Some thoughts after interviewing Tim Dreby:
Everyone has beliefs that seem too bizarre, illogical, or fantastic to someone else to accept. Religious views, paranormal interpretations, political convictions, interpersonal conflicts — all can put us in a category where other people consider what we think to be incomprehensible. Just spend time with someone from a different culture than yours, and you are likely to encounter things that don’t make any sense to you at all, yet the other person is living with them as if they were true.
We’ve learned to co-exist with different beliefs as one of our most cherished values of tolerance in a multicultural society. That lesson can be key for encountering the different realities in situations where someone is being called psychotic, delusional, schizophrenic or mentally ill.
Respect and support may stretch our thinking, but can be vital to recovery. Cross-culturally, we accept that even the most strange or unfamiliar belief has value, meaning, and purpose in the person’s life. We give it the benefit of the doubt. The same is true of bizarre beliefs that get called psychosis. And using diagnostic language instead can amount to the same kind of put-down that goes with cultural supremacy and racist insult.
Arguing to convince someone to change their belief rarely works under the best of circumstances. And it rarely works in times of high stress, conflict, and desperation — when someone is in extreme emotional suffering and their belief might be a part of them defending themselves. Pushing someone to change their belief, especially in the context of power differences and a history of argument and struggle, can just inflame a situation and drive people into greater isolation. Families and mental health professionals commonly forget this, undermining the relationships of support that are so crucial to recovery.
We forget this partly because of the ideology of mental illness as brain disorder. Strange beliefs, we are told, are symptoms of mental illness, nothing more and nothing less. Broken brain computation. But the biological ideology is only part of why we challenge strange beliefs. We also have common sense experiences of strange beliefs turning out to not be real. When people are feverish or intoxicated, for example, or distraught after a breakup or betrayal, they may start to believe something very unlikely or strange. Extreme sadness can color our thinking so that we start to believe very dire, and untrue, things about reality. We then reasonably expect the belief to pass and we can be confident in our insistence it isn’t real. And people often do want to be reassured about reality being “real,” that the feverish vision is a result of their high temperature, the rage they feel is from the wine they just drank, their suspicion is just a sign they are upset at ending their relationship, and their predictions of failing at work are just signs they are depressed. We often appreciate challenges to our mistaken ideas from people we trust. When someone is afraid and emotional, they can start to conjure impossible realities, and having a friend dispell those beliefs and get us back in reality is often a very useful way to respond.
But not always. I do sometimes work with people through “reality checking,” and I have even said “Is that real, or is that part of your altered state? Might this belief change later?” to people. But only if that kind of questioning is useful to the person. In my own life I might have a worry or fear, and want my friend to say “Will, that’s just not true.” It can be enormously relieving – sometimes. Other times, someone challenging my reality is the worst thing they can do. It all depends on what kind of internal dialogue I might be having, what kind of needs I have, and the power of the emotions caught up in the belief. And if you get it wrong I am generally going to let you know pretty quickly, and our friendship then requires you to listen and respond in a new way.
Generally I don’t challenge a person unless they are themselves in a dialogue of challenging themselves. I’ll help them explore both sides – but crucially I will suspend my own judgment, helping them discover their own belief and the best way for others to engage with them. Through getting to know the person I learn what is helpful to them.
Typically people I work with have strange beliefs held strongly because they have so often been challenged by the very people they need support from. A common scenario in family counseling is to explore the possibility of accepting, rather than challenging, the belief. I often ask “how is it going to tell your son he is delusional? Is that effective?” If it isn’t, it is time to look at other approaches. And a belief held 99% can quickly become a rigid 100% belief when it is under attack – stopping the challenge may paradoxically make someone more open to change.
Telling someone they are mentally ill is one of the most extreme kinds of challenges imaginable, because it essentially says the person’s belief system — and their very act of thinking — should be completely discounted and ignored. This is why it is often so vitally important to drop the effort to convince someone they are mentally ill — not just because the science isn’t solid behind the biological and diagnostic model, but because dropping the challenge helps defuse the power struggle between who is right and who is wrong. It establishes mutuality of respect for different views, which is the foundation of any true relationship.
But what if the belief is just too strange to be true? Defies logic and reason and even the laws of physics? Personally I may have an advantage in these situations, because I have experienced some pretty strange things, and as a result I have a very spiritual perspective on what is “real.” Demons, telepathy, synchronistic time travel messages — my world has visited alternate realities. When someone tells me about theirs, I can relate. I may say “I didn’t witness this, but I believe it is possible,” and I feel very comfortable saying this, because I know that reality — or multiple realities — are much stranger than things might seem. I’ve experienced that truth myself.
Often it is possible to find some parallel experience to help people relate. A good question to help defuse conflict is to ask, “Was there ever a time in your own life when everyone around you didn’t believe something vitally important to you? Do you think this might be parallel to what is happening to the person you want to support?” “Were you ever hurt terribly – and have the pain become even worse because people didn’t believe you?”
I also often encourage people to listen to the feelings and emotions around a belief. Someone who has survived violence wants to be believed because they want to be accepted and supported emotionally. They want to not be alone with their terror. Sometimes it can be very useful to set aside any doubts or challenge and instead focus on the emotional need for support, connection, and validation. If someone asks if you believe them, you can say you know their experience is real because you can see how it affects them, how hurt they are. You can acknowledge that you were not there and can’t be a witness, but at the same time you are a witness the reality of their suffering. And you can ask them what they are experiencing now, and tell them that you believe 100% that it is real – because you trust they are not lying and you know that whatever they are experiencing is real. You might not know how to interpret it, but you know it is real, because they experience it happening to them.
The logic, objectivity, and debates about what is “real” generally start to have less and less importance once a relation of support, respect, and listening is established. The issue of “reality” is put in a different light. The real focus can be on the person’s life, their needs, and their experience of suffering – not whether they are in touch with “reality” or not. People can get on with relating with each other, and move beyond the narrow power struggle. Scientists and philosophers have been debating for millennia what is reality: there is no need to answer that question now. Instead we can focus on caring for each other.
My colleague Tim Dreby is a living example of this different approach to alternate realities. Parallel to the Hearing Voices Movement Tim developed his own methods that I find deeply inspiring. His personal ‘messages crisis’ is an extraordinary story that would make a great Hollywood film, full of intrigue and drama. Today he works with people in support groups and private practice by sharing his own experiences and how he manages them, and comparing with what others have been through.
I just interviewed Tim for Madness Radio, and you can listen to our show here — it’s free, so please support Madness Radio by leaving a comment and spreading the link:
Special Message from Tim Dreby | Madness Radio
What if coded messages, covert realities, and elaborate plots can be seen only by you? Does that mean you are out of touch with reality — “paranoid” and “psychotic?” Or could it be true that you really are a target – but you are so upset that everyone thinks you are the problem instead?
Tim Dreby, a psychotherapist in the San Francisco Bay Area and author of an upcoming memoir, is a survivor of a schizophrenia diagnosis who endured a life threatening — and real — encounter with gangsters, police, and political conspiracy. Today he leads support groups for people facing overwhelming intuitions, coded messages, and mind control, helping them regain control and heal from trauma.