On talking people out of delusions

Question

One psychatrist I know recently wrote, offhand: "I remember when I was a student I tried so hard to convince someone that they weren't royalty, hours of passionate debate, and it just did nothing."

This got me thinking - are there published descriptions of what it feels like to try and convince a person with a grandiose delusion that it's wrong? When this fails, what are their responses to arguments, etc.? I feel like I've read fictional descriptions of this scenario plenty of times in various fiction books, but maybe in reality it looks different and now like I'd imagine?

Answer 1

There is surprisingly little information, publicly, on how you should support someone suffering from delusions, but there is a good set of information from Australia's New South Wales Government website at https://www.health.nsw.gov.au/mentalhealth/psychosocial/strategies/Pages/communicating-psychosis.aspx

2 key points relevant to your query are that you should not state any judgements about the content of the person’s beliefs and experiences; and you should not argue, confront or challenge someone about their beliefs or experiences.

Let's say someone believes they’re the Queen of Denmark, and not Queen Margrethe II. Your telling them they’re crazy will result in them still believing they’re the Queen of Denmark — but now also believing you’re crazy for disagreeing. Attacking someone with a clinical delusion almost always causes them to put up their defences and retreat further into their beliefs.

Equally, feeding into their delusion will only give them more reason to think their beliefs are justified.

Austraila's Queensland Government have also published some guidelines (PDF) on how to help someone suffering delusions.