Living with someone who has a mental illness can be a challenge for family members. People with mental illness need a special type of interaction and if one is not familiar with their symptoms and inner world, it can be hard to show sensitivity to their needs. More than 54 million Americans have mental illness in any given year, although fewer than 8 million seek treatment. A big proportion of people suffering from mental illness, —their symptoms are unrecognized, undiagnosed, and untreated for a significant period of time. It is important for the family members to be familiar with the warning signs of mental illness so that they can be empathic and sensitive to them.
Communication is the key factor in interaction and if you lack empathy and sensitivity, you can unknowingly hurt the feelings of your loved one who is suffering mental illness. This is true whether your relative is a child, adolescent, or an adult. You need to be mindful of your relative’s symptoms and understand what is going on in their head so that you can tailor your remarks when communicating with them. Mental illness in a family can affect every one who lives with the person. Following are some of the techniques that will be helpful to use when living with a person with mental illness.
1. Active listening
For people who are suffering from mental illness need to be listened to and it helps them in their healing process. They needs to be heard, not dismissed. They are not looking for a solution but actually your listening ears and empathy. Try to refrain from offering solutions, re assuring or judging when your relative is having problems with reasoning or emotions. You can express compassion and empathy by saying things like,” I see”, or “ aahh”. This is sufficient to make the person feel that you understand. “ That must have been so hard” Sometimes we get tempted to offer solutions and bombard the person with questions like, Why did you not ——-“ and so on. These questions are perceived as interrogation and the person gets defensive and argumentative. Sometimes paraphrasing is also effective because it gives a chance to your relative to reflect and clarify their thoughts and feelings. In this way listening and just listening helps both of you.
2. Refrain from Offering your Input
It is easy to get tempted to offer your own input when talking to your relative. It is best to refrain from doing so as people with mental illness already have enough thoughts and feelings going on in their heads. It will be distracting for them to take account of your thoughts and feelings. Accept what the person is presenting without interrupting and feeling compelled to offer your viewpoint. If you feel that you have to say something, keep it simple and short. If your relative tunes you out, it is not because of rudeness but it could be very symptomatic. So you need to limit your input. Some of these mental illnesses are associated with poor concentration and this could interfere with their ability to comprehend your message. You need to have a supportive conversation.
3. Speak Calmly Without getting too Excited or Emotionally Laden.
Try to convey your message in a calm manner with a pleasant body language so that you deliver respect and calmness in your words and tone of language. It is easier for your relative to understand you when you present a calm composure. If you have heightened emotions, try to present them in a controlled fashion and in a matter of fact style. Stating facts is okay but when you load your conversation with intense emotions, they get confused and are likely to over react too. In this context, it is also important to note that criticism, and expression of hostility can back fire. People with mental illness do well with families who have a calmer style than the families who have an emotional style of communication. Strong emotions can overload parts of the brain responsible for thoughts and feelings and lead to problems. By staying calm when they are upset, you role model for them and also facilitate effective communication and reduce the stress level of your relative.
4. Use Simple Words and Speak with Clarity
When communicating with a person with mental illness, it is important to refrain from giving long explanations and using too many words.
Many psychotic people are going through a jumble of ideas at one time and it is constantly running in their head. When you engage in lengthy conversations, it becomes like a back ground noise and they are not able to process. By speaking in short, and simple sentences which have clarity, they are able to process your communication more effectively. If you want to make a request or express your feelings, it is best to use the “I” statements for optimal effectiveness. For example, you can say,” I really appreciate it when you clean up the counter after fixing your sandwich.” This way you avoid giving them commands and refrain from attacking their egos. This results in gaining their cooperation and also, they have less need to defend themselves when you respect their dignity.
5. Give Direct Messages
When communicating with a person who has mental illness, it is important to remember to be straightforward and direct. They appreciate direct speech since their symptoms interfere with their ability to concentrate and comprehend. If you communicate in complicated manner, they get confused and have difficulty comprehending your message. They can overreact and have a temper tantrum. They are also not able to take criticism, sarcasm, teasing, and subtlety.
Calm, simple and direct communication works the best. For example, “ I am studying for an exam. Could you please turn the volume low on your radio?”Avoid giving hints and making indirect requests.
6. Avoid Arguments and Heated Communication
People with mental illness could be experiencing auditory hallucinations, overwhelming feelings of depression, intense anxiety, mistaken beliefs and cognitive disorganization. These symptoms can interfere with their ability to engage in rational discussion. They might have odd reaction to your tendency to control and change their behaviors. They lack the ability to engage in rational and logical conversation so it is best to refrain from arguing with them. One helpful way to deal with them is to let them know that you understand how they feel rather than questioning their delusions. When you reflect on feelings, they are able to listen to you. If you question the reality of their delusions, they are likely to over react and start an argument.
7. Be Positive and Show Unconditional Positive Regard
It is important to note that people with mental illness suffer from inferiority complex also and feel lonely, demoralized, lack of respect, understanding and positive regard from others. These are painful feelings. You may be able to have an influence on these feelings when you demonstrate your positive regard for them. When you show that you accept them and have compassion for them, you give them hope and understanding and they respond better to your requests.
8. Give them Hope
People with mental illness are often desperate and feel hopeless and helpless. When you communicate with them, it is important not to give in to their negative outlook. Instead, give them hope by reflecting on their feelings and also letting them know that things will get better. Try to emphasize their strength and stay positive in your communication with them by giving them a ray of hope. Express your positive feelings and this will, in turn, give them a feeling that someone appreciates them and eventually boost their self esteem also. Saying, “ I am proud of you for your achievements” or “ I am happy to be with you.” Sometimes, it is good to be specific when you are giving praise in order for that behavior to be reinforced. For example, “ I am glad to hear that you joined the support group.”
9. Express your Love
People with mental illness also have a tendency to feel that no one loves them. It is very important to make them feel that you love and care for them. Simply saying that you love them, makes them feel that they are accepted for who they are and they do not feel so lonely and unsupported. By giving them this message of love, you help them strengthen the bond between you. Many of these folks have been traumatized in the past and have lost their trust. They tend to over generalize and believe that no one loves them. When you let them know that you love them, it gives them a sense of hope that they are not lonely and someone cares for them.
Besides these communication ideas, it is also important for the relative of a mentally ill person to understand that they should not take his or her remarks personally. Mental illness can affect how people perceive and respond to others. If they are being unresponsive to your requests, and do not sound enthusiastic, it is because they are internally going through some thought process that is inhibiting their capacity to understand you. Don’t take it personally. Also, try to be a good observer and see what kind of communication skills work best with your relative and try to use those skills more frequently. If you notice a discomfort level, and a negative response to your tactic, then try to refrain from using them in the future.
Living with a person with mental illness can take a lot of energy from you. Try to respect your own needs and rights. Don’t allow yourself to be hassled in conversation with your relative. If you allow your relative to harass and belittle you, you will not be giving them a good message. You also need to be assertive and try to state your needs calmly and simply as needed. Assertive statements like, “I feel angry when you try to verbally abuse me. I would like you to show respect to me.” If you are too tired to engage in a conversation with your relative, then give yourself a space and avoid confrontation. It is better to have successful communication than having destructive and over productive communication with poor quality.
In summary, it is very important to show sensitivity and empathy to your relative who is suffering from some kind of mental illness.
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Reference: The Family Intervention Guide to Mental Illness by Bodie Morey, Kim T. Mueser, Ph.D