How to Reason with a Delusional Person: Helping a Sibling with Delusional Disorder

How do you reason with a delusional person—especially when that person is family? You’re in a difficult position to be sure, but by working to understand your sibling’s delusional perspective, you can learn how to reason with a delusional person—and how to help a sibling get into treatment so that they, and your family, can finally begin to heal.

Pete and Elizabeth were pretty typical for a brother and a sister; there had always been some sibling rivalry, but they loved each other, and they grew up to have a close relationship. Right after college, Pete got a help desk position at a company that built computers. But something started going very wrong in his life.

Elizabeth realized her brother was obsessed with a woman at work. She asked if the woman was his girlfriend, and Pete explained that she was his true love and that they were “destined” to be together—even if the woman didn’t know it yet. Startled by his answer, Elizabeth began to worry about her brother’s mental health.

No matter what Elizabeth said, she couldn’t make her brother understand that his coworker was not in love with him—in fact, she found out, he had already asked his “true love” out once and had been rejected in no uncertain terms. Yet her brother continued to claim that they were meant to be. A few weeks later, he admitted he was planning a “grand gesture” to prove his love, though he wouldn’t share details. At that point, Elizabeth knew she had to do something to bring her brother back to reality and save him from himself.

Her first instinct was to try to talk him out of it. She confronted him directly and begged him to understand that his love was a delusion, and that he needed help. He turned on her, angry at what he perceived as a lack of faith and support, and claimed she had betrayed his trust. Though hurt that her words had failed to reach her brother, Elizabeth wasn’t ready to give up on him just yet. Realizing she did not have the tools she needed to reason her brother out of the beliefs that had so obviously transformed into a full-blown delusional disorder, she turned to the professionals at a local residential treatment center for help.

Understanding a Delusional Perspective

Talking to any delusional person can be difficult, but when it’s your beloved sibling who’s living with a delusional disorder, it can be downright painful. You’re put in a difficult position, wanting to support your brother or sister but not knowing how, or if, you can make them see their delusions for what they are. The first step to helping them is to try and understand what they are going through.

Delusional disorder, formerly known as “paranoid disorder,” is a condition where an individual experiences persistent delusions—unshakable beliefs or ideas not based on objective reality. They experience psychosis, meaning they have trouble distinguishing between which perceptions are true and which are false. They may often misinterpret situations and draw false, perhaps seemingly nonsensical conclusions. As confusing as this can be for you, remember that it can be just as confusing and disorienting for your sibling, if not more so.

Delusions tend to center around common themes:

  • Your sibling may experience non-bizarre delusions, such as an untrue belief that they are being stalked, followed, conspired against, or—as in Pete’s case—that they are loved by someone who is, in fact, a stranger or distant acquaintance.
  • Alternatively, they may suffer from bizarre delusions, which center around impossible situations and ideas, such as that they are turning into a vampire or werewolf, or that they’re being haunted or possessed by a ghost.
  • Then there are grandiose delusions, which involve an overinflated sense of self-worth. They may be jealous and believe their partners are unfaithful. They may falsely believe they have a medical condition or think a celebrity or stranger is in love with them.

To a rational person not suffering from delusional disorder, such beliefs may be jarring, frustrating, or even frightening. It’s okay to feel disturbed or distressed by your sibling’s delusions—these feelings are valid, and do not mean that you are a bad sibling or do not love your brother or sister. But it’s important to remember that, behind these delusions, the sibling you love and want to help is still there—confused, perhaps, but still the same person you grew up with. The best way to help them is not to confront them directly, as Elizabeth initially did, or worse, try to ignore the problem entirely. To truly reach them, you’re going to need help.

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How to Reason With a Delusional Person

How do you reason with someone who is delusional? How do you convince someone that their reality is warped, that their perceptions cannot be trusted? The truth is, the best way to help your brother or sister is to approach them gently, with firm but calm compassion, and guide them towards seeking professional help. Simply telling your sibling they are delusional will not dispel the delusions themselves; however much you love them, talking to them is not likely to be enough to help them find their way back to reality. Such work takes time, patience, and the support of a trained mental health professional who can help your sibling find their own way and develop their own tools for identifying and managing their delusional symptoms.

When broaching the subject of your sibling’s delusions, take care to stay calm and avoid using emotional language that may be perceived as a personal attack. In Pete’s case, he believed his coworker was in love with him when she was not. When Elizabeth tried to tell him he was wrong and that she didn’t understand how he had jumped to such a “crazy” conclusion, Pete not only believed she was wrong, but decided Elizabeth was not sane for disagreeing with him.

On the other hand, it’s also important not to give in to or support your sibling’s delusions in order to placate them. Though it may calm them in the short term, it will only reinforce their delusional beliefs and make it harder for them to understand that they need help.

Instead, calmly ask questions about their delusions. Ask them how they arrived at their conclusions, and do not judge or correct them. This will help guide your sibling to logically re-examine their beliefs and may help them to spot faulty logic. You may gently suggest evidence to the contrary, and ask them their opinion. But do not directly tell them they are wrong or delusional, as it will make them resist working with you.

How to Help a Sibling Get Treatment

It’s likely you will need help convincing your sibling to go to treatment. Ask other family members for help, or anyone else your sibling knows and trusts. Residential treatment may be your sibling’s best hope for healing, as a long-term inpatient program offers copious amounts of time, space, and resources that other treatment options do not. When you contact a residential treatment facility, explain the situation and ask for help. The staff at these facilities have experience in dealing with delusional people and can give you advice on how to talk to your sibling about attending treatment.

At a residential treatment facility, your sibling will have access to psychiatric and medical support all day, every day during their stay. One-on-one therapy sessions will begin right away to discover and address the root causes and triggers of their disorder. They may be prescribed certain medications to help them manage their delusional symptoms, such as an antipsychotic. They may also participate in treatment for any co-occurring conditions they may be experiencing, like depression or anxiety, that could be exacerbating their delusional symptoms. With the help of their therapists, your sibling will learn life skills and coping mechanisms that can help them identify, examine, and deal with delusional thoughts whenever they arise. And they will be in a safe environment with other people who face delusions as well. This can be wonderfully healing for a person who has delusions, as they need to know they aren’t alone and that other people have trouble distinguishing which thoughts are real, too.

Residential treatment can help you and your family heal as well. Inpatient treatment gives you and your sibling some much-needed space, and allows you to take better care of yourself while your sibling focuses on their own healing journey. You and other members of the family may also actively participate in your sibling’s treatment plan through family therapy, which can help uncover and resolve negative family dynamics and help you each learn to better support and care for one another moving forward.

Perhaps most importantly, residential treatment can help you see that it is not your responsibility to “cure” your brother or sister of their delusions. Instead, your role in their recovery should be to do what family does best—love them, support them, and help them get the help they need, when they need it.

For Pete, it was almost impossible to imagine a world in which his “true love” did not love him back. But eventually, Elizabeth, armed with the guidance she had received from their local treatment center and with their parents’ support, managed to convince him not only to call off his grand plan but to see a therapist and give long-term treatment a try. It took a lot of time and a lot of work, but eventually, Pete returned home with a clearer head and a mental health toolkit filled with coping mechanisms and a sense of self-awareness that would help him cope much better with his delusional disorder in the future than he had in the past. And Elizabeth was there to welcome her brother home with tears of relief and open arms, ready to help him find a new way forward one day at a time.

BrightQuest is a long-term residential treatment center for people struggling with mental health disorders as well as co-occurring substance use disorders. Contact us to learn more about our renowned San Diego-area program and how we can help you or your loved one begin the journey toward recovery.