How to Recognize and Respond to Hallucinations and Delusions

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Hallucinations and Delusions are the hallmark symptoms of psychosis. A person in psychosis experiences reality very differently from the general population. The juxtaposition of a person in psychosis and a person not in psychosis often leads to feelings of great discomfort, fear, confusion, and stress for both parties. Whether from schizophrenia, bipolar disorder, brain injury, or the increased use of drugs such as crystal methamphetamine, experiencing these symptoms in some form is not entirely uncommon. This article describes what hallucinations and delusions are and suggests ways to respond to the people in our lives who experience these symptoms as distressful.

What are Hallucinations?

Hallucinations involve hearing, seeing, feeling, tasting or smelling something that does not actually exist. A hallucination feels very vivid and real. The most common type of hallucination is hearing things that are not there, such as voices. Some people find comfort in their hallucinations, but typically the experience is alienating, stressful and often terrifying. With paranoid schizophrenia, for instance, hallucinations are commonly experienced as a belief that people, even loved ones and healthcare workers, intend to do the person harm. As a result, the person experiencing hallucinations often feel immense distrust, discomfort, and even terror of those around them. In turn, this person’s community (family, healthcare workers, friends) can feel similarly uncomfortable, confused, awkward, and at times, fearful.

What are Delusions?

Delusions are firmly held beliefs that are not true. There are many types of delusions, such as delusions of grandeur, control, or reference, but the most common one is the delusion of persecution. This ...

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...hiatric emergency if you cannot establish safety and you believe the person may harm themselves or others. Maintaining physical distance and calling for professional help is likely the best course of action in this situation.

People who experience hallucinations and/or delusions often respond to the same elements that foster human connection in anyone. Empathy, safety, trust, rapport, transparency, and support are the universal ingredients of positive human relationships. The main difference between someone in psychosis and someone not in psychosis is the altered perception of reality. Tragically, it is this clash of realities that often leads to a sense of danger and fear for both parties. Fortunately, an understanding of hallucinations and/or delusions and how to approach a person in this state will help build a relationship that increases safety for everyone.
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