Joseph et al., 2021). As already mentioned, a strong patient-therapist connection can have a crucial impact on the outcome of the intervention, therefore it is very important to carefully conduct initial interviews keeping in mind that they might have a long lasting effect on the patient facilitating further steps. A frequent side effect of delusions can be be strong doubt towards therapists or even suspicion, therefore there might be a strong need for trust from the patient’s side. This can be achieved by practicing active listening, being patient, showing authentic interest and focusing on other strategies to create a safe space for the patient to express fears and worry. (González-Rodríguez et al.,2020)

Delusional patients often struggle with friends and family, many have to endure being branded as insane or unwell which can raise their concern and suspicion, thus showing sympathy and clearing them of the assigned label is crucial. This might include showing some kind of understanding towards the delusional belief portraying it as something ordinary, or not as unusual to win the trust of the patient. Regarding this aspect it is also very important to be neutral, a therapist can not talk about personal beliefs that contradict the one’s of the patient, this doesn’t mean that the therapist should agree with everything the patient says but rather acknowledge and validate the patient’s feeling. Focusing on the emotional state of the patient is important as the delusions might cause high degree of distress, the patient’s well-being should be the primary concern of the therapist, thus working on coping mechanisms and techniques to decrease anxiety, worry or even panic is key. This also includes fostering pleasant activities as well as finding some kind of meaning in life in general to avoid isolation in order to strengthen the patient-therapist relationship as well as the patient’s quality of life. (González-Rodríguez et al.,2020)

It is quite obvious that the primary concern is not to clear the patient of all delusions but to assure that the patient can lead a healthy, functioning life. The main task of the therapist is to create an alliance with the patient that allows them to build a foundation in order to work on coping mechanisms and tools that are crucial for the patient’s wellbeing. Building such an alliance can also help to work on the delusions without causing mistrust.

REFERENCES

González-Rodríguez ,Alexandre; Seeman, Mary V.  (2020). Addressing Delusions in Women and Men with Delusional Disorder: Key Points for Clinical Management. International Journal of Environmental Research and Public Health, 17(12), 4583–.       

Joseph, S., & Siddiqui, W. (2021, July 21). Delusional Disorder. NCBI. https://www.ncbi.nlm.nih.gov/books/NBK539855/