Hi Costello, I'm glad that your son is being able to question his delusional thinking. Sometimes I think it's what we're most fearful of, and our minds can't stop worrying about them. I'm sorry that he's got so upset in the past with the bad things that he fears happening in his mind.

The only thing I can think of to make it any clearer is to say... have you ever had a very vivid dream that you can't get out of? And in the dream these crazy things happen, but you believe them. And then, for a moment when you wake up, you think the dream actually happened? It's as though that dream, and the moments of confusion before you're clear of it, were happening when you were awake. In a dream we can't help what we believe. Sometimes I think the psychosis is like a painful waking dream. And with hard work we can learn a form of "lucid dreaming", a way to remind ourselves of reality when we're dreaming awake. It's really hard... at the moment my "tell" as to whether it's real or not is how do I feel. If I'm blurry and confused then it might not be real. So I try not to act on it until I'm feeling clearer.

I should reiterate, it's not happening nearly as much as it used to. The longer your islands of clarity the easier it is to spot phantoms.