Note: I have debated with myself the morality and ethics of providing this kind of primer for years. I finally decided that I should provide it because, after extensive contact with mentally ill people, I am convinced that someone who is dangerous cannot follow these strategies for any significant period of time. For a few days, yes. Over months and years of interactions with other people, no.
If someone is mildly psychotic, or mentally ill but not dangerous, they may be able to use this primer to hide their illness. Almost nobody who is crazy enough to be dangerous is going to be able to hide it for any length of time, and the very few who will are outweighed by the interests of people who aren't dangerous and will otherwise be unjustifiably committed.
Julie Cochrane
BS Psychology 1990
Georgia Tech
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How to look like you're not psychotic:
Refuse any medication you are not willing to take permanently. Otherwise, your lack of psychotic symptoms may well be taken as evidence the medications that you want to quit taking are working and are necessary. Anyplace an adult can be involuntarily committed to will very, very rarely inject someone or force pills down their throat. More likely, they'll confine you, restrain you, or threaten you with hospitalization or being in hospital longer if you continue to refuse the medication. If you aren't willing to take it for life, or if you've tried it and the side effects make you decide to quit taking it, refuse it despite their threats. If you can look not psychotic, not manic, and not depressed, while not taking the meds they want you to, you can outwait them and they will eventually have to discharge you without requiring you to take the meds you've rejected.
Remember, it is extremely expensive to keep someone in a mental hospital, and there are always more very dangerous crazies than there are beds. It's the opposite of private facilities run for profit. The state never provides enough funds to house all the people in the state who really are homicidally psychotic and actively suicidal.
If you persist in being visibly non crazy while refusing meds you don't want, the financial pressures within the system to discharge you will prevail, no matter how much some relative or some misguided doctor wants to keep you in. For most mostly sane people, they'll be discharged sooner rather than later.
On the other hand, if there is medication you think does help you that you are willing to keep taking, fine, take it.
Show a penchant for bright colors and "busy" music like dance music. Psychotics tend to perceive sensations as more intense than they are--colors appear brighter, sounds are louder or more intense, sensations on your skin and so forth are more intense.
Don't talk to yourself. If caught talking to yourself, tell them you're thinking of writing a book about your experiences and trying to plan it out. Decline to write it down "yet" as you feel that will interfere with your creative process. No, of course you aren't talking to anyone else. Another excuse, if plausible, is that you were praying. God doesn't talk back, you don't know if prayer is effective or if God even exists, but you think it can't hurt. Pick sick relatives, or world peace, or the victims of a natural disaster, as who you're praying for. Say you try to spend some time praying every day because you think it's character building. Pick a mainline denomination as your religion of choice and be moderately observant, not a holy roller. Ask for a Bible, but only read a chapter of it on a random day once a week. Pick Psalms or Proverbs and tell them you find it a pleasant release from boredom and again, character building. Talking to yourself will be viewed as proof positive you're having auditory hallucinations.
Do not make any ambitious claims about your intellect, your strength, your prospects, anything--even if they're true. Do not denigrate yourself, but present your view of your own abilities and prospects as basically average. "I don't think I'm all that smarter than other people, I just take tests pretty well." Grandiosity is a symptom of psychosis.
Do not speak in absolutes. Qualify everything with ifs, maybes and exceptions. No nevers, no alwayses. You'll seem a little diffident, maybe eccentric, but that's okay. Psychotic people frequently see the world in absolutes.
Be skeptical of all conspiracy theories, if a doctor brings one up. He may be probing for delusions. Yes, people do conspire with each other or "conspiracy to commit" whatever wouldn't be outlawed. Better to be thought over-skeptical of conspiracies than be thought delusional.
Do not pick at yourself. Do not pick at scabs, do not pop pimples, do not pull your hair, do not bite your nails, avoid scratching when you can. Psychotic people tend to have physical hallucinations on their skin, like the feeling that bugs are crawling under their skin.
Take a bath once a day, if possible. Wash your hands after you go to the bathroom. Brush your hair and teeth once a day. Put on clean clothes in the morning, if available. Depressed people show "poor self care." So can bipolars. Yet excessive washing or obsessions with cleanliness will be marked as a sign of OCD or delusions about germs or such. Be moderate.
Do not let yourself stare off into space or stare at people. "Staring episodes" are a sign of psychosis.
Do not give anybody the silent treatment. It may be misread as a symptom of catatonia or somesuch if the psychiatrist is really intent on finding a problem.
Do not sit still for extended periods of time, do not move around constantly or fidget. One could be misread as pseudo catatonia, the other could be misread as a symptom of mania.
Talk in measured speech that's not in a monotone. The monotone will be considered "flat affect"--a symptom of psychosis. Rapid speech that flies from idea to idea will be considered pressured speech, a symptom of mania.
Sleep regular hours or give a damn good act of same. Resist any temptation to sleep in the daytime. Sleep, or appear to, seven and a half to eight and a half hours. Go to bed and get up at the same time whenever possible, but don't rock the boat if they want you to do something that requires getting up early or getting to bed late. Bipolar or depressed people frequently mix up their days and nights or sleep too much or too little.
Do not express feelings of hopelessness or guilt, nor excess optimism. The first will be taken for depression, the second for mania.
Show reasonable emotion in your facial expressions. Don't go stony faced or ridiculously animated. "Flat affect"--that is, showing little emotion--is a sign of psychosis. Show too much emotion and it will be obvious you're acting.
Do not harp on one subject and return to it over and over again, it's a sign of obsession and perhaps delusion.
Do not ever, ever threaten harm to yourself or someone else, or express any wish to harm yourself or someone else, or any wish for anyone to come to harm, even jokingly. If confronted with whether you wish harm to various examples of bad people, express the view that it's a pretty negative subject and that you don't think it's good for anyone to dwell on that kind of negativity. Asked what about the police or military, say that of course there are people's jobs who require that kind of thing but it's still probably not good for them, just a dirty job someone has to do, you're glad it's not your job to worry about that.
Avoid discussing religion, sex, or politics. You're not political, you're not excessively devout, your small religious observances are because you think they're character building or good for people, in moderation. When asked about your sex life, say you believe sex is a very personal and private thing, your sexual desires and interests are pretty average as far as you can tell, but no matter who the doc is, he/she is definitely not going to be allowed to invade your privacy by digging for explicit revelations about your sexual thoughts, fantasies, or behaviors. Don't be morally disgusted, just maintain that being forced to talk about it to some stranger is icky and that you aren't doing it, no matter what. This you can be pretty absolute about--"As far as I can tell, my desires and sex drive and so forth are pretty much like other people's, but no way in hell am I going to talk about my personal sexual feelings, mores and acts with you. Sex between people who aren't consenting adults is wrong, and that's all you need to know about my sex life." From then on, "I've said all I'm going to say to anyone here about sex. Everybody has certain rights to privacy no matter what anyone else says, sex is one of the most private matters there is, and I am not having this conversation. We need to talk about other stuff, because I am not talking with you, any of you, about sex. It's private."
If pressed, "I would never do anything sexual that wasn't by myself or with another consenting adult, and I would never do anything sexual to hurt myself or anyone else, and that's all you need to know about me and sex." "I don't care if you think you need to know more, I don't care what your reasons are, I'm not talking sex with you. Or anybody else who's not a partner or a buddy, either. Nobody here is that kind of buddy, nobody here is ever going to be that kind of buddy. I do draw the line there." Whatever they suggest might be consequences to you for staying mum, don't be drawn in. "I don't care. Well, I don't care enough to talk sex with you. Coercing me to talk sex with you, applying pressure to me in any way to talk sex with you, is so unethical that I can't imagine how you live with yourself."
I say that much about it because doctors probably will press you to talk about sex, and there is nothing that lends itself to a trumped up diagnosis more than crap an incompetent or unethical pshrink, even a well-meaning incompetent, can read into anything else you say about your sex life other than you expressing a belief in consenting adults and that you would never do anything sexual to hurt yourself or someone else.
Don't cut. It doesn't look psychotic, but it does look dangerous to yourself. Don't bang your head against a wall or hit yourself in the head or anything like that, even if you're making a joke.
Cultivate interests you can talk intelligently about in harmless stuff like various arts, crafts, and music. Express moderate and reasonable career aspirations if the subject comes up.
Don't be afraid show a bit of anger about situations where anger is normal and to be expected. You may be tested with such a situation to see if you're trying to fake good. Express your anger by expressing a desire to leave the situation. Express anger at someone you have reason to dislike permanently as a desire or wish to rearrange your life so you don't have to interact with them, by moving, changing jobs, or just avoiding them. The psychiatrist will probably consider the avoidance of conflict unhealthy, but it's not a symptom of psychosis or dangerousness.
As the doctor says it's unhealthy, get stubborn, "Well, maybe so, but it's just the way I am. I don't want confrontations, and I don't like being around people who regularly piss me off if I can avoid it."
If he can present you with examples in your past behavior where you didn't do that, just say that avoiding the situation or person would have been a better idea, or looking for a way to get away (if you couldn't immediately leave for some reason). React to the example where you didn't just avoid a conflict by, "Yeah, well, I learned something from that. Confrontations just aren't worth it. I'd rather just walk away."
If the doctor tries to claim you aren't dealing with your anger, say, "Sure I am. I'm taking care of the problem and taking care of myself by choosing not to be around that." That's if it's someone you don't have to interact with. If it's someone you do have to interact with, "Well, I guess we all have to get along in difficult situations, don't we. Everybody could handle their relationships better than they do, but those are things I prefer to work on with my pastor on an outpatient basis. I'm just more comfortable with the style of advice I can get from a pastor at the church of my choice. I don't mind living away from those of my loved ones I'm going to maintain relationships with while I learn better relationship skills, but I'm not going to do that locked up, where the counselor isn't someone of my free choosing."
Realize that you do not have medical confidentiality with inpatient pshrinks no matter what they say. The person listed as taking care of your interests---next of kin or guardian ad litem or judge or whoever is paying for your care--will always have access, no matter what anyone else tells you. A pastor or priest who is not being paid who promises you personal confidentiality must give it unless you threaten to hurt yourself or someone else, or give him/her reason to suspect child abuse has occurred or is occurring. If you're grown and you were the abused child, the pastor or priest still has to keep it confidential. Catholic priests have the best track record for maintaining confidentiality, if that works for you. Even if you aren't or weren't Catholic, you can claim to feel really comfortable with a specific priest, and gradually allow yourself to be persuaded to their religious position---devoutly enough to satisfy the priest, but definitely not overdoing it.
If you can do these things, then even if you believe pink elephants are beaming secret messages into your brain or wish you could get away with wearing a tinfoil cap, you will look sane enough to be discharged if you just outwait the system.
