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Are there any conversion tricks or strategies to talk an individual with schizophrenia out of their delusions?

Suppose one has a friend who is delusional, and the friend believes there is a conspiracy going on against him. Although the extent e.g. people and time required to orchestrate such a conspiracy would be impossible, this person does not think of it as such. Complicating matters is the fact that this person declines to take antipsychotics, precisely because he believes this is what his enemies would like him to do.

How might one talk this person out of their delusions?

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    $\begingroup$ No. You just need to provide unconditional love and acceptance. Look into the Hearing Voices Movement. Simply accepting people’s unusual beliefs and treating them like normal human beings has been surprisingly effective in helping people eventually let go of those unusual beliefs, because the origin of those beliefs usually at least somewhat stems from social isolation and rejection. $\endgroup$
    – Biointhetrunk
    Mar 18, 2018 at 21:28
  • $\begingroup$ We don't seem to have a question about that here, but generally, delusions are the most difficult part of psychosis to address with [psycho]therapy, which is a little surprising. cochrane.org/CD009785/SCHIZ_treatments-for-delusional-disorder $\endgroup$
    – Fizz
    Mar 27, 2019 at 7:58
  • $\begingroup$ @Fizz: you mean "which is little surprising"? $\endgroup$
    – Quora Feans
    Jan 3, 2020 at 10:29
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    $\begingroup$ @QuoraFeans: no, I meant it's surprising that something that involves thoughts/ideas is so resistant to psychotherapy in contrast with say hallucinations, which may not be able to do much about perceiving (although presumably one may be able to learn to ignore them). $\endgroup$
    – Fizz
    Jan 3, 2020 at 16:43

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You need to understand that their experience is highly emotionally significant for them. Not necessarily in a good way, but it is. For affected people it feels true - it "is true". What medications tend to do - they dampen the affective significance, among other things, and people in time become more able to be in touch with ordinary reality. By definition delusions are "unshakeable beliefs".

Having said that - it is known that there are possibilities of treatment without medications, or at least minimising their use. They tend to involve group and community based psychological interventions over long time. Scandinavian countries (e.g. Norway) do a lot of work in that regard. From my colleagues I have also heard that medication use is less in India - but the family ties and family member availability seem greater hence it becomes more of a group intervention. The model is that many family members in a loving way provide information that conflicts with the delusional content.

Then there is http://www.isps.org/ - a reputable organisation for psychological and social approaches to psychosis.

I hope this shows you to not expect a solution that you might be able to effect on your own. The psychotic experience can be very disturbing and you may be in for something that you do not expect when trying "to talk this person out of their delusions". Often you can become a part of the delusion - which then lessens credibility of what you say in the person's eyes.

Good luck

P.S. Of course - we can have a different picture in illicit drug induced psychosis - by definition psychosis should abate soon after drugs are out of the system. It happens however that with recurrent drug use people develop psychosis that does not abate.

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