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Diagnosing delusion
angst kitten
danaeris wrote in psychology
So, I have a question. This is the second time I've run into it (with separate people -- first a friend, and now a relative), and I'm kind of at a loss as to how to handle it.

Essentially, when a person has beliefs that are potentially delusional, how does the mental health professional determine their validity? Some beliefs are clearly delusions (tinfoil hats and aliens, for example). But others are not so clear.

With my friend, she was clearly bipolar with some paranoia, and yet she was clever enough that her doctors never seemed to see what was really going on. It was never clear to me how we, as her friends, were supposed to get her the help she needed when the mental health professionals didn't seem to be catching on.

With my relative, she says that A is happening, and her immediate family says that it is a delusion. I'm not there on the ground, so I can't judge for myself, but A is in the realm of possibility. Her family is insisting on being present for her appointments with the psychiatrist they chose, and she feels like she can't trust that psychiatrist because she didn't choose him/her. My initial instinct is that she has a right to a therapist and/or psychiatrist who she believes is on her side. But then I think about my friend and the frustration of knowing that her doctors couldn't see what I could see, and I'm not sure.

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It is important to remember that your friend and your relative must want to change in order for them to accept any help, whether you believe that the helpers are competent or not. The only information missing from your post is whether your friend and/or relative are harmful to themselves or to someone else and in what ways - the answer to this should determine the urgency of your friend and relative in seeking the appropriate treatment. Other than that, patience and empathy will serve your friend and relative to benefit them. Therapy takes time and it is important to build trust between the therapist and the client to ensure collaborative effort in finding the right type of treatment that works, long-term rather than getting a quick fix.

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