Topic Tuesday // Challenging Psychosis: Working with Thoughts // 23 Aug, 7pm AEST

[CherryBomb]

@Former-Member I imagine it's pretty challenging and frustrating caring for someone experiencing psychosis. Any tips on maintaining a relationship?

[Shaz51]

Hello @CherryBomb, @Former-Member

I was just wondering if psychosis was a step to take if CBT did not work or was it used for certain problems -- if that makes sense

[CherryBomb]

@leitor good point from @purebliss

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@purebliss wrote:

CBT is only suitable if the patient is able to examine his/her thoughts. It would not be useful if the person with psychosis does not even have a slightest doubt about the voices. Sometimes medications can stabilise the symptoms enough for CBT to be effective. 

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[Shaz51]

Hi @CherryBomb, @purebliss, @Former-Member

CBT is only suitable if the patient is able to examine his/her thoughts. It would not be useful if the person with psychosis does not even have a slightest doubt about the voices. Sometimes medications can stabilise the symptoms enough for CBT to be effective. ---- Ohhh I seee thank you

[leitor]

@CherryBomb Second opinion didn't get that far, he tried to get her on the antipsychotics and she ran away. Maybe they are the best treatment, but if she won't take them then I'd like to try some gentle reasoning.

Hopefully we can have another attempt in a month or so, she has located another psychiatrist. Seems strange that she finds them and books herself in, when she insists there is nothing wrong with her, but a part of her knows something isn't right. 

[Former-Member]

I think one of the most important things is going slowly and remembering that you're a supporter, not a director. You might need to balance your own goals with what's important for your loved one. If something is frustrating, you might need to explore what is going on. E.g. if they have stopped attending appointments, there might be particular barriers that can be overcome.

Another thing that can help is to avoid language that could be triggering, for example it might help to talk about “thoughts”, “beliefs”, “preoccupations”, “concerns” etc rather than delusions. Try to listen respectfully to descriptions of symptoms without endorsing or challenging the experience.

And a third thing I'd like to suggest is reflecting strengths and exploring existing strategies. Even if they don't seem like helpful strategies. Even isolating oneself can be a coping strategy as it might mean avoiding high stress situations which trigger symptoms.

I would love to hear everyone else's tips on this as well. It sounds like lots of members tonight have experience with caring for someone very close to you who has had symptoms of psychosis. 

[CherryBomb]

@PurpleMum yes, there are often signs that mental health is deteroiating. Usually these are 'negative' symptoms, meaning that people start to decline in functioning (e.g., not showering, not sleeping well). Did you notice any of these? What advice would you give to carers during this phase?

@Shaz51, yes makes senes to me! CBT can be used on a range of mental illnesses. The only thing with it is @purebliss pointed out is that it requires some form of awareness of one's own thoughts. Even then, it's not one size fits all. The other part of CBT is that sometimes rather than focusing on thoughts, making behavioural changes (e.g., establishing a sleep routine, and daily schedule) can help too. 

[Koya]

1. Look after yourself - make sure you and the person you are caring for are out of immediate danger.
2. Try to stay calm..if you can pull this off your calm may be contagious and help bring them down maybe to a state where they regain insight and then you can work with their evolved brain. It can give you time too to regain your calm and access your wisdom

[PurpleMum]

My partner is extremely paranoid and angry and the whole world is against him. I already do the things that are listed in CBT and challange those thoughts. He hears voices too and I try and do a reality check with him when he tells me about it. He is newly medicated (two weeks), while I see some inporovement in mood (initial diagnosis prior to psychiatrist was depression) I dont see any change in the other symptoms. My struggle is the hate he projects when he talks about other people and even the paranoia is difficult. I just want to cry and cry. Sometimes I want to walk away because this person is awful!!!! And yesterday he was told his ct scan shows he has lesions all over his brain. I honeslty do not know if I can do this. We live seperately. I am a single mum to two boys with high functioning autism. How do I be supportive and loving when I am exhausted???

[CherryBomb]

@leitor sounds like a challenging situation. It seems like, as you mentioned, that there's a part of her that knows things are not quite right. From your conversations with her, what is she making of her experience? Is she hearing voices? Does she recongise they're voices or are they 'real' to her?