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I have a friend who I've known for over forty years. Early on in our friendship, my friend was diagnosed with paranoid schizophrenia and has been on medication and psychiatric care ever since. There are occasional psychotic episodes that result in them being sectioned. We "talk" (it's mostly written messages) more than we used to, because of the growth of social media.

The problem I have is that I'm lost when it comes to replying to many of my friend's messages. They are often extensive descriptions of delusions, conspiracy theories, the health problems caused by decades of taking psychotropic medication and dreadful descriptions of the physical and mental distress my friend constantly feels. I think they are asking for sympathy and support, pouring our their distress to anyone who will listen, but I don't know how to respond. I can't fix anything for them, and after all this time, neither can anyone else.

I am as supportive as I can be. I express sympathy but I tend not to ask too many questions because they end up going down a rabbit hole of paranoid delusions. I rarely try to correct their delusions because I know from experience it won't work. I can't bring myself to agree with them when they are asking for validation of their paranoia, I either ignore it or try to change the subject. I'm worried that this will affect our relationship and eventually turn me into "one of them" on the other side of the divide, or severely weaken our friendship.

My question is: are there any proven techniques or strategies that are used to talk to people with these sorts of conditions?

I'm not trying to fix anything or find a cure, I'm not looking for a magic bullet, it's all about keeping our relationship going through difficult conversations.

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    Are you able to get in touch with someone in your friend's care team? You could probably get a more directed answer that coincides with your friend's treatment plan. – Lux Claridge Sep 23 '19 at 13:04
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    @Lux Claridge - In the past I've had problems trying to discuss my friend's condition with the professionals involved because I'm a long way away (so can't speak face-to-face) and not a family member. I hit the 'medical confidentiality' wall. Also, the professionals involved get dragged into the conspiracy theories and I don't want to be lumped in with them. I suspect that, after all these years and such a severe case, that the care involved is limited to managing medication and dealing with the consequences of the physical problems. I think any talking therapies ended many years ago – User2349B Sep 23 '19 at 22:14
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    A helpful link: wikihow.com/Help-Paranoid-People (if anyone wants to write an answer using this as back up, feel free to do so) – Ael Sep 24 '19 at 10:06
  • @Ælis Thank you so much, that's exactly the sort of thing I was looking for – User2349B Sep 24 '19 at 13:06
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    If you're interested in general strategies, you could also search on Psychology & Neuroscience - I'm not familiar enough with their stack to say if this exact question would be on topic, but it could be helpful for learning more about schizophrenia (for example, this question about addressing delusions). – Em C Sep 24 '19 at 17:12
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There are certain techniques for 'active listening' that don't involve you agreeing or elaborating, but encourage the other person to talk (and release emotion). Here's a couple of useful ones:


Mirroring:

Best, in my opinion. Repeat the last / relevant 2-3 words as a question. Really encourages them to elaborate, and you can do it repeatedly without them noticing.

Example:

- My friend asked me to a party the other day, but some stuff came up and I couldn't go.

- Other stuff?

- Yeah, my dog was sick...

-Sick? (How bad?)

- Etc.


Labeling:

Putting a name on their emotions. Don't use the word "I", as in

I think you're very worried about this

Try something like

It seems like this is really worrying you.

It helps show that you understand what they're feeling, even if you can't agree or empathize.


Hope this helps! You can find a lot more in Leil Lowndes's How To Talk To Anyone or Chris Voss's Never Split The Difference.

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    Hey there, this seems like a very nice first answer! Do you think you could also add a link to online resources about "Morring" and "Labeling" (maybe just a Wikipedia link like [this one](en.wikipedia.org/wiki/Mirroring_(psychology) and the same thing for "Labeling"?) – Ael Nov 12 '19 at 21:01

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