a) try to make sure they're being properly medicated b) talk about the feelings, not the facts. Client: I was kidnapped by aliens. Therapist: Gah, that sounds terrifying.
Doesn't always work, but it neatly sidesteps either having to either lie about your beliefs or argue with the client. Also: don't lie to the client about believing them. Don't bring this up, but if they ask, acknowledge that it doesn't sound like the way you think things are, and you haven't personally seen any aliens (or whatever). Then bring it back to the fact that the main point is not whether you believe it or not, but how it's affecting the client's life, and what the two of you can do together to make it better.
Because from what I've seen, delusions are rarely random-- they're often very good metaphors for what actually happened. "I was sexually abused" may just not have quite the right emotional resonance for what the experience felt like-- "I was kidnapped by aliens" may be a better way of describing how it felt. So if you talk about how it feels to be kidnapped by aliens, that's sometimes what the client actually needs you to know.
There's a theory about trauma that says what heals is not necessarily having all the facts of what happened-- it's being in touch with and able to deal with all the feelings that the trauma caused. So, like that.
And, hm, a random thing you should know. I feel like you already know lots of stuff. Um... not everyone can use therapy? Don't trust that other people's experiences/ids/minds work like yours? Always bring a book to sessions, so that if your client no-shows or is late, you're not sitting there being frustrated and bored and worried/annoyed at them? Try to use the vocabulary your clients use to describe things (unless you're deliberately doing psychoeducation)?
"Write up your notes right after sessions or you'll forget everything," that's a good one.
no subject
a) try to make sure they're being properly medicated
b) talk about the feelings, not the facts.
Client: I was kidnapped by aliens.
Therapist: Gah, that sounds terrifying.
Doesn't always work, but it neatly sidesteps either having to either lie about your beliefs or argue with the client. Also: don't lie to the client about believing them. Don't bring this up, but if they ask, acknowledge that it doesn't sound like the way you think things are, and you haven't personally seen any aliens (or whatever). Then bring it back to the fact that the main point is not whether you believe it or not, but how it's affecting the client's life, and what the two of you can do together to make it better.
Because from what I've seen, delusions are rarely random-- they're often very good metaphors for what actually happened. "I was sexually abused" may just not have quite the right emotional resonance for what the experience felt like-- "I was kidnapped by aliens" may be a better way of describing how it felt. So if you talk about how it feels to be kidnapped by aliens, that's sometimes what the client actually needs you to know.
There's a theory about trauma that says what heals is not necessarily having all the facts of what happened-- it's being in touch with and able to deal with all the feelings that the trauma caused. So, like that.
And, hm, a random thing you should know. I feel like you already know lots of stuff. Um... not everyone can use therapy? Don't trust that other people's experiences/ids/minds work like yours? Always bring a book to sessions, so that if your client no-shows or is late, you're not sitting there being frustrated and bored and worried/annoyed at them? Try to use the vocabulary your clients use to describe things (unless you're deliberately doing psychoeducation)?
"Write up your notes right after sessions or you'll forget everything," that's a good one.