‘Delusions’ and ‘Paranoia’: What Are They, Really, and How Can We Engage Them in a Loved One? 


The following is the second excerpt adapted from Healing Companions, a book by the MIA author Sam Ruck (his pen name) that describes his life with, and love for, his wife and her “alters.” His earlier installment addressed the problems with “psychosis.” 

So many words get thrown around these days—words which define extreme states, or try to, in a way that diminishes the human beings who live through them. Such words don’t factor in the impact of traumatic experiences and the new, internal realities they create for people, sometimes for decades. 

I’ve repeatedly seen this with my wife. More than that, I’ve lived through it, doing my best to help her navigate such states and move beyond them. It hasn’t been easy, but I’ve learned a few lessons along the way that I’d like to share. One is that such commonly used words don’t come close to conveying the lived experience I’ve witnessed firsthand.

For instance, what are “delusions”? 

Here’s a basic definition from the internet: “a persistent false psychotic belief regarding the self or persons or objects outside the self that is maintained despite indisputable evidence to the contrary.” 

To me, this kind of sounds like a more specific way to define “psychosis,” and hence the quotation marks around the word, as I have issues with that one as well. I never thought my wife was “delusional” even after I became aware of the word’s popular use, but that doesn’t mean I didn’t at times struggle with some of the things various parts of my wife believed as they left their forced isolation and began to live outside with me. So let me share some experiences and see where I failed and where I succeeded in helping my wife through her more challenging perspectives.

Perhaps the most reality-challenged belief that a part of my wife named Amy shared with me was her insistence that she had been a spy in Europe. What do I do with that kind of statement? Well, like most of us, I disputed it, over and over and over. But the more I disputed her claim, the more adamant she became about it! This was not working. And so, I finally came to the point at which I changed tactics. The next time she brought up her claim, I said honestly and without patronizing, ‘Honey, will you please tell me about it sometime?’ And that was the last she ever mentioned it.

I still don’t know what to make of that interaction and her insistence on the validity of that memory until the moment I validated her. Perhaps she just needed to be heard and validated. I honestly don’t know, but what I do know is when I argued and disputed with her, it only escalated her claim, but when I validated her and her belief, it released her in some way that she has never brought it up again. You be the judge.

But there were lots of other “delusions” my wife had, and most of those didn’t resolve themselves so easily. In the beginning of our journey, I tended to dispute them like most of us would. When she first emerged, that same part of my wife, claimed that her inside world was more real than the outside world. This seems to be common in the Dissociative Identity Disorder (DID) community. For some reason I thought I could argue her out of that belief, but it only seemed to solidify it for her. 

So I had to learn to shut my mouth when she made these claims. Instead of arguing, I simply decided to live with her and enrich her life on the outside with me. I spent a couple of years doing all kinds of fun things with each part of my wife who joined us on the outside those first five years. It was almost, I imagine, like having grandchildren. If I’d do it for a grandchild, why not my wife?

And you know what? I remember the day when Amy decided she liked the outside world with me and our son better than her inside world. In fact, she told me she now wanted to stay outside permanently. And one by one, each part of my wife who joined us outside came to that same conclusion. They no longer wanted to be “insiders,” as they are called in the DID world. They wanted to make a life with me and our son on the outside. I had won the argument by not arguing but by simply living with each part of my wife and making life with me and our son far more attractive than anything on the inside.

But what do I make of that belief that the inside world my wife experienced is more real than the outside? I see it as another example of the Rip Van Winkle effect, which I described in my recent piece for Mad in America. Imagine if you had been trapped inside your mind for four decades, and only rarely did you get glimpses of the outside world. Which place would you think feels more real? Wouldn’t that inside place feel more real to you if you suddenly found yourself on the outside? First you were forced inside because of the trauma. Now your brain has kicked you back outside. You didn’t really get a choice in either decision, so coming to terms with the outside is just a prolonged orientation process—and I, as my wife’s primary attachment figure, am the one called to do it.

Here’s another “delusion”: when Amy first came out, she would longingly look at all the delightful toys and little girl dresses and clothing which are available today. But nothing fit her. She would look at her hands and body and tell me, “These aren’t mine.” She would tell me she hoped in heaven to get a body of her own. It broke my heart to see her pine for the childhood experiences she had lost because of the dissociation. Her parents were not wealthy most of her childhood, and so she rarely got big Christmases.

And so, for the first three or four years, I lavished her with Barbie dolls and all the exquisite clothing that is made for them. We also bought Barbie’s little sister doll, Kelly, and Ken’s little brother, Tommy, and all the delightful things for them. For a couple years I played dolls with her. We amassed a huge cache of dolls and clothing, and we would spend a couple hours, a few times a month, changing all of them and setting them up in our bedroom so she could see them and be delighted by them. 

And even though I couldn’t buy her the beautiful little dresses she saw for little children, I found her a gorgeous ‘princess’ dress that I bought for her to wear on a cruise so she could satisfy the longing in her heart. I came to view these childish longings as a result of the dissociation. This part of my wife had been trapped inside and missed all the experiences she associated with a happy childhood. 

Quenching Her Childhood Longings

Now, I had a choice. I could either ignore her longings or tell her to grow up, treating her like she was delusional: seriously, this is her body and her life, not the one she missed during the dissociation! But I decided the best way to deal with her disappointments was to satisfy them the best I could.

And as I validated the various longings each part of my wife confided with me, little by little she was released from them. At this point it’s been years since I’ve played dolls or done some of the delightful, childish things those parts of my wife longed for. Today all of them happily busy themselves with adult activities, games and friends, and I firmly believe it is because I engaged the disorientation that left her feeling like an unhappy little girl that had lost her childhood in forced dissociation.

I came to view those deep longings like the proverbial monkey caught with its hand in the cookie jar, its obsession with the cookies stronger than its instinct for self-preservation. So  I decided to indulge my wife’s deep longings for her unfulfilled childhood wishes. I decided to satisfy her desires to overflowing, until they were satiated and quenched, and she could happily release those proverbial cookies and be released from the death grip of her own cookie jar—her missed childhood. 

Today she has moved on from so many of those longings created by the disorienting Rip Van Winkle effect. I almost miss some of them, as we have yet to be blessed with any grandchildren, and I miss the delights that satisfying those dreams brought to me as well. It gave me joy to bring her joy.

But some “delusions” can be dangerous. That same part of my wife, Amy, once  told me and our son that she wanted to buy some store-bought children’s fairy wings so that she could jump off a building and fly! Our son and I freaked out! I believe this was a different aspect of the Rip Van Winkle effect. After discussing the “age of alters” on my blog one time, it was suggested by one of my readers that the age at which the dissociation occurs—due to trauma—is the age that becomes associated with that part of the trauma sufferer. But these splits also “freeze in time” childish perspectives, including the inability to separate fantasy from reality. And so, to this part of my wife, she thought store-bought fairy wings would enable her to fly. Happily, as she spent more time outside with me and our son, she learned to differentiate between fantasy and reality as the normal maturation process was restarted.

The last “delusion” I want to share illustrates how the various parts of my wife relate to me. I believe the Rip Van Winkle effect cannot be overstated when dealing with the long-term effects of childhood trauma and dissociation. As the dissociation is broken, the newly released parts of my wife still operated from the perspective in which they were “frozen” internally for over four to five decades; therefore, all seven voices-turned-”alters” that joined us on the outside originally viewed themselves as little girls, since the overwhelming majority of my wife’s trauma occurred during her early childhood.

And so, as each part was released from her mental imprisonment over the course of our healing journey, each one brought to life her perspective at the time the dissociation occurred with her—that of a little child. None of them had any interest in being a wife to me. So I chose to relate to each part in a manner that felt most comfortable to her. I didn’t demand that she accept my reality, i.e., that she was part of my wife. Instead, I entered her reality and chose to relate to her accordingly. Most of the parts wanted to relate to me as the daddy figure they didn’t have with their absentee, emotionally broken father and their emotionally abusive mother, but others were ambivalent, and so we simply interacted as friends until she was ready for something more. 

I didn’t force what wasn’t desired. Instead, as I related to each one, met her where she was, and helped her release the pain, lies, and fears she had carried from the trauma—including the lack of healthy parental figures during her childhood—each girl was released from the death grip in which she was caught. And each one began to move forward. In fact, two of them quickly moved forward and matured until they wanted to relate with me as girlfriends. One part later wanted to become engaged as my fiancée.

Engaging “Paranoia,” and the Reasons Behind It 

Next up: Another word that gets tossed around. How does the internet define paranoid? “Paranoia is thinking and feeling like you are being threatened in some way, even if there is no evidence, or very little evidence, that you are.” 

As I said in my recent piece addressing “psychosis,” it’s all a matter of perspective, and when I took the time to understand why my wife was constantly afraid, she no longer seemed unreasonable. On the contrary, I would argue she was quite reasonable. However, the reasons were based upon her past trauma, making her “paranoia,” I believe, another instance of the Rip Van Winkle effect.

It’s important to put ourselves in the place of our loved one when the trauma was happening. For my wife, she was a toddler who was at the mercy of her neighborhood abuser. She had no ability to stop the abuse on her own, and in her mind, he kept her from the only source of relief from the abuse that her parents represented—because he threatened to kill them all if she told them what he was doing.

So, she did the only thing her brain could conceive to mitigate the abuse: she became “hypervigilant” as she tried to decode all the sounds and events in her immediate environment. Thus, every unexpected noise was a potential sign her abuser might be returning. Every unexpected event could be a prelude to more abuse. She tried to control her surroundings and the people in them in her desperation to minimize her abuser’s ability to hurt her, which, of course, was impossible and exhausting.

As a result, for the first 20 years of our marriage, my wife would wake me at least once a night and tell me she heard a “noise” downstairs, and she wanted me to verify it wasn’t a break-in. I would sigh. There was no point in arguing: if I didn’t do it, she would fret the rest of the night. So I trudged downstairs and checked things to satisfy her and then came back to bed with the “all clear” message to her. And anytime I got out of bed to go to the restroom or got up early to go to work, no matter how quietly I tried to sneak out of the room, I would hear her gasp as she startled awake at the barely audible sounds I would make as I left the room. She never slept soundly, because her brain was on “red alert” to detect any noise that could signal the next abusive episode.

But over the course of the last 15 years, as the traumatized parts of my wife were released from the dissociation and came outside to be with me, I was able to help each one deal with the past trauma and then accept her newfound safety with me. (I call this validate and turn: In chapter 5 of my book, I fully explain this concept. Here is a short synopsis: I learned to validate her feelings and perceptions that she shared with me, which were based upon her trauma of sexual abuse and not being heard or protected by her parents in the past. Then I slowly began to turn her to her new reality of safety and love with me today:). And as I did so, the hypervigilance has slowly diminished until, today, I rarely make a trek downstairs to check for noises, and I can quietly sneak out of the room without hearing the familiar “gasp.” It makes me smile with happiness, as she is slowly lowering her defense-alert level.

Just like other so-called “delusions,” if I argued or minimized her perspective and feelings, it only escalated her fears. She needed to be heard! She needed to have me care for her in a way her parents never could because of their own trauma issues. And as I did so, it released her slowly from the death-grip the past had on her. Then she felt safe to have me hold the truth of her abuse so that she could rest in her newfound relationship with me and move into the present.

So if your loved one is “paranoid,” ask her (or him, or them) about it. Don’t be distracted by “outlandish” claims of aliens, secret societies, the CIA, or anything else.

Remember, childhood is full of fantasy and dreams and childish perspectives, and sometimes the mist of past events can make memories fuzzy. Focus on the immediate fear. Ask what would help her feel safer. Remind her that she isn’t alone anymore, and you will help her be safe. Be careful not to do things that might escalate the fear, but honest engagement probably won’t—because now your loved one will know she has an ally and someone to watch her back in a way that probably never happened during the original abuse. . . and that is when real healing can begin.

So, is my wife “delusional”? I would argue not. Instead, I would argue that she is disoriented and suffering from large parts of her personality having been trapped in a forced dissociation caused by her trauma. Just like Rip Van Winkle, her perspective is from another time, and as her primary attachment figure I am tasked with the duty and pleasure of orienting her to current circumstances today. 

I chose to walk with her where she was during the orientation process, and then grow with her as we found our way together rather than forcibly demanding that she accept today’s reality before she was ready.

I’m still walking with her, and we’re still finding our way.


Mad in America hosts blogs by a diverse group of writers. These posts are designed to serve as a public forum for a discussion—broadly speaking—of psychiatry and its treatments. The opinions expressed are the writers’ own.


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  1. I think it should be noted that Mr Buck’s opinion regarding his wife’s experience is not shared by the vast majority of researchers who have devoted their careers attempting to find the reasons for psychotic disorders. I have worked in research with people who have paranoia and delusions as a psychiatric nurse for 30 years. I appreciate the effort and the care that Mr. Buck has given his wife over the years however his wife situation is about one person, not the thousands that the psychiatric community has had the opportunity to work with.

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    • Hi Susan,
      I do agree that there is a HUGE difference between what my wife and I have experienced and how we view that experience and what most people do. But, I wonder if that is because when she began to experience all these various things, we embraced them. Instead of drugging her or desperately trying to ground her to minimize the experiences, we chose to ‘live’ in them. And as we did, we began to understand them and figure out how to heal them. At this point it’s been years since she’s struggled with most of these things.

      Moreover, I have dedicated the last 16 years of my life to walking with my wife on our healing journey. Unlike the ‘experts’, I am there with my wife 24/7 365. I don’t get a day off. I have to be available in the middle of the night, whether I’m at work or home. Whether we are on vacation or not. In all phases of life. Those experts have a breadth of experience that I don’t. However, I have a depth that they can never replicate because I have been in the trenches with my wife helping, holding, affirming and living with her through everything she experienced from day one.

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    • Sure…..give em all neuroleptic drugs, which do tend to shorten a persons life span by 20 years or so….sure take a bow. Degrade them, drug them, strap them down….sure take a bow. For woman a little electric shock is always beneficial…perks people up. Tell em it is all in their brain…their fault…tell em that there is no cure….it is a forever disease.

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      • Thank you. Psychiatric treatment has added to the trauma in ways that make actual care disappear. It’s so sad and demoralizing. But getting people who work within he paradigm that diminishes people who are suffering requires they take a big picture, challenging look at what they’re doing, and I suppose the chllenge that would induce is too hard for them to take on. Just drug ’em.

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  2. That was a very touching story. It is evident how much you love your wife. Its sad that psychiatry wants to medicalize the human experience. The “mentally ill” have historically never actually been listened to and had our experiences invalidated. I’m just now starting to discover my voice at 47. I’m learning to validate myself instead.

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