What Do You Say to Someone Who is Delusional?

Reader’s Question

What would you say to someone that has had their brainwave watched for as long as that person has been living and has to listen to those people stating the most extreme and stupid things? That same person knows that everywhere he goes there are people taking peoples’ pictures all around his physical person.

Our Consulting Clinical Psychologist’s Reply

What you are describing is a paranoid delusion. A delusion is a false belief. A paranoid delusion is the false belief that we are being persecuted by external forces. Common parts of the delusion include the feeling that our thoughts are being monitored (typically by electronic means in high-tech countries), the feeling that these external forces are inserting thoughts/feelings/things into our thought process, and the feeling that they were selected for this monitoring/control for some special reason (this part is often grandiose, with the person feeling they are a special person, have special powers, have a special destiny, etc.). They will also feel they are able to read or hear the thoughts of others, as though they have a special ESP power. Hearing some of these thoughts can take the form of auditory hallucinations — another common component of this condition.

Individuals with a paranoid delusion are tormented on a daily basis. They feel the entire environment is involved in their delusion and typically see “signs” in everything. They feel billboards are directed at them, the radio/television is sending them messages, people talking on cell phones are reporting on them, and planes overhead are photographing them.

This is a significant psychiatric disorder and often begins in the late teen years. Paranoid delusions are produced by excessive amounts of a neurochemical in the brain called Dopamine. You might want to read my article entitled Chemical Imbalance on my website for further information (www.drjoecarver.com). We have medications that stop new delusions from forming (they lower dopamine in the brain) but the old content still remains. At the present state of understanding and medical science, that’s about all we can do with this very complex psychiatric condition.

As for what to say, I would encourage the person to seek help. I wouldn’t confront them on the contents of their delusion but rather focus on how miserable they must be to be tormented this way on a daily basis. Recommend they seek help due to their level of distress. Sadly, paranoid delusions are very difficult to treat as the individual almost immediately feels the mental health professional is part of the conspiracy to control their thoughts and prevent their superior destiny. I have one patient who feels he has the DNA of Moses (from the Christian Bible) that will one day “activate”, giving him God-like powers. Medications allow him to work as no new delusions are occurring — but his fellow workers don’t discuss religion with him.