Helping My Friend

Hello folks,

I've had a really good friend since high school. The guy is diagnosed with schizophrenia, I'm not sure which type, ADHD, and psychopathic tendencies. I don't know whether he is on any kind of meds (besides 'self-medicating' with marijuana, which he recently quit using), and I believe he isn't in any therapy either, and hasn't been for a while.
He is always somewhat delusional, but the problem is that he has frequent episodes of really losing touch with reality. He now also found a friend who is also schizophrenic, and they strengthen each others delusions and seclusion.
I know he doesn't know much about his disorder and how it affects him.
What I notice is that most people ignore him whenever he is in one of those episodes. I think that's sad, since I guess most of you know how hard you need support and friendship during those times, as would anyone with mental issues.. Since so many people abandon him, he gets worse because of this.
I would like to just be there for him, and maybe even try to help him in some way. I just don't know how. I don't know what I can do. I don't think it would be right to argue with him about the reality of his experiences, and I wouldn't want to throw him off the deep end by just stating that this is not real and part of his illness. I am glad that I'm one of the only people he still trusts, and I don't want to ruin any friendships by invalidating him and his experiences like this. I don't think it's right to talk too much about the experiences he is having, cause it only gets him in deeper, but I don't want to ignore it either.
But what I think must be worst for him is the social abandonment and avoidance he is experiencing. I don't want to be one of the people who do that to him. I have trouble watching my own boundaries too so I don't want to get myself into situations that would be too much for me to handle, cause especially combined with the ADHD, he can get a bit, overwhelming.
So, according to you, how should people best support someone who is going through schizophrenic episodes?

Greets, TC

The problem with trying to reason with someone who is in acute psychosis is that he may hear or see you saying or writing something you didn't, or you may say something you didn't intend to say or you may say it in a way you didn't intend and he will interpret it as hostile or conspirational or whatever, either immediately but usually only after a period of time when he's alone so that you mightn't even have an opportunity to explain yourself. This may happen to some extent anyway, and even with people who are supposedly normal. Still, the best you can do is try to educate him when he isn't in acute psychosis. You might want to direct him to my blog post when he seems to be in a good enough shape to read it properly, and you definitely should read it yourself: link.

I also consider the main difficulty the greater risk of misunderstanding, in both directions.
But I believe that you can also talk with someone who is “... in acute psychosis ...”
You should make sure that you always make explicit what you mean; don’t let room for ambiguity.
I believe that keeping a distance only increases the chances of misunderstanding. Talking makes things clearer and approaching someone in recognizable normal manner can be associated with a normal response. I once asked the way from a screaming madman and he gave me a totally normal answer.
TheCollective wrote:

I don't think it would be right to argue with him about the reality of his experiences, and I wouldn't want to throw him off the deep end by just stating that this is not real and part of his illness.

I think that when talking about someone’s delusions all the nuances and complications arise as when differing in opinion with a normal person. Often it is possible to disagree as long as you are respectful.
It is important to make clear that you don’t share his delusions. Delusional persons often have so little real communication with others that they don’t realize that others don’t share their delusions.
Aaron T. Beck et al (2009). Schizophrenia: cognitive theory, research, and therapy (p. 95):

One patient, for example, giggled when questioned by doctors. He believed that they were playing a game with him since they “obviously” knew what he was thinking without having to ask.

Just don’t expect delusional people to change their opinions after you have said something like “Paranoia!!” Someone who interprets hundreds of events a day within their delusional system will not change his mind after one remark. Also realize that a delusional person is expert in his own delusional system, so that you can lose the argument.
You can just give your view of the events he interprets delusionally.

While reading the question of TheCollective, I wondered if these schizophrenics were also identities of TheCollective or belonged to a different cluster of identities.

Guangxi wrote:While reading the question of TheCollective, I wondered if these schizophrenics were also identities of TheCollective or belonged to a different cluster of identities.

You are asking whether I need this help for one of my alters? Funny.
If yes, I should tell you that my other alters keep this 'delusional' way of thinking in check. Yes some of my alters share certain ideas about reality with my friend. But because these identities are not the only ones in this body, we straighten each other out so to speak, so no break with reality happens. Should one of the alters crash, another one takes over. I often wonder whether I developed DID to help handle the possible childhood-onset schizophrenia, or whether the 2 are sort of related in any other way. But I guess that's another story.
I've spent lots of time trying to build communication with these alters and to talk about their ideas, and I think it's easier to help people inside my head than external ones.
So no, my friend is an actual, external person.
Actually I've often wondered whether my friend might have DID instead of, or along with the schizophrenia. I'm obviously scared to talk to him about this suspicion because I don't want to get any even weirder ideas into his head right now. He talked to me before about having non-human friends around (which can be both part of schizophrenia, but also DID), but he didn't want to disclose much more that I can remember.

It's one of the difficulties, when we're talking about certain shared delusions about government mind control, Illuminati, etc, and very suddenly he takes this side-road which doesn't make any logical sense, say, thinking his neighbor is one of them, and his parents are mafia, and all of it's the fault of the Turkish people. I don't know how to tell him exactly that this side-road crosses the line from being possibly real-ish to "bizarre", especially since these side-roads in his thought-process are so sudden and very outspoken and adamant.

mctps wrote:The problem with trying to reason with someone who is in acute psychosis is that he may hear or see you saying or writing something you didn't, or you may say something you didn't intend to say or you may say it in a way you didn't intend and he will interpret it as hostile or conspirational or whatever, either immediately but usually only after a period of time when he's alone so that you mightn't even have an opportunity to explain yourself.

Sometimes I notice that he interprets certain things we are talking about in a wrong way yes. Like, say my point was, that the unknown forces influence people (through commercials and food, medicine etc), and he thinks they're spying on him cause they're his neighbors and they know that he knows too much.
I haven't noticed any consequences though, except for maybe conversations falling apart. That is, if he's not hiding his ideas about me in an expert way. However, so far he has been the kind of person who will randomly come to my doorstep to get his explanation, so I guess that's good.

I'm actually scared that he might hurt himself or other people, since he has these psychopathic tendencies, and this delusion of being spied on, and carries big blades around to protect himself. This really has me worried. I don't really know his parents or anything, and don't know what else I can do about this.

Yes I will try to find out how much education he can take when he's more stable. Thanks both of you for the links.

Guangxi wrote:I think that when talking about someone’s delusions all the nuances and complications arise as when differing in opinion with a normal person. Often it is possible to disagree as long as you are respectful.
It is important to make clear that you don’t share his delusions. Delusional persons often have so little real communication with others that they don’t realize that others don’t share their delusions.

That's an interesting point, stating that they don't even know that it's not the norm to think that way. I will think of this when communicating with him.
In contact with another schizophrenic person, I found myself unable to make any valid point at all, since the person was indeed an expert in his own delusional world. Maybe with him it is possible to disagree. It might be my own social difficulties that prevented me from speaking out about my take on his world. I'm scared that if he's really unable to be reasoned with, that he might pick up and leave immediately or we'd get into a fight, which would affect and possibly destroy the friendship.

Would it be possible that this psychosis was triggered by him stopping the MJ? I know that certain species of MJ can suppress psychosis, while others can induce it, and was wondering whether anyone here has experience with using MJ and how it affects the schizophrenia. I kind of feel a bit guilty, cause long ago and before I knew of his schizophrenia, he took his first hit with me.

Thanks for helping me to understand and help my friend.
Sorry for the long post..

That's an interesting point, stating that they don't even know that it's not the norm to think that way.

That reminds me I've had a few such short episodes when I've thought the people around me had the same (delusional) perspective of the world but had simply figured out how to deal with the crazy world, how to be decently successful and so on.

Also reminds me it can be depressing, depending on the delusion, to be deprived of it. But in some cases it might not even be possible through any human intervention. It could be that the episode has to run its natural course, as it were. Anyway, I don't think your friend would be unhappy to be deprived of his delusions, from what I can tell from the little you've written here, although there's always that risk when you've thought you're someone special even though you're just a regular guy with schizophrenia.

I'd like to also make clear I DON'T advise avoiding trying to reason with delusional people though. If you read my theory at my blog, you'll notice I differentiate between rational delusions and delusions sustained by some sort of pathological thought process (what I attribute to mind control by the subconscious). Of course, you should reason with people who are merely having rational delusions, inasmuch as anyone is ever fully rational. The tricky part is being able to tell when someone is having reasonably rational delusions and when he's not really in control of his thought processes, e.g. unable to recall obvious facts or experiences or interpretations that would dispell his delusions. Well, sometimes it might be obvious, but that kind of depends on a few things, such as how honest he is about his thoughts and so on. But it does sound like you've had some success in differentiating between the two states.

P.S. I suppose it is possible to throw a reality monkey wrench into the process of his pathological thought and force him out of it if you make him recall the right thing(s), I mean even when he's really deep in psychosis. Sometimes that might be possible. But I suppose the acute period is not the optimum time as a general rule. I think preemptive strategies are better on the whole. But I'm not sure. I don't have terribly much experience regarding these things.

P.P.S. Regarding losing arguments with a delusional person, that's often but not always a sign that his delusions are in fact what I'd term "rational". If he is able to consider your point of view AND able to dismiss it through argumentation, then, yeah, maybe your position isn't as solid and well considered as you thought. It's why I encourage people to educate themselves about parapsychology: it gives them a whole new arsenal of arguments and entirely different perspective from which to dispell delusions that would otherwise be very difficult to discredit.

Revised my previous message a bit just now. (I noticed you're online so you might want to know.)

P.S. I think a lot more people would regularly be classified as schizophrenic if they didn't have a tendency to forget or ignore or dismiss things they can't explain or don't want to be true. I think in many cases periods of long "psychosis" are simply people being too honest with themselves (as well as ignorant of parapsychological explanations, so they have to resort to whatever sort of paranoia seems the most rational option in the culture they belong to).

Well I just wanted to give my compliments on your blog. Lol I'm imagining deep conversations about colliding worlds now. Anyway I think your blog is really good and it kinda worries me that I actually understand what you're talking about and agree on most of it. I've been at odds with this 'subconscious' our entire life, and in here 'she's' actually alleged to have created the alters. and..
Well I won't go on about it any further, there's just no way to do that properly.. Too much, and I don't know whether I should jump into this rabbit hole at all.

And yes I have differentiated between the 2 states you mentioned. My friend does have the irrational version. I don't know how much control over his own thought process he ever has. It's just worse now.
I do think he's a special person in his delusions and that it would hurt him to be snapped out of it if that's even possible. Like you said, sometimes these things might have to pass naturally. I should just hope for it to pass without doing much harm and try to talk to him better after this episode. Of course I'll still be here for him but I'll save the tough stuff.
Like I said, I'm kinda worried about the knives and him getting hurt physically or emotionally, by the damage he causes to his surroundings right now, which just makes it hard to watch, even more so because I sorta know what's happening in his head.

It's just sad to see what the problem is, and still be powerless.

mctps wrote: I think in many cases periods of long "psychosis" are simply people being too honest with themselves (as well as ignorant of parapsychological explanations, so they have to resort to whatever sort of paranoia seems the most rational option in the culture they belong to).

Yes it would be good if this friend of mine had some more peace of mind to actually research his thoughts and teach himself other ways to interpret certain things. But he has severe ADHD and he doesn't nearly have the patience for it, if he even has the interest which I doubt too.

Anyway, thanks for your help!