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Hacks for Extreme Non-Rational Agitation

Because participants experiencing psychosis aren’t in touch with consensual reality, they may be easily confused and frightened. For this reason, it is important to be as concrete and clear with the participant as possible.

Do not attempt to dissuade the person from their delusions or use logic to argue. Rhetoric will only confuse them and create the potential for further conflict. Likewise, humor is not the best tool to use with people experiencing psychosis because they may believe you are laughing at them, which will exacerbate negative feelings. Instead emphasize or “lean on” the ways in which the participant’s chaotic reality may intersect with consensual reality to keep the conversation focused, and use concrete suggestions to meet their needs.

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Once you have grounded yourself during an escalated situation, next engage in active listening with the person who is agitated. This can seem counterintuitive or difficult when you are dealing with somebody who is, for example, screaming at you, and it may feel like you’re rewarding them for being completely irrational. But it is key to getting them more centered and grounded so they’re less agitated and less likely to become a danger to themselves or others.
Generally, it’s important to use “person first language” when describing people who are marginalized due to some part of their identity being stigmatized, such as folks struggling with their substance use, people who do sex work, and folks living outside.