Can anyone give me advice on the best way to communicate with a Paranoid Schizophrenic in the midst of a severe delusion with auditory hallucinations? This person, who I will call X, seems to go through a cycle of 3 months of lucidity followed by 2-3 weeks of deluded thinking. X believes that God communicates with him and warns him of “Bezelbubs” or demons. These demons hide in kitchen appliances,in paintings,shoes,books,etc. To rid his home of these demons,X has been known to set fire to his mattress,put his shoes in the oven,shave them out of his hair,etc.etc… X is currently on Clopixol injections after he developed tardive dyskinesia due to prolonged use of Haldol.
X’s mental disorder is a result of a brain injury he incurred approximately 15 years ago. X is married into my family, and his wife, my biological family member(let’s call her Y), is at her wit’s end. I am frequently summoned to their home to “problem-solve”…which usually means calling the police to have X admitted to hospital and explaining to Y that she can’t talk him out of his delusion.
I know that I should neither confirm nor deny X’s delusions, but then what do I say to him? Is silence the best course, or is changing the subject?
Shy, maybe you should try a new doctor. There are some good medicines out there – better than Haldol; I’m surprised they had him on it that long. A schitzophrenic i know of is balancing somewhat on Risperdol with Cogentin against side-effects. Actually the Doc added Depacote recently too. So many new medications!
It’s said, in older people schitzophrenia sometimes regresses. I recommend the book A Beautiful Mind as a good reading on the illness. Perhaps your family member would like to read it to understand his illness better??
I agree about the medications. Is this person’s doctor (psychiatrist, I assume) an expert in the field? With all of the changes that go on with meds, only a specialist would have the most up-to-date info–and know how reliable it is (any doctor can hear about a new med, but a specialist would know all about the recent complications etc. involved with these new meds, and will know more about the REAL story behind them (actually, I was at a talk recently on Risperidol for depression, and the psychiatrist was touting all of its positive effects; after, when the group I lead was discussing meds, I brought this up–they started rattling off a list of side effects and other problems they and friends had experienced using this drug to treat non-psychotic disorders).
As for talking with X, yes, about all you can do is calm the person down…get him distracted, maybe even calmly try to get him to talk about the delusions (any hallucinations?). They are trying to use CBT to “treat” schizophrenia, but I’m skeptical about that (it can work during periods of lucidity, but during a full-blown psychotic episode?). But I have been in the middle of such episodes and have just tried to calm the person down and “ground” them…get them to talk about the delusion in a “matter of fact” way…when things start to get destabilized, I move on to a more benign topic…but in the end, it’s a matter of getting them to the ER for whatever tranq-type drug/combos they are going to give.
No easy task, shyster. Looks like you’re doing the best one can do in this situation. Just remember, keep the emotions low, and encourage the family to read up on “expressed emotion” to see how to try to reduce the chances of full-blown episodes.
funny i’m a paranoid schizophrenic who communicates with god on a daily basis and i have the seed of lucifer buried deep within my mind, i’ve even experienced out of control psychosis (though that was months ago and i’ve since learned to control myself better)
however now i live on my own and hold a job pay for an apartment and live a normal life (with the exception of having friends…(this is due to not being able to see them from not having a car)) however i still see friends at work and my family
i’d say with the exception of not leaving my house (do to it being hard to get around) i live a pretty normal life…
I hope my very loved family member can reach this stage in his life someday. Thank you so very much for responding. 