Sunday, May 29, 2011

Dealing with the Paranoid Schizophrenic Client

Dealing with the Paranoid Schizophrenic Client By: Jim Silvania

We’ve all had them but what do we do with them? This is not something we learned in kindergarten.

My experience with this situation is that they were good paying professional individuals who you try to assist until you realize that something is definitely wrong.

            Schizophrenia is a group of severe brain disorders in which people interpret reality abnormally. Contrary to some popular belief, schizophrenia isn't split personality or multiple personality. The word "schizophrenia" does mean "split mind," but it refers to a disruption of the usual balance of emotions and thinking. (1). It is an illness that affects well over 2 million American adults, which is about 1 percent of the population age 18 and older. (2)

 Paranoid schizophrenia is the most common type of schizophrenia. Around 40 percent of people who are schizophrenic suffer the paranoid type. In paranoid schizophrenia, delusions are often focused on the perception that you're being singled out for harm. Your brain misinterprets experiences and you hold on to these false beliefs despite evidence to the contrary.(3) No matter what evidence you find to the contrary a paranoid schizophrenic is not going to believe you, so don’t even try.

  For instance, they may believe that the government or a competitor is monitoring their every move; their being stalked.  In such matters you may have been hired to find the “boogie man”, “secret agent” or the alleged perpetrator of the delusions. The delusional content (the beliefs) of a paranoid schizophrenia are marked by grandiosity, or persecution, or both. Anger, irritation or argumentative behavior may be the most prominent features, as is extreme jealousy. These delusions can result in aggression or violence if they believe they must act in self-defense. (3)

            Russell Crowe's portrayal of the esteemed mathematician Dr. John Forbes Nash in, ‘A Beautiful Mind' (2001) provides a dramatized example of the above. In the movie we see the world through the eyes of Dr. Nash as he is approached by an agent to help in the decoding of sophisticated secret transmissions. We are drawn into thinking that Dr. Nash has a special ability to see secret codes where others cannot. His covert work is apparently fraught with danger as he is chased by foreign agents intent on doing him harm, but he must continue as a matter of national security.  At movies end we understand that the agent with whom Dr. Nash has been working and other significant people in his life are all hallucinations. (3) What if Dr. Nash had hire you? At what point do you open your eyes to the reality of it all and what do you do about it?


My first learning experience resulted from a call from a law firm to assist one of their major business clients. It was alleged, by the client, that his business had been burglarized by a competitor.  First question to arise: no forced entry; ok then it must have been an inside job. Second question: nothing was missing. The client next alleged that he was been watched at night from the field behind his house: a herd of deer. The delusions and hallucination worsened to the point that we felt his children were in danger. Working with the local police, who had a previous history with the client, we had him committed on an emergency bases.  Lesson learned: never have clients committed before they pay their bill. 
Dealing with a paranoid schizophrenic can be extremely frustrating. It is difficult to know what to say and/or do. Here are some tips for a private investigator that comes in contact with a paranoid schizophrenic who is actively suffering:
·         It can be helpful to stand side by side rather than directly face a paranoid schizophrenic.
·         Also avoid direct eye contact, as this increases their paranoia.
·         Do not fight with them or contradict their radical views. Show understanding and compassion when they vocalize their mistrust of the world.
·         Temporarily accept their reality as reality.
·         Never criticize by saying:  "Don’t be so paranoid!"
·         Realize that they have tunnel vision and can only see their point of view.
·         Accept that the person may truly feel they are not sick and do not need help.(2)
·         Most importantly “Do no harm” and remember they can only be committed against their will if they are declared a danger to themselves or others.
            How do you ethically deal with these situations? Private Investigators are bred to help people solve their problems but helping someone who suffers from paranoid schizophrenia is not in our skill level and extremely difficult even for health care professionals. But what responsibility do we have once we’ve taken on this individual as a client?  First you will never convince your client to seek professional help. In fact once you suggest professional help you become the enemy, part of the conspiracy that’s out to get them.  To them you must be incompetent because you don’t see the forest for the trees; you can’t find their “boogie man” or bring about a resolve to the reason you’ve been hired.

            In Ohio, where I practice my trade, Private Investigators are governed by Ohio Revised Code #4749; 4749.13(B)(3) states: “No person shall divulge any information acquired from or for a client to persons other than the client or the client’s authorized agent without express authorization to do so or unless required by law”. So do you risk violating the law in order to gain assistance for your client?






             Laws vary from state to state but when a person becomes dangerous to himself or herself, or to others, you may be forced to disregard any confidentiality agreement.  You are the professional investigator.  Your investigation now turns from your client’s needs to your own needs and protection. One should learn the professional agencies in one’s community should you ever find yourself dealing with the paranoid schizophrenic client. Some other hints:

1.      Finding a sympatric relative willing to do the right thing is a God sent.
2.      Many police departments have professional psychologist on staff that might be able to provide some insight and guidance.
3.      Check with the police precinct supervisor to see if they are familiar with the individual or their address.
4.      Call the county or city health department or any past medical professional who may have previously dealt with your client.
5.      Document your every move as you may someday be explaining it to a jury.  It’s better to have tried and failed than to not have tried at all. 

           


Bibliography:

1.      www.mayoclinic.com  12/02/2010
2.      www.nami.org   12/02/2010
3.      www.healthcentral.com  12/02/2010
                                                           
           

Jim Silvania, CLI & CFE, the owner of Silvania Investigative Services, has been conducting investigations through Ohio for the past 43 years. Web page: www.jimsilvania.com, email: jsilvania@wideopenwest.com

1 comment:

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