Sometimes the distress associated with psychosis is caused by loneliness, fear, and loss of self, rather than hallucinations or delusions. At the risk of sounding overly optimistic – something we caregivers are notorious for – I’d like to share five steps that can assist you in assisting your loved one in overcoming fear and isolation.

1. Maintain trust and participation
It’s natural to wonder if your ongoing kindness and empathy are making a difference. However, while it may go unnoticed, trust is the foundation for assisting a loved one.

Participating in their treatment is also important. While evidence suggests that including family members in treatments such as family therapy and open dialogue helps prevent relapse, you don’t have to be a formal intervention to play a role. Talk to your loved one about their treatment and assist them in identifying solutions to their day-to-day problems. If they agree, you can communicate with their medical team or attend appointments.

Being trusted and involved also means encouraging your loved one to do other things to stay healthy. Maintaining a healthy lifestyle, for example, and utilising non-clinical services such as support groups and peer mentor programmes.

2. Question beliefs
Cognitive behavioural therapy (CBT) is commonly used to treat depression and anxiety, but did you know it can also be used to treat psychosis? CBT works by delving into the beliefs that drive our reactions to events. You don’t have to be a psychologist to apply some of this.

In the case of an auditory hallucination, the event could be a voice telling your loved one that they are worthless or incapable of doing anything right. Their reaction could be to lose confidence, withdraw, and become isolated. But there is a belief between the voice and the reaction. In this case, a conviction that the voice is correct. Our goal is to challenge that belief and, hopefully, change it over time. While it may not completely eliminate the voice, it can alter how your loved one responds and help restore their confidence and sociability.

3. Make psychosis acceptable
Symptoms of psychosis, like many beliefs and experiences, can be viewed in the context of everyday events. Have you ever heard someone laugh and thought for a split second that they were laughing at you? At the extreme, this can develop into a paranoid delusion. According to this article, not everyone who hears voices is suffering from psychosis. Recognizing that psychotic symptoms can be part of everyday life can help your loved one feel less alone in their experience. Perhaps you have a personal event that you can share.
Being trusted and involved also means encouraging your loved one to do other things to stay healthy. Maintaining a healthy lifestyle, for example, and utilising non-clinical services such as support groups and peer mentor programmes.

4. Determine the causes and early warning signs.
Knowing when the symptoms of psychosis are approaching can help you prepare to confront them. Stress, a lack of sleep, and drug and alcohol use are all common triggers. Others, such as places, people, or situations, are less obvious.

Discuss your loved one’s triggers with them and determine the best way to manage them. It could be avoiding them entirely or finding a way to make them less dangerous.

Early warning signs are also essential. Knowing the warning signs allows your loved one to seek additional assistance before reaching crisis point.

5. Create a relapse prevention strategy.
When things are going well, the last thing we want to talk about is what to do if things go wrong. Encourage your loved one to consider their preferred course of action if symptoms worsen. Templates and thought-provoking questions are available online.

There are numerous therapeutic and medicinal approaches used to treat psychotic symptoms, and these steps are only a sampling of the many options available. Living with psychosis can be a lifelong challenge, and everyone’s techniques and supports are unique.