Reader’s Question

I am starting to worry about one of my good college friends because he seems to be hearing things that nobody else hears. He says he hears strangers insulting him or saying such things as “Look at that guy, he can’t compose himself,” or “Look at how wierd he is.”

This all started about 3 months ago when we were eating at a restuarant, and he claimed he heard the waitress and this couple a few tables away insulting him. He claims he was the only one to hear it because he has amazing hearing. But this has been disproved because several people have insisted they never said things he claims he heard them saying.

To me it seems like my friend is just having some kind of auditory hallucination. He is also hearing the insults more frequently. I hung out with him for a day, and there were 3 instances where he said strangers were insulting him. I was always there next to him, and I never hear any of the things he claimed he heard. I try to think about things rationally and logically, and it seems to me that there is no way all those strangers could have been talking about my friend. The situation is getting worse now because he believes that he can hear his next door neighbors insulting him every day, and now he wants to take revenge on them. I really want to help him before he does something crazy. I think he hears the negative judgments about himself because he used to get picked on a lot when he was a kid. He was always a loner and got bullied for a big part of his life. In his family, his brother has a mental disorder. My friend also smokes marijuana but stopped recently for 3 weeks on his therapist’s recommendation. Still, his condition has gotten worse.

Is there anything I can do to convince my friend that he doesn’t have the amazing hearing and that it’s all in his head? I am worried that he might hurt somebody else or get himself hurt. I’ll leave the treatment to the professionals, but I want to help. What can I do to convince him that these strangers aren’t constantly insulting him?

Our Clinical Psychologist’s Reply

Your friend’s therapist was wise to recommend your friend stop using cannabis. Contrary to some opinions, marijuana is by no means a harmless drug, and it can induce psychotic symptoms — most commonly paranoia — in some individuals. It is not thought to be a causal factor for other types of psychoses such as schizophrenia or paranoid schizophrenia, but it can precipitate the onset of a more severe disturbance of thought processes if the person has any predisposition toward such an illness (i.e., a family history for the illness, genetic vulnerability, etc.).

Disputing or confronting false beliefs directly is not generally effective and is most often interpreted by the paranoid individual as an indication that the person confronting them is untrustworthy or is against them. The two best things you can do for your friend are to solidly support him for refraining from psychoactive substance use and complying with all aspects his treatment.