Have you noticed a family member beginning to act strangely? Does he seem to think that someone is trying to hurt him when there was no apparent danger? Or maybe he has started following a complex belief system that you can’t quite understand? It could be that your loved one is experiencing psychosis. Psychosis and the disorders that cause it are complicated to understand. Thankfully, I came across a resource that helped me comprehend how to help someone in psychosis. Schizophrenia: A Blueprint for Recovery by Milt Greek, a person living with schizophrenia, helped demystify psychosis and gave me further understanding of its impact on individuals and their families.
This book makes it clear how confusing and even terrifying psychosis can be for the individual and his family. It isn’t an easy situation to navigate and a lot of people can get it wrong. First, take a look at what psychosis means. Mental Health First Aid USA defines psychosis as “a mental health problem in which a person has lost some contact with reality, resulting in severe disturbances in thinking, emotion, and behavior.” Psychosis can show itself in a variety of symptoms such as delusions, visual and audio hallucinations, disorganized thinking and paranoia. Schizophrenia may be the disorder that is most commonly associated with psychosis but other disorders including bipolar disorder, schizoaffective disorder, depression, or substance use can have psychotic symptoms. If you have a family member or loved one who is experiencing psychotic symptoms, you want to make sure you don’t escalate the situation and are able to assist him in getting the help he needs. Here are the do’s and don’ts of helping a family member in psychosis based on what I learned from Schizophrenia: A Blueprint for Recovery.
The Do’s and Don’ts of Helping a Family Member in Psychosis
Don’t panic or overreact
When your loved one is experiencing psychosis he might say or do some strange or even alarming things. The important thing to do is to learn more about what your loved one is experiencing while remaining calm. Milt Greek writes “people with schizophrenia are emotional sponges” meaning your family member who is experiencing psychosis can easily be affected by the emotions other people are displaying.
You may think being in a psychotic state will prevent him from picking up on how you are feeling and acting but that may not be the case. He may be even more tuned-in to negative emotions around him than you are, which is why it is important to monitor your behavior, too. Also, don’t take any thing offensive he says personally or try to confront him about it. It is best to calm yourself before engaging with him.
Do listen non-judgmentally
Hear what your loved one is saying and don’t dismiss it or laugh it off. Empathize with the emotions he is experiencing. If your loved one is paranoid and acting afraid, understand that he is legitimately feeling fear. Often times people in psychosis don’t readily tell everyone what they are experiencing and why. Ask questions like “what can I do to help?” or “can you tell me more?” Keeping a calm tone and making it clear you understand the emotions he is experiencing might allow him to feel comfortable enough to open up.
Don’t make medication, treatment, or diagnosis the focus
Depending on where you and family member are in the cycle of discovery, this may not be the first time you have seen your family member in psychosis. You may know the disorder that is causing this behavior and that he is prescribed medication to manage that condition. While that may be the case, informing your family member that he is just experiencing the symptoms of a disorder and that he needs to take more of his medication may only aggravate the situation.
The psychosis your loved one is experiencing seems just as real to him as reality seems to you right now. Telling him what he is perceiving isn’t actually reality will only drive a wedge between you and him. It’s perfectly fine to calmly ask a few questions about medication to gain better understanding of the situation, but insisting or forcing medication while your family member is still in a psychotic state will only lead to him believing you are working against him. You want to make sure your family member thinks of you as being on his team, not an enemy.
Do speak slowly and simply
People in psychosis or who have just come out of a psychotic state might struggle to understand complex language like double-entendres, metaphors, exaggeration, or sarcasm. During this time, it’s best to speak in short clear sentences as you don’t want to further confuse or upset your loved one.
Ask one question at a time and give him enough time to respond. Try to remain at the same eye level as him: if he is sitting, don’t stand and hover over him. Also, if others are in the room with you, don’t speak about him as if he is not there. You want to communicate to your loved one that everyone is working with him to help him get better.
Especially if you are a parent, it may be second nature for you to threaten a consequence for your child’s behavior. When it comes to psychosis, it’s not a good idea to issue some form of negative repercussion for his behavior. The motivations for his behavior come from his mental health disorder, not from a lack of discipline. Furthermore, when your family member is in psychosis, trying to rationalize him out of his behavior is probably not going to work.
Do stay positive and encourage help
As mentioned earlier, the emotional turmoil that psychosis brings is very real and often very scary to your family member. It’s important to keep your side of the dialogue comforting and positive. Psychosis may make life seem overly dangerous, dark and threatening. Your loved one may think there is no escape. Try not to add to this negativity.
Ask him “how would you like to be helped?” or if this has happened before, “what has helped you when you felt like this before?” He may give you an idea of who he prefers to turn to during this time, (e.g. he may find his therapist more comforting than his psychiatrist or vice versa). Knowing who your family member trusts is an important part of finding the right intervention.
Don’t hesitate to contact a mental health professional
Your family member may not be willing to get help. This can be very frustrating and confusing for most families. If you are concerned that you or someone you care about is experiencing psychosis, it is important to seek help from a qualified mental health professional. Our Resource Specialist can help you find expert mental health resources to recover in your community. Contact us now for more information on this free service to our users.Contact a Resource Specialist
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Mental Health First Aid USA (1st ed.). (2013). Lutherville, MD: Mental Health Associates of Maryland.
M.G. (2012) Schizophrenia: A Blueprint for Recovery. Athens, OH: Milt Greek.