Tuesday, January 19, 2010

Working with Paranoid Clients

I work with a few clients who have paranoid beliefs and typically interactions with them involve a careful balance. On the one hand, I'm not supposed to encourage delusional thoughts and engage ongoing conversations that involve peoples' paranoia. But then how successful is it to tell a person her beliefs are all in her head? Or even discourage her from these thoughts? Even when a person isn't psychotic, her reality is her reality.

A couple of coworkers told me early on to approach clients with paranoid tendencies by saying something along the lines of "This situation must be causing you a lot of stress. Do you have someone to talk to about it?" This would hopefully encourage clients to seek a counselor [we don't have therapists on site]. A therapist would ideally be well equipped to deal with a person with paranoid thoughts.

But then, what to do when a paranoid client already has a psychiatrist and/psychologist. She takes psych medication and still truly believes she's the protagonist in a wide reaching conspiracy. Sometimes I catch myself having a thought of, after hearing the same story again and with such conviction, well who knows? Her reality is so vivid to her. And sometimes these are thoughts people have had for 10, 20, or more years. That alone is hard for me to grasp.

4 comments:

fightingmonsters said...

I do the same thing sometimes as well (wondering if there is something in the stories I mean!). I probably shouldn't admit to that!

oregonamy1972 said...

I often think to myself, "Just because you're paranoid doesn't mean they aren't out to get you." That's one of the saddest things to me...imaging living a life where you are afraid every single day and every single minute. It would be like living in a nightmare. I can't even imagine.

C. Marie Byars said...

Interesting thoughts.

Anatolia said...

Admittedly belatedly for Fightingmonsters and Amy, thank you two and C. Marie Byars for reading and commenting!

CB, your comment made me smile. Though I wrote my last paragraph with a bit of tongue in cheek attitude, to see folks so entrenched in their beliefs it can be tempting to stop and think... Well, maybe?...

Amy, I understand what you mean. It's interesting to see different ways people cope with paranoid beliefs.