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Most of us who experience a severe psychotic disorder must be medicated--this is non-negotiable. However, medication isn't always enough. Despite being well medicated, some level of delusions may persist in our minds. To help deal with this, albeit imperfectly, there are cognitive methods that can be used. By the same token, cognitive methods, by themselves, are not enough to do away with a severe psychotic disorder. Regardless of how skilled you are in correcting delusions through a cognitive technique, medication is the foundation on which you're building. 

Medications can be fine-tuned in conjunction with a prescriber. The prescriber could be a psychiatric nurse practitioner or an M.D. psychiatrist. There may also be one or more other types of education and licensing that allow a professional to prescribe medication. The point is that you work with that person, and you bring up thoughts about which you have some doubt. Keeping secrets makes everything more difficult. And not sharing with anyone about what is eating at you can cause internal wounds to fester. 

If you have thoughts you somewhat doubt, it helps to speak about them. This is not like going to church and sitting in a confession booth. You are not there to admit to all your supposed wrongdoing and be forgiven. It is about therapy, and it is about getting some relief. And it is also about using someone else's mental resources to augment your own in the battle against psychotic symptoms. 

The first step to deprogramming a delusion is to acknowledge that a specific thought you're having is questionable. If a thought has a lot of emotional charge to it where you feel a need to have it, or if it obsessively frightens you, either one of these will reinforce a delusion. And if either of the above are true, it is more likely that a thought is in fact a delusion. This is because delusions are reinforced by the emotional mechanisms in the brain. I have observed this. 

If a thought or a perception is emotionally neutral and does not trigger or get triggered by an emotion, the likelihood is better that it is an accurate thought and not a delusion. 

The second step in deprogramming a delusion is where you amplify in your thinking the concept that the thought is questionable. This is not accomplished by yelling at yourself. Instead, it is done with intent focus. Concentration, not forcefulness is the way to do this. 

If you have decided that a thought is probably a delusion, yet it persists in your thinking, you've achieved more than half the battle. All that remains is repetition of the mental exercises. When you initiate the deprogramming of a delusion, your subconscious will probably work on your behalf and will help your delusional thought to stop occurring. 

If a mental health consumer has too many delusions, it might be too difficult to address them with cognitive methods, without also increasing the dosage of antipsychotic or adding a second one. The author, yours truly, takes exceedingly high dosages of two antipsychotics. Without high enough antipsychotic, the brain may not be getting what it needs. 

Jack Bragen is author of "Instructions for Dealing with Schizophrenia: A Self-Help Manual," "Jack Bragen's 2021 Fiction Collection," and other books.