Delusions that affect marriage relationships

The most difficult “psychotic” marital problem is probably that of what is called “paranoid schizophrenia,” a chronic disorder characterized by fixed delusions, which are woven into the person’s total attitudes and are completely resistant to any kind of argument or persuasion. They may sound completely plausible at the beginning, and often cause very great embarrassment, inconvenience and distress to many people, and particularly to the marriage partner.

A common delusion affecting the marriage relationship is that the partner is being unfaithful and carrying on a constant “affair” with someone else. The attempts by the partner to reassure such a person are completely ineffective, and often add to the emotional tension. All kinds of reasonable actions are adduced as “proof,” and bitter aggressive recriminations may be made, even for hours on end during the night, the person not allowing the “victim” any opportunity to sleep, even following him into another room to carry on the accusation.

As time goes on the character of the delusions may become more obviously false, for example the idea that neighbors are injuring the person with electric waves, or “thought waves,” or the conviction that a group of “super scientists” can “see” everything the person sees and can speak and act through him, or that the person is God’s anointed agent to rule the world. There is no limit to the range of these delusions, but their main characteristic is their fixity and lack of change except very slowly over the years.

No successful treatment for the relief of these delusions is at present known, and unless they are of a kind or intensity that would bring a risk of danger to the person or to others it is not often necessary to put the sufferer in hospital. The marital partner therefore finds that it is either necessary to develop some way of accepting and tolerating the fantastic ideas, or else, if the situation becomes impossible to the partner or the children, to break up the marriage.

In most cases the partner finds ways of coping with the situation with help for most of the time, and when there are bouts of greater intensity the person may be given some hospital care to tide him over the difficult period. Deluded people are often easier in their minds in the “protected” environment of a mental hospital than they are at home.

In many cases the partner will be able to get some help from the doctor about ways of handling the situation, but sometimes the marriage counselor may be asked about it. In general it is best to accept the feelings and ideas of the deluded person without argument, and say, in effect, “if that is so what do you want to do about it?” This does not mean agreeing with the delusions, or disagreeing with them. When bitter accusations are made it may be best again to say “You think I’m doing so and so?” with no attempt to defend, explain, or argue. It may be necessary to say “We will just have to agree to differ on that.” It is not at all necessary to defend oneself against all accusations, or even most accusations. It is better to allow one’s life to be its own justification and to allow others to think unjustly if they have made up their minds.

Tags: Counseling