Is a person with psychosis dangerous

Psychoses> Dealing with psychoses

1. The most important things in a nutshell

Psychoses occur only in phases and in very different forms. When dealing with affected people, the following are important: openness, mutual recognition, mindfulness, acceptance, the effort to be included and joint ventures.

2. Special features in the clinical picture

When dealing with people with psychotic disorders, a distinction must be made between acute phases and periods of remission.

In-patient stays are sometimes necessary in the acute phase.

In the remission phase, trusted caregivers and a regular daily routine often help - however, it is very difficult to make generally valid statements, as the needs of people are very different and can vary greatly depending on the state of mind.

3. Mindfulness for yourself and others

People with psychosis are more vulnerable and thin-skinned than healthy people. Due to constant consideration on the part of the relatives, they can soon be overwhelmed for their part. The guidelines for dealing with one another should be as open as possible and mutual recognition of needs and perspectives. The special need for protection of the patient must not result in the relatives giving up on themselves. The endeavor to understand and empathize with the world of the person concerned has proven to be more helpful in the long term.

4. Help in dialogue

If you ask people with psychosis what they need in acute crises or, in retrospect, what has contributed to their recovery, seemingly insignificant things are important:

  • Authentic, self-evident experiences that promote "normal" self-image
  • Experiences of normalcy
  • Time, rest, patience
  • Retreat, "space"
  • Habits and idiosyncrasies that promote "self-awareness" (dreams, diaries, nature experiences, etc.)
  • Relatives and friends who hold on to you
  • People who are just “there”

("Help in dialogue" is quoted from: "It is normal to be different! (Blue brochure). Understanding and treating psychoses." Created in a dialogue between people who have experienced psychosis, relatives and therapists / scientists in the working group on psychosis seminars ( The brochure can be downloaded from> Download> Mediathek> Druck).

5. Accept the situation

It is important for the person concerned and the relatives to recognize the psychotic disorder and to accept this situation - whereby acceptance does not mean resignation. Much more productive is a "playful" way of dealing with the consumed perceptions or utterances. With "playful" is meant: see and hear, be open and curious, look closer or withdraw again, gain experience with the unfamiliar and in this way take away its strangeness and horror, but never the often existential all-encompassing dimension of the Downplaying illness. Blame should be avoided.

The big hurdle on the way to acceptance is that mental illnesses are subject to many false prejudices - usually both among those affected and their relatives as well as in the environment. "Unpredictable, dangerous, sluggish, stupid, incurable" - the general picture moves within this range. "Split personalities", "genetic predisposition" and "the parental home" are further building blocks of the prejudices that those affected put in a drawer from which it is difficult to find out. In view of these prejudices, it is all too understandable that many affected persons and their relatives have to struggle for acceptance for a long time - with themselves and with those around them.

In the meantime, there are trialogical information and education projects in many places with the participation of experts, people with psychosis and relatives, which counteract these misjudgments. More information under Psychoses> Treatment.

6. Include in the family

Even a person with psychotic disorders should continue to be consciously involved in family matters. He should express his opinion on issues that are of concern to him. Relatives are often tempted to take everything from the person concerned. However, this can increase the negative symptoms (e.g. listlessness, low self-confidence, fear, passivity). The aim must be to maintain or regain extensive independence despite the psychosis.

7. Support activities

People suffering from psychosis often lack drive and energy. This can either be due to the negative symptoms (decreased attention, speech impoverishment, flattened mood, loss of interest and others) or occur as a side effect of psychotropic drugs. It is helpful for the patient to be encouraged and supported to do as much as he can.

Small, gradual steps should be targeted so that a sense of achievement is possible. Important areas in which those affected need such support are hygiene, personal hygiene and minor household chores.

8. Joint ventures

Some sufferers find it pleasant to pursue non-verbal activities with a relative, e.g. going for a walk, watching TV or reading together. It is also seen as helpful by those affected if they can express their feelings and thoughts through creative design, e.g. by writing, painting, making music or making pottery. Honest and positive feedback is very important here, false praise can destroy the absolutely necessary basis of trust quickly and for a long time.

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