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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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However, in your example you assume that Science has clearly established what is real and what is "delusion". You are assuming that our knowledge of reality is complete as it is now, and it is not. I'm just saying, your example is bad because you assume that you clearly know what is right and what other people experience. Can what people may claim to experience be entirely delusional? Yes. But sometimes people experience things, real things, that are not fake - but not explained yet either. Be careful where you draw the line.

You personally don't handle anything, if the psychologist is a good psychologist then they will be able to determine their patient's mental state despite how they may try to trick them. Your friend might think that she completely fooled her therapist, but sometimes therapists have a way of going about things that are in the best interests of the patient and not what the friends and family of the patient believes is best. Your relative has a right to a therapist that is "on her side" and doesn't deserve going through a therapist who only cares about what your relatives want them to say.

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