Improving communication
One of the best things you can do for a relative or friend with schizophrenia is to have a good
relationship with them. Besides helping to counter the isolation of schizophrenia, it also helps to
anchor them to reality and boosts their self-esteem.
Good communication improves any relationship, and communicating with someone who has
schizophrenia can be very difficult, for example, how do you talk to someone who thinks they
are God. And what do you do when they do not want to talk?
Reading the guidelines below will help to make this easier. Remember to talk to someone with
schizophrenia in much the same way as you did before they became ill. Although you have to
make allowances, you are not talking to a child. Put yourself in their position. Which would you
prefer, someone who is condescending or someone who treats you with respect and makes you
feel you are a worthwhile human being?
Talking to someone with delusions
When someone insists they are Jesus Christ or that the CIA is after them, don't say they are
talking rubbish. It is important to recognise that these ideas and fears are very real to the person,
but at the same time you wish to show that you do not agree with them.
This means calmly
saying things like: "I know you can hear voices talking to you, but there really isn't anyone else
in this room". Or, "I know you really believe you are Jesus Christ, but you are not. You are
Michael Smith".
Once you have made your point, don't become involved in an argument. Try and move on to
some other topic. This is often easier said than done, of course. It is very tempting sometimes
to give in and say, "Okay, you are Jesus Christ". This will only feed the delusion. If you have
schizophrenia and a hundred people insist you are not Jesus and one person says you are, you
will believe the person who agrees with you.
Keeping your cool
Schizophrenia can make people irritable and aggressive. Staying calm in the face of this is
easier when you understand why.
People with schizophrenia are sometimes very sensitive and have low self-esteem. These things
combined with their delusions mean they may easily take offence and feel they are being
criticised unfairly. If the person is being irritable and unreasonable, do not shout or storm off.
Try instead to explain calmly why you feel angry.
Give a clear reason, such as "I'm upset that
you left the door open when you came in last night. We have had a number of burglaries in this
area and I don't want us to be burgled to". When you want the person to stop doing something
annoying, always give a reason. Saying "Don't do that" is not enough.
If you have a row and the person becomes withdrawn
People with schizophrenia often leave the room during an argument and the family's natural
reaction is to go after them. The best approach is to back off and leave them some privacy and
still show you care. You could say something like, "I'm really sorry you are upset - let's talk
about it later".
Think before you speak
You cannot always be spontaneous when you are talking o someone with schizophrenia. The
paranoia and sensitivity that go with the disorder can make people misinterpret what you say.
A casual remark like "I hear your mother has been sick lately", can be translated into "Your
mother has been sick because you make life so difficult". It pays to say something more specific
like " hear your mother has been sick with the flu".
Again, when you get angry, avoid generalisations like "It's all' your fault" or "You are nothing but
trouble". A more specific "I wish you hadn't done that because ......." is better. Remember to keep the
person informed about things that are coming up in the future, a visit from relatives, for instance. Spring
the news on them suddenly and you risk making them suspicious, and they will think something like,
"they have been keeping this from me for weeks ......"
Keep sentences clear
Anyone under stress but especially someone suffering from schizophrenia can be confused by
complicated instructions. Here is an example: "Could you put the garbage and milk bottles out and when
you have done that, the garden needs hosing, but don't water the plants on the table because I have
already done them". It is better to say "Could you please put the garbage and milk bottles out" and, when
they have finished that, say, "Could you please water the garden, but you don't need to water the plants
on the table".
The same goes for giving choices. Do not bombard someone with lots of options like "There is egg and
lettuce sandwiches, cheese and pickle, ham and salad or would you rather have tuna?", narrow it down to
two or possibly three choices.
,b>Bizarre words, unfinished sentences and other conversation quirks
Some people with schizophrenia use made up words (neologisms). If you do not understand them it is
more useful to say "I don't really understand what that word means" rather than saying "Don't talk
rubbish". Also be prepared for the person to either refuse to explain or give an explanation you do not
understand.
When this happens, it is a good idea to change the subject, otherwise you end up in a conversational
stalemate and if the person insists in continuing a conversation you cannot comprehend, it could mean
they are becoming psychotic. Again, make it clear you do not understand and either talk about something
else or offer a distraction.
Some people also suddenly stop what they are saying in mid- sentence (this is called thought blocking).
What you do here is remind them of what they were saying before "Jill, we were talking about..." The
same goes for times when the conversation suddenly switches to a completely different topic (this is
called tangential thought). Again, lead them back gently: "Jill, we haven't finished talking about..."
If the person does not want to talk
If you are trying to talk and the person seems distant, do not take it personally. It is because the person
cannot process what you are saying - you are probably competing with a cacophony of other voices in his
or her head. There will be times when the person needs to withdraw.
You can try saying "Is there some reason why you do not want to talk to me?" When the person does not
want to talk, accept it.
You may not be able to keep them in the 'real world' all the time. Remember too
that people with schizophrenia often have a strong desire for privacy. Ask too many questions and they
may think you are prying. You need to respect their need for privacy while at the same time showing that
you care. You can do this by saying something like "I see you do not want to talk right now and that is
OK. If you want to talk later on, I will be here".
