Tips for Speaking to Someone With Schizophrenia
Trying to communicate with someone who has schizophrenia might seem difficult. The truth is, though, that a lot of the stigma surrounding schizophrenia causes us to be too careful and reserved when communicating with a loved one with schizophrenia. Having normal conversations with them cannot be overvalued, and this genuinely is a positive way to show them your love and support.
So, just how do you speak to them? You speak with them, and here are some ways to go about doing so.
What Not to Say to Someone With Schizophrenia
People with schizophrenia sometimes feel isolated or like they are difficult to converse with. They might experience disorganized speech, cognitive difficulties, and problems relaying their thoughts in ways that others can understand. They might also seem as though they lack the motivation to do simple daily tasks — something they might not communicate to you in oral speech.
Empathy, education, and compassion are necessary for speaking with someone who has schizophrenia. They do not need you trying to “fix” their condition and let’s be honest here, you cannot simply “fix” schizophrenia. Instead, you find ways to work with them and their schizophrenia.
You really need to think about what not to say to your loved one who is dealing with schizophrenia. You should certainly never blame them for not trying to fix their own condition, and telling them that their symptoms are “all in your head” is incredibly insensitive and inaccurate. You should also avoid forcing them to talk to you because you think that will make them feel better — it might not. Also, expressing any type of pessimism over their condition is likely to lead to them cutting you off even more.
Responding to Changes in Symptoms
People with schizophrenia have heard enough pessimism and tend to be aware of the stigma. What you can do is start learning how to respond to the fluctuations in their symptoms. As is the case with almost any mental health condition, symptoms of schizophrenia have an ebb and flow. It is up to you to start learning how to recognize them as they occur.
Psychosis plays a major role in schizophrenia. In this state, an individual might lose their sense of reality, exhibit disorganized behavior, and experience hallucinations or delusions. They might also lose interest in their usual daily activities, experience a decline in interpersonal communication, and become unable to express their emotions.
Let’s talk symptoms. There are both positive and negative symptoms of schizophrenia to look out for. Positive symptoms, which refer to exaggerated ideas, perceptions, or actions, include disorganized thoughts and hallucinations. Hallucinations can affect every bodily sense, including smell and taste, although auditory hallucinations are most common. When you notice these happening, try suggesting other activities to your loved one so as to gently divert their attention to something more constructive and realistic.
Delusions are centered upon a fixation with false beliefs and are hard to dissuade despite concrete evidence to the contrary. Instead of rejecting these beliefs outright, try asking questions and showing that you at least acknowledge their beliefs.
Negative symptoms, which are those that show an absence or lack of normal mental functioning, include affective flattening, which makes them come across as lacking emotion. It might not necessarily be apathy; instead, it might be due to a lack of environmental and social stimuli. You can provide that stimulation by offering — but not forcing — opportunities for your loved one to join you in certain activities.
With alogia, a person experiences a lack of speech. They might not be able to string thoughts together or just do not have the desire to make conversation. Refrain from pointing out these problems. Instead, keep distractions (like cellphones and tablets) at bay and try to stimulate the conversation in a natural way.
And, finally, there is avolition — the lack of motivation to even start doing everyday tasks such as communicating. They might also struggle to maintain their personal hygiene. Even the most simple task can seem overwhelming, so try to help your loved one focus on taking everything one step at a time.
It is okay to reach out to your loved one to tell them that you are worried about them. Let them know that you are there to offer them any help that they might need. Do not push your help onto them, and certainly do not try to force them to seek professional help. That might end up actually pushing them further away from getting help.
An easy and nonthreatening way to start things off could be: “I know that you have been through a lot. I just want to let you know that I care about you and am here to help however I can.”
Just don’t expect a “normal” reaction. Someone with schizophrenia might remain silent or only utter one or two syllables. Other times, they might say that they want to discuss the things you want to, but their body language says otherwise. These behaviors are related to the illness and are not the individual trying to send you mixed signals. You have to remember that someone with schizophrenia might not be able to express emotions or speak out loud, but they do still have their own opinions and ideas.
Using an Icebreaker
Use an icebreaker like you would in any normal conversation. Start off by broaching a neutral topic. They likely are not expecting you to address their health issues or emotions. If you are co-workers, talk about something related to the job. Speak about something not related to schizophrenia. Refrain from an overflow of offers to help them but still show them support. You can let them know your intentions and give them the leeway to approach you when they are ready.
Offering Advice and Suggestions
It can be all too tempting to advise someone on how we think they should be “fixing” their condition. They might not be in a good place to weigh the consequences of their own choices, so they might misunderstand or take your advice out of context.
Should your loved one press you for advice, proceed with caution. You do not wish to devalue the advice of their doctors or the support of their other loved ones. And, of course, you are not their doctor and should not be telling them which medications to take or how to proceed with counseling.
Instead, suggest that they consult with their physician, counselor, or psychiatrist about a medication or supplement that you have heard might be helpful to people with schizophrenia. Keep a neutral enough tone while talking about it, and reinforce the idea that it is truly best for them to speak with a licensed professional about treatment. If they approach you with some of their distressing personal issues, be supportive and kindly suggest that they speak with a counselor.
When to Break Confidentiality
Sometimes, what a person with schizophrenia might tell you can stay between the two of you. Other times, you might find yourself needing to break that confidentiality. But how do you go about it when you want your loved one to trust you?
If your loved one indicates that they want to harm themselves or someone else, this is a case in which confidentiality needs to be broken. But there is an effective way to handle it. Consider whether you need to inform their caregivers and/or doctors about this. You can remind your loved one that you care about them and that threats of self-harm or harm to others are going to be taken seriously.
Find some compassionate but neutral words to express this person’s need to communicate their feelings with their family and doctors. You can say something along the lines of “I am concerned about you right now and would like to share this with your family since I think their support and understanding could really be helpful to you.” This lets them know that you are not betraying them but want to keep them — and those around them — safe from harm.
A Few Final Tips
Remember that educating yourself on schizophrenia is important since there are different types of schizophrenia. And, of course, not everyone exhibits the same symptoms of schizophrenia.
Speak with your loved one like you would anyone else. Brace yourself for reactions that are difficult for you to process and respond to. Take their lukewarm responses in stride until they clearly show you that they do not want to communicate with you at the moment. Their “odd” ways of communicating or behaving are not something that you should bring up since this can only make matters worse.
Inappropriate reactions are something a person with schizophrenia is prone to, so do not be taken aback when it happens. Instead, continue the conversation as you were or just save it for later when this person has calmed down and is reacting more appropriately.
Your loved one might figure out what your intentions are and get angry or agitated with you. Do not engage them on what is causing them to become so upset. Instead, reaffirm the fact that you care for them and will be glad to continue the conversation whenever they are ready. Leave it on their terms.
Are you or your loved one dealing with schizophrenia and not sure who to turn to for help? Do not hesitate to reach out to the National Mental Health Hotline at 866-903-3787. Asking for assistance is the first step in finding a way to meaningfully communicate. Sometimes, a knowledgeable outside source is needed to find ways to open up and speak with one another.