Help! How Do I Talk to My Delusional Cousin?

Consensual reality has taken a real beating lately. Fake news, alt facts, conspiracy theories, Russian Facebook bots... Sure, we'd all like some civil discourse. But what do we do when we can't even agree on what is true?

Delusional is a big word to throw around, especially when you are trying to stay in some sort of relationship with friends or family whom you believe, frankly, to have gone over the deep end. Does it really apply to this situation? Or is the use of the word a lit match in a room full of gasoline?

Let's start with some clarification. The Diagnostic and Statistical Manual (DSM-5) defines delusions as
 fixed beliefs that are not amenable to change in light of conflicting evidence. Well, that sure sounds like what we are dealing with.
Delusions are taken as indicators of a mental or physical disorder. But before we go making armchair diagnoses, consider how powerfully our minds cling to ideas that are demonstratively false, the fear of spiders, the hope in lottery tickets, trickle down economics. Let's exercise some restraint and some humility here.

What follows are techniques used in the field of mental illness that may prove useful to communication across the reality divide between people who care about each other. They do not presume that the other person suffers from a mental illness. They do not presume that you have your head screwed on straight either. Actually, how great it would be if both parties agree to use best practices for talking with somebody who is delusional!

The first recommendation follows directly from the definition. Delusions are fixed beliefs that are not amenable to change in light of conflicting evidence. As a consequence, it is utterly pointless to present evidence that will "prove" the delusion is false.

You have already experienced this. Whatever evidence you present is either discounted because the source is unreliable. Or it is absorbed into the delusion with an alternative explanation.

Save your breath.

The rest comes from Xavier Amador. Amador is not my go to person for understanding people with schizophrenia. But he does give good advice for dealing with delusions. He outlines a four-part strategy: 

  • Listen, reflectively with respect and without judgment. Hear the other person out. Ask questions to make sure you understand the position, not questions to challenge the position. For example: Do you think the Secretary of the State of Georgia falsified the vote totals? or Do you think the Secretary of the State of Georgia certified accurate results? There may be some nuances here that you are missing. Don't go beyond the broad strokes. Just make sure you know what the issue is.
  • Empathize strategically with emotions stemming from the delusions. For example: That would feel really disturbing or My position must feel really frustrating to you.
  • Agree where you can. For example: Every legal vote should be counted and People who commit crimes should be prosecuted.
  • Keep the relationship going with things that you do share. For example, my family members don't respond to each other's political posts on Facebook. But we like each other's photos, jokes, positive news.

I am not suggesting that this strategy will heal the national divide. That is way above my pay grade. As long as there are no threats of violence, this is simply a holding pattern to allow friends and family to hang in with each other until things sort themselves out and consensual reality makes a comeback.

May it be soon.

No comments:

Post a Comment

Popular Posts