Is it possible to convince a delusional person that what he believes is not real?Do you have to pretend to believe in the customer’s illusion to practice therapy?Is it possible to prevent the therapist from entering your client’s illusion?We will try to answer these questions and clarify how delirium management occurs in therapy, regardless of the disorder facing the spectrum of schizophrenia.
Delusional ideas may be present in some disorders of the psychotic or schizophrenic spectrum, is this the case of delirant disorder ?, which is characterized by having only delirium as a psychotic symptom, a brief psychotic disorder or schizophrenia.
- Illusions are erroneous beliefs and misinterpretations of perceptions or experiences.
- And they are also little or no sensitive to change.
- Even if evidence is found to the contrary and is not shared by another individual in society.
An example of illusion may be that of a woman who thinks her husband is unfaithful to her, although she has no proof and all that reality does not suggest infidelity, she believes in her.
However, because of your misinterpretations of reality, that is, because of your illusion?the woman cannot abandon this idea and keeps thinking about it.
It is important, especially in therapy, not to confuse delirium with hallucination. Hallucination refers to an experience of sensory events without an ambient signal in sight.
They are totally involuntary and very unpleasant, disruptive and cause a lot of stress to those who suffer from them, hallucinations involve the senses without real and external stimuli that justify this activation.
Sometimes hallucinations are present in delirium, for example, a person who thinks about persecution can hear voices and think that the people chasing him have put speakers in his house to drive him crazy, in this case the person would suffer an illusion and a hallucination.
But can there also be hallucinations? Voices that keep insulting the subject without illusion, knowing they’re hallucinations?Or simply a delirium without visual, olfactory, tactile or auditory disturbances.
The goals of schizophrenia therapy or delirant disorder may be different from other interventions. In this case, it is extremely important to teach the customer how to deal with stress and reduce the vulnerability of having a hallucination, delirium or psychotic crisis.
To do this, it is about reducing activation, in addition to rehabilitating basic functions that have been modified with the advent of psychosis: attention, perception, cognition, reasoning, learning, etc.
In turn, it also seeks to develop social skills, problem solving, coping strategies and restoring daily functioning; However, it is not as simple as it seems, how do you work on everything said before if it is not an illusion in the first place?
Cognitive behavioral therapy uses verbal tactics as the first weapon to combat delirium.
In this verbal tactic, embodied in a cognitive restructuring format, we seek to discuss the evidence the person has that the illusion is true, propose alternative explanations, and allow the person to find those explanations. In addition, reality tests are performed. it is also carried out, if possible.
However, cognitive factors involved in persecution beliefs often prevent a person from understanding and finding evidence, as a result, verbal tactics are often not entirely useful at first if these care biases are not addressed.
Although you have to work in therapy, it will not be short the time when the therapist will have to live with this delirium before he can delve into his tests of content and reality.
One of the attitudes that can be adopted in the management of delirium in therapy is to pretend to believe in the delusion of the person in order to strengthen the therapeutic bond and ensure that the client has full confidence in the therapist.
This is not recommended because we do not seek to reinforce the belief in illusion with evidence that someone other than the customer also believes in illusion.
Therefore, even at the beginning of therapy, the therapist cannot make it clear that he believes in the things the client says.
However, it is really interesting to promote the therapeutic link. It is likely that the entire social and family circle of the delusional client has already tried to refute it with evidence.
Therefore, ideally, the client does not go through the same situation in therapy; the therapist will not be able to make good connections taking paths that others have already taken, so at first it is recommended not to enter the content of the illusion, believe it, even if it does not believe.
Don’t make explicit any judgment about the illusion will be one?Temptation? Where we won’t fall until the client is prepared to face verbal tactics. In addition, any intervention will be better if there is a link between the client and the therapist. .
One thing is certain: we cannot build this bond by saying that what he thinks is not real.
The illusion in therapy is considered problematic when, after our refusal to believe, the client thinks that the psychologist is also in his illusion.
Although this does not happen with somatic delirium? When a person believes that her body has changed, her face is square, her arm is longer than the other? Or an illusion of guilt? Does the person think they have committed a terrible, unforgivable sin? It could occur in an illusion of control over thought, greatness, or persecution.
In the case of the first illusion of thought control, can the subject believe that someone introduces thoughts that are not his own into his mind?This illusion is known as the type of “insertion”.
When the client understands that the psychologist is another person who does not believe him and his goal is to provide unreliable evidence of reality, that person may be taking the therapist to his delirium.
Thus, the therapist will be part of this organization that acts against their interests and will not be able to help the client. It is very important to avoid it!
It is difficult for a delusional person to undergo therapy alone, and even more so that therapy pays off if the person thinks the psychologist is also against it, so before starting to try to prove that what he says is impossible, it is recommended to be patient and not go too fast.
Therefore, it is better to focus on the cognitive part without paying attention to delirium.
Just because illusion and misconceptions are persistent does not mean that therapy is unnecessary. One of the main goals of therapy is to improve the functioning and well-being of the person, so that the therapist can fall into delirium and work from there.
If the person has an illusion of reference, in which he thinks that certain details, phrases or events are messages addressed to him, we can talk about the emotional impact of these phrases, why they affect him and what they mean to him, what he does. with them a person to say that kind of message he hears.
At no time should we believe in delirium and this should not be explained. It is a question of restructuring in a different context from that of “reality”. This is done in your reality.
Thus, by not focusing so much on the denial or not of illusion, but on stopping it and paying attention to the emotional and cognitive impact of the messages of this illusion, an improvement can be achieved, so the best interventions to manage the illusion are not always those that directly address the problem.