Delusion Disorder – Causes and Symptoms

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"Health Watch"

Delusion Disorder – Causes and Symptoms
Communicating with someone who has delusions

A delusion is a fixed false belief that can't be swayed by reasoning. Paranoid, grandiose, and religious delusions are most common.

A paranoid delusion is very frightening: The person thinks someone is out to harm him. Acknowledge what he says but don't agree. For example, if your patient tells you that the FBI is after him, hone in on his feelings: "Sensing that you're being watched all the time must be very frightening."

Keep your patient's environment as safe as you can. Try to have the same staff assigned to his care each day and prepare him for any changes without providing too many details; for example, "Mr. Jones, we're getting some new patients today so we have to move you to a different room." If he responds negatively, reassure him that he'll be safe and you'll protect him.

Grandiose and religious delusions are typically less frightening. A person having a grandiose delusion, for example, thinks he's someone very powerful or important. Someone with a religious delusion may claim to be a religious figure.

Follow these guidelines to maintain a therapeutic relationship with your patient:
  • * Accept him as he is. His mental illness is causing his abnormal perceptions.
  • * Monitor for hallucinations and delusions to assess his response to psychotropic medications.
  • * Assess his safety and monitor for warning signs such as withdrawal and depression.
  • * Give him appropriate feedback on how you interpret his communications and try to help him focus on the realities around him.
  • * Encourage him to learn about his medical illness and help with his care; involve him with diversions such as reading, writing, or solving puzzles. These activities can diminish irrational thinking and help him feel comfortable and safe.

Responding to disorganized speech

Classic verbal disturbances that might occur with schizophrenia include associative looseness, neologisms, clang association, word salad, and echolalia.

Associative looseness means one thought isn't connected to the next. When you tell your patient you've brought his medication, he might reply, "Blue lights and gold. I go round and round. The grass is green." These phrases seem disconnected but could shed light on his thoughts. If you suspect that the colors are significant, ask, "Are you asking what different medications you're getting here?" If you can't make a connection, tell him you don't understand but you'll keep trying.

A neologism is a word or phrase the patient constructs that's meaningless to everyone else, such as "I bessaton the coaglese and vergified the rest."

Clang association is meaningless use of rhyming words: "I read the bed and said the head then led Ted to the dead."

Word salad is a mix of words or phrases that has no meaning to the listener, such as "animals, fast food, family, working, birds, loving, the net."

*Dr Smita Pandey Bhat is a Counselor and Clinical Psychologist. She has completed her M.Phil and PhD in Clinical Psychology, from Central Institute of Psychiatry (C.I.P), Ranchi. She has seven years of experience in this field at different places. She provides psychological counseling, psychotherapies like, Supportive Therapy, Cognitive Behavior Therapy, Interpersonal Therapy, Social Skills Training, Assertiveness Training etc. as per the requirement of the people. She also provides assessments like Intelligence Tests and Personality Assessments for Children as well as Adults.

The areas of problems that require her services is ranging from mild emotional problems to severe mental problems. She provides counseling to children for the problems like, lying, stealing, truancy, identity problems, low self esteem or self confidence, poor performance in school, learning disabilities, autism, attention deficit and hyperactivity problems, emotional outbursts, anger outbursts, crying spells, sadness and depression, problems regarding the choice of career, problems in sleeping etc. She also provides counseling to parents called as Parental Management Training and counsel them for good parenting strategies.

For Adults she provide services for work related stress, stress within the family, tension, anxiety, depression, low self esteem or self confidence, problems in dealing with stress or coping or making adjustments, problems in married life, problems related with sleep, boredom and stress burnouts. She also provides management for obsessive and compulsive behaviors. She teaches them techniques so that they are able to cope better in their lives and have a good quality of life. She also provides cognitive rehabilitation to the patients of chronic schizophrenia , dementia and brain injury patients helping them to learn self help skills and help them refine their cognitive abilities like attention , memory, organization and planning etc. through cognitive retraining and other behavioral techniques.

Dr. Smita Pandey Bhat has given lectures on clinical psychology for nursing students and staff, as well as M.Phil students. She is a clinical psychologist of repute and has made appearances on several live television shows and appeared as Celebrity Guest on indiatimes.com

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