SCENARIO A
Meet Paula.
She lived at the homeless shelter where I work. Paula is the woman who REALLY wrote the Harry Potter series.
Paula was very proud of her literary abilities. She absolutely hated that “British b*tch” who stole her masterpieces.
In fact, we learned to refer to JK Rowling as “She-Who-Must-Not-Be-Named.”
Is this delusion dangerous? YES or NO
SCENARIO B
Meet John.
He also lived at the homeless shelter. John is often attacked at night by my co-worker Mike. Apparently, Mike waits until John is asleep and then repeatedly hits John’s legs.
John’s legs show no signs of the violence, and no one ever witnesses the incident.
Is this delusion dangerous? YES or NO
DELUSIONS – WHAT YOU NEED TO KNOW
Last week we started the conversation about delusions. We learned that:
- Most delusions are not dangerous—even very bizarre delusions.
- There are two types of delusions that should concern you. The first is “command hallucinations.” They can very dangerous, and you should call the police immediately.
The second type of problematic delusions is “persecutory delusions.”
Persecutory delusions are where the person believes that someone (or something) is out to get them.
According to the research, there is an elevated level of risk with persecutory delusions.
In my experience, though, most persecutory delusions are not dangerous.
In fact, I know three people who believe they have had chips implanted in their brains by the government.
There is one specific persecutory delusion that is more problematic in my experience (and supported by research).
It isn’t good if the person with the delusion knows their “alleged persecutor.”
“Persecutors” such as “the government” (a non-person) or JK Rowling (a celebrity that the person doesn’t have access to) are likely not dangerous delusions.
So, is Paula’s delusion about JK Rowling’s plagiarism dangerous?
No. Paula has no ability to retaliate against a billionaire who lives in another country.
Is John’s delusion that Mike is attacking him at night dangerous?
Maybe. It is worth monitoring.
SO, WHAT IF THE “PERSECUTOR” IS AT YOUR ORGANIZATION?
This one is hard to give a “one size fits all” answer.
The best I can say is that you should monitor this very closely.
In particular, you are looking for:
a. Violent language.
b. Increasing levels of fixation on the “persecutor.”
c. A history of violence (the best predictor of future violence is past violence).
If you see any of those three things, you likely will need to take more drastic measures (e.g. ask the person to leave, call law enforcement, etc.)
I know this stuff is hard and complicated.
Let me finish, though, by reminding you—again—that most delusions are not dangerous. These are the exceptions.
Want to learn more about interacting with individuals suffering from extreme mental illness? See below!
Have a great week!
Ryan
