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Delusions and Coping Strategies in Acute Schizophrenia

Abstract: How do you cope with people who are hearing voices or seeing things that do not exist?

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Delusions and Coping Strategies in Acute Schizophrenia

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Question(s): 
Written by: Fabio Piccini, doctor and Jungian psychotherapist, in charge of the "Centre for Eating Disorders Therapy" at the "Malatesta Novello" Clinic in Cesena. Works privately in Rimini and Chiavari. E-mail:
First version: 22 Jul 2008.
Latest revision: 24 Aug 2008.

How do you cope with your son hearing voices or seeing things that do not exist?

Answer:

If you're in a domestic emergency and you need to cope with acute delusions or hallucinations of a schizophrenic relative, the first and foremost thing to do is trying not to panic, but instead being calm and reflexive. Avoid screaming and fighting but try to listen carefully to your relative and then try to behave as follows:

DON'T

Say things like: "you're completely crazy" or "this is true madness", or "you need a shrink". Don't try obsessively to change his/her mind (you will only make him/her feel more anxious).

On the other hand don't say things like: "you're right", or "I can see it" if you don't think so, or things like: "Me too", just to make him/her happy. Also, don't make a joke of his/her perceptions and sensations; do not minimize them. Do not laugh, nor be aggressive or angry.

DO

Listen attentively giving him/her all your attention, then reply that it's really difficult for you to understand such a deep inner experience. Try to show, cautiously, the difference between what s/he pretends to see, hear, feel and the objective reality that one can touch and feel.

Be empathic and patient and honestly try to see the things the way s/he does. Then try to move conversation towards another thing or try to start an activity that requires concentration and attention in a different field (like asking him/her for help you to do some housework, some gardening work, some cooking work.

Suggest to call Dr. XX (psychologist or psychiatrist, or social worker) and to have a word with him/her about these feelings to ask his/her opinion about them.

And last, but not least, do not panic, every problem has a solution!

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