Psychologist | Forensic Questions Psychiatrist

I have a psychotic friend?

I have a friend, my oldest friend since we were 12, whom I have observed to mentally deteriorate over many years. This person has violent tendencies with a history of domestic violence, women beating, felony (terroristic threat), bad meth addiction, benzo addiction, pot addiction, and a nice rap sheet to boot. His stepfather was an extremely abusive alcoholic OB-GYN doctor, with a highly bizarre and eccentric personality. The guy is completely dependent on his mother for financial support as he is way too mental to maintain employment. He has delusions that he and I created the universe so he feels strongly connected to me. As a child he: wet the bed until about 14, played excessively with fire, and tortured the hell out of pet gerbils. I'm not making this up, as far as I know he has the classic shared symptoms of serial killers.

He admires them deeply for their sick deeds. He has books about serial killers. The walls in his house are laced with oddity shrine materials, animal skins, skulls, bone art with feathers, wolf heads, Jason Vorhees mask, Michael Myers mask, posters of his favorite slasher films etc. He let slip to me once when he was almost passed out at the end of a meth binge that he wanted to harm my wife in a way that I don't want to mention. He has a collection of machetes, and hand made stabbing weapons. He also has an almost complete law enforcement uniform. He's been in and out of jail several times for domestic and drug related crimes. I've wanted for years to cut ties with this person because I have a wife and child who I would do anything to protect. He is jealous of me having a good life and at a certain point he may try to harm my family.

I'm not a paranoid fruitcake. I believe my threat assessment is real and justified. I need advice from a person with specialized training in criminal psychology on how to deal with this person, if I should cut ties (how to do it), or maintain a very distant relationship with him so as not to enrage him, etc.

Male | 44 years old
Complaint duration: years
Medications: unknown
Conditions: multiple

3 Answers

Oh dear, yes ,your childhood friend is indeed in a “mess” & if he does not access to an RX for his substance dependence, he will die or be arrested or be killed…. I am very sorry to have to inform you …. However, the stakes are that HIGH & the only way I can inform you is to say it “like it is & NOT beat around the bush,” as the saying goes…. My recommendation to you is this:
Every time you have contact with your friend, make sure to tell him in your HONEST, heartfelt way how much you worry about him & how happy you are to see that he is still with us in this deadly pandemic, when all of us are terrified of DEATH as life is a gift … Now, you cannot say to him anything about his being addicted or that he needs to get into an in-patient treatment for at least 6 months to start, as he is clearly in total denial and anything you say will only result in his NOT only NOT hearing you, but he will AVOID you, & you know he really needs your loving support. So, you have a big decision to make: Do you even want to get involved to very slowly build up TRUST so maybe, just maybe he can tell you how he sees/feels he is doing? He may be unable to, and staying in contact means you intend to follow him in his struggle to keep staying alive … if he was able to see how self-DESTRUCTIVE he is, BE assured he would NOT be BEHAVING this way. But right now, even knowing he is self-destructive, it is very, very, very hard for him to do anything else. The HOPE is that somehow, through someone’s loving care, very SLOWLY OVER A LONG TIME, your friend will get it & commit himself to take care of himself CORRECTLY = MINDFULLY.
Hope this helps you.
Best,
MTL
Thank you for your questions.
This is a very complex situation indeed. The level of paranoia, interpersonal trauma, and violence not to mention active substance use exacerbating the psychosis would warrant you take prudent measures to protect yourself and your family. This means disclosure to your wife about the threat of harm to her. You probably already understand how unattended a healthy relationship/friendship is with this individual under these circumstances. I would also imagine you have kept ties with this person, in part, to "monitor" for potential safety risks to yourself/your family. I would also be concerned for his mother's safety.I obviously cannot advise you as to specific actions you should take aside from the obvious to notify local crisis/mental health authorities and local law enforcement to address imminent risks of harm. As well, you probably have grown quite weary of this person's grossly declining condition including the preoccupation with illicit drug use, poor reality testing and violence.
From your description it appears he is in need of desperate help. He should seek IP care, followed by IOP therapy followed by OP therapy. As much of a friend he is to you, you need to slowly distance yourself from him because of the potential threat to your family.