Sorry to hear that he left through no fault of your own, and you apparently presently don’t have a dialog with him. It’s certainly difficult to impossible to practice LEAP if you have limited contact with your loved one as it’s a very “talky” process. I’m sure it’s very distressing, but likely he will eventually come to an impasse and have imminent wants and needs to rescue him from whatever situation he’s in and that’s a point where LEAP could provide leverage.
I want to reiterate it’s not necessary that your loved one “open up” about their delusions and for you to understand the inner workings of delusions to practice LEAP. It can be useful for background for how and why they feel and think certain things, and to help avoid arguments and reduce conflict. But by definition delusions aren’t real and therefore won’t be a component of any agreement or plan that results. Agreeing with or centering plans around specifics of delusions being “real” could be perilous and escalating and I wouldn’t recommend it.
With paranoias there’s often a phase when delusions or symptoms are new or distressing and that’s all you want to talk about, and reflective listening and reporter style questioning skills are helpful when the subject actually wants to be heard and understood and empathized with, but alternatively they may go straight to being uncomfortable or secretive about delusions or symptoms and being overly prying or intrusive can stifle progress. I liken this to someone you know becoming engrossed in a new relationship, and either can’t shut up about it or are very touchy or even secretive out of fears of vulnerabilities or outside interference.
Believe me, I know my brother’s delusional systems backwards and forwards and having personal experience and a proven track record with dealing with my own delusions helps extremely little as far as progress with LEAP goes. He’ll go over them in great detail over and over again as if I’m learning about them for the first time, instead of the broken greatest hits records that they are and we make very little progress. Knowing about them and listening to them are actually a huge impediment to progress, so be very careful what you wish for. However, acknowledging his feelings surrounding his issues and listening to him without judgement means he’s less angry with me overall than other siblings, and lines of communication stay open. My sister often makes the most progress with him, and I feel her background in sales and marketing is key here. It’s Agreeing and Planning that closes deals, and the rest just gets and keeps your foot in the door while you learn what your client perceives they want and need, and then you can jump in with a proposal and arrive at an agreement on mutually beneficial terms.
So rather than focus on his delusions, I suggest it’s more productive to focus on wants and needs and what terms you are willing to negotiate with him to provide them. Avoid “giving away the farm” when giving room and board or other support. Someone who’s pragmatic enough to hide information to protect themselves, could perhaps be bargained with for food, shelter, money, cigarettes etc in exchange for other things. Love may be unconditional, but support not necessarily so.
In my case, my primary motivator for starting medication was a realization that I would be unemployable without it, and as I recovered I flirted with and experimented with periods off medication, but this was only with various other supportive therapies. Ultimately I would always go back out of fear of losing my job or social status or other hard won gains. My conclusion was medication is cheap insurance and it was risky and reckless to run around “uninsured”.