The following is obviously not something that will work for everyone/every type of delusion/etc, but i find with my aunt that responding to her delusions with logic can cut through the delusion for her – far more effectively than trying to convince her she’s not having a delusion.
A regular one for her is that the police are going to come and arrest her. She will be terrified that they’re on their way to lock her up. Sometimes its just that, with no reason given, and sometimes its “They will arrest me unless I [do a particular thing].” A frequent one is “unless i bake them a cake.”
It sounds silly to someone mentally sound, and my cousins were always cruelly amused by it and mocked her for it behind her back. But to her, during an episode, its 100% real, and 100% terrifying.
And obviously, telling her, “thats not correct, youre having a delusion” would not work, and would just cause her to think that she’s on her own with her impending arrest. You could tell her til youre blue in the face that she’s deluded, but that wouldnt cut through the delusion.
What DOES work (again: for her; this is not a one-size-fits-all approach) is engaging with the delusion long enough to bring logic into the equation.
She thinks she’s going to be arrested: i ask her what for. What crime did she commit? Tell her that the cops cant arrest someone without cause, so what crime did she commit that theyre arresting her for? Sometimes that alone is enough to have her go “…oh. None. I havent broken any laws.” In which case we can say “So there’s no reason to arrest you then, is there?” and she goes “Huh. True. Okay,” and thats that; the delusion has been cracked – or at least, the threat of it has been neutralised.
Sometimes it’ll be something like the “unless i bake a cake” thing. In which case, I’ll inform her that not baking a cake (or whatever task she thinks theyre demanding of her) isnt a crime. Sometimes that alone is enough to have her going “oh yeah,” but if it isnt, following up with “So if the police arrest you for something that they know isnt a crime, THEY can be punished. So they’re not likely to do that,” at which point, even if the delusion hadnt been cracked, she at least no longer feels unsafe. The police cant arrest her for not baking a cake. And if they try, then THEY’RE in the wrong. I think there was only one time where her delusion/fear continued past that, and i said something like “I promise that if the police arrest you for not baking them a cake, that i will get a lawyer for you and we’ll make the cops lives a living hell for arresting you for something that isnt illegal,” and, that was enough to put her fears at ease. She still thought the cops were going to arrest her, but she was no longer scared of it, because i promised to reign hell on them if they did.
And again, it’s not an approach that would work for everyone, and we’re lucky in that her delusions are easily countered with logic. i dont even know if that approach is a pchyologically approved way of dealing with delusions, but if the options are “Tell her she’s deluding and a) have her trust in me be eroded by not taking her seriously, and b) leave her mired in fear and panic,” versus “Settle her fears by telling her that on the off chance she’s arrested, that I’ll protect her and get her out of jail quickly, meaning she’s no linger scared,” then i know which one i would prefer.
I dont know if this counts as encouraging the delusion or arguing with it, but i would hazard a guess to say its… neither? Maybe? Its approaching the delusion from the deluded person’s perspective with a view to putting their fears at ease. I’m not trying to tell her that she’s deluded and she should stop worrying. In her mind, its real, and telling her it isnt wouldnt work. So I’m challenging the delusion within the parameters inside her head. “The cops cant arrest you, that’s illegal” works where “The cops wont arrest you, youre deluded” would not.
At the end of the day I prioritise her peace of mind more than reality. Telling her that she’s having a delusion wont get rid of it. But giving her the tools within her delusion to remove the fear from it means that she’s no longer mired in terror, and thats more important than trying (and probably failing) to force her back to reality.
Which is kind of the same approach i used with my Nanna during her last days of dementia. She would want to get up and go and make dinner for everyone. Telling her “No, youre an 80 year old woman who cant stand on her own anymore, you’re not cooking dinner for anyone” would have just distressed her. But telling her “No its ok, [your daughter] is cooking dinner for everyone tonight; youre off the hook! You get to relax!” calmed her and gave her a sense of happiness that her daughter was treating her to a night off.
Idk if that’s the medically approved approach or not, but I know it stopped my Nanna’s distress and put her in a state of contentment instead, which was vastly preferable, in my opinion.