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Delusional Friend

Question:

What is the best way to deal with a paranoid persons delusional behavior. I recently became re-acquainted with an old friend who is now a disabled, lonely woman. She is obsessed with notions that people terrorize her and are constantly plotting against her. She believes people break into her apartment and destroy things, and that her enemies are “getting to” the people she is close to and turning them against her. I hate to abandon her, but don’t know how to deal with her delusions. Is it best to just act like I believe all this stuff and sympathize or try to be gently realistic with her. She does see a therapist and psychiatrist – but clearly her condition has worsened over the past 10 years. By the way, her paranoia is what caused the fall-out between us 10 years ago. She has alienated everyone who tries to be her friend and help her. I hate to abandon her since she is physically disable as well – but I don’t know how to respond to her.

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Answer:

I wonder what your motives must be in this situation. A mixture of good will and guilt I suspect. I encourage you to examine them here in as much as while there is no doubt that your desire to be a friend is noble, it’s not a good thing to let your actions and choices become dominated by guilt either.

It’s not good for you to buy into your friend’s paranoid delusions. You don’t do her any favors by reinforcing her distorted world view. However, to attempt to confront her directly would put you into a therapist sort of role that is incompatible with being an actual friend. Perhaps you can find a way to ‘agree to disagree’ with her interpretations so as to find a middle space where your affection for her can avoid getting clobbered by her paranoia.

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p> It’s very good and appropriate that your friend is seeing mental health professionals for her paranoia. There are medicines that can help with this sort of thing, and it is very good that she is being monitored by someone who can be appropriately responsible for her care should there be an exasurbation. Not knowing how agitated your friend can get, I’ll encourage you to be watchful of your safety, and encourage you to not wait to call for appropriate immediate professional help for her if you come to believe she requires it.

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