HELPING SOMEONE EXPERIENCING PSYCHOSIS

Psychosis is a complicated disorder that can be terrifying for the person experiencing it and for those who want to help. But helping is crucial. Particularly with psychosis, the sooner a person gets treated following a first episode, the better long-term outcomes are likely to be.

Whether the person is having a first episode or is being treated for psychosis, there are many ways to be supportive. The following information is adapted from Mental Health First Aid Psychosis Guidelines.

HELPING SOMEONE EXPERIENCING PSYCHOSIS

Psychosis is a complicated disorder that can be terrifying for the person experiencing it and for those who want to help. But helping is crucial. Particularly with psychosis, the sooner a person gets treated following a first episode, the better long-term outcomes are likely to be.

Whether the person is having a first episode or is being treated for psychosis, there are many ways to be supportive. The following information is adapted from Mental Health First Aid Psychosis Guidelines.

HOW TO HELP

USING YOUR WORDS, EARS, AND BODY

THINK ABOUT LANGUAGE

  • Use everyday rather than “dumbed-down” language. Do not patronize the person.
  • Use language that normalizes the person’s experience, for example refer to their “stress,” “concerns,” “the voices,” “the person you’re seeing,” rather than saying “this is insane” or “you’re losing your mind.”
  • Use the same terminology that the person uses to describe their experiences. “I hear you saying you feel uneasy and you can’t rely on your friends.”
  • Do not use stigmatizing terms like “You’re ‘crazy,’ ‘nuts,’ ‘psycho.’”

LISTEN NONJUDGMENTALLY

  • Convey empathy when communicating with the person and listen to them nonjudgmentally.
  • Acknowledge what the person is saying and how they are feeling. “That sounds really upsetting/frightening” or “It sounds like you don’t know what to do.”
  • Listen carefully to the person, reflect what you hear, and ask clarifying questions to show that you are listening and understand correctly.

USE APPROPRIATE BODY LANGUAGE

  • Do not touch the person without their permission.
  • Minimize body language that shows your distress and avoid nervous behaviour (e.g. jiggling legs, fidgeting, or nail biting).
  • If the person is sitting down, do not stand over or hover near them. If you feel safe, sit down, too.

RESPONDING TO HALLUCINATIONS AND DELUSIONS

See SIGNS OF PSYCHOSIS for a description of hallucinations and delusions.

WHAT NOT TO DO WHEN RESPONDING TO HALLUCINATIONS OR DELUSIONS

  •  Do not pretend to agree with the person’s hallucinations or delusions.
  • Do not try to reason with the person about their hallucinations or delusions.
  • Do not dismiss, minimize or argue with the person about their hallucinations or delusions.
  • Do not act alarmed or embarrassed by the person’s hallucinations or delusions.
  • Do not laugh at or make fun of the person’s hallucinations or delusions.
  • Do not ridicule the person, even if what they are saying doesn’t make sense to you.

WHAT TO DO WHEN RESPONDING TO HALLUCINATIONS OR DELUSIONS

  • It is important to know that delusions or hallucinations are very real to the person.
  • Ask the person if they want to talk about what they are seeing or hearing.
  • If the person wants to talk about their hallucinations or delusions, you should listen in order to demonstrate empathy and develop an understanding of what they are experiencing.
  • When talking to the person, you should use their own terminology when referring to hallucinations or delusions, e.g. “the voices,” or “your worries about your safety.”
  • You should acknowledge that what the person is experiencing is real to them without confirming or denying their hallucinations or delusions. “I accept that you hear voices or see things in that way, but it’s not like that for me.”
  • If the person is hearing voices, they may respond to the voice they are hearing, for example, by talking or whispering to themselves. Remember that the person is experiencing symptoms that are beyond their control and you should not blame them or take their actions personally.

HELPING SOMEONE EXPERIENCING PARANOIA

See SIGNS OF PSYCHOSIS for a description of paranoia.
  • People’s experience of hallucinations or delusions may cause them to become paranoid and not trust people, even those close to them.
  • Tell the person that you do not see any threats, but that you will stay with them if it helps them feel safe.
  • Encourage and support them to move away from whatever is causing their fear, if it is safe to do so.
  • Tell the person what you are going to do before doing it. “I’m going to get out my phone.”
  • Give the person simple directions, if needed. “Sit down, and let’s talk about it.”
  • Stay with the person, but at a distance that is comfortable for both of you.
  • Do not encourage or inflame the person’s paranoia, for example, by whispering to someone about them.
  • Do not use body language that could exacerbate paranoia such as approaching the person with your hands in your pockets or behind your back, or standing over or too close to them.

If a person is severely psychotic – is acting very strangely, has disorganized thinking, is unable to communicate with you, or seems dangerous – this is a medical emergency. Whether this is a first episode or the person is in treatment, medical help is needed now.

Getting someone experiencing psychosis to agree to get help can be especially difficult.

 You can find ways additional ways to encourage someone to get help on page 8 of Mental Health First Aid Australia, Psychosis Guidelines.

IF YOU OR SOMEONE YOU KNOW FEEL(S) SUICIDAL, go to the emergency room, call a mental health professional who can talk to you NOW, or call the police and say you have a mental health crisis, not a criminal situation!

In the US, call the National Suicide Prevention Lifeline: 1-800-273-TALK (8255)

FIND INTERNATIONAL HOTLINES

Text HOME to The Crisis Textline at 741741. They are available 24/7 in the U.S., Canada, United Kingdom, and Ireland.

See Also: HELPING SOMEONE WHO IS SUICIDAL