Talking Tips
- Speak kindly, clearly, and simply
- Listen, and then restate what you have heard
- Acknowledge what your family member or friend is saying without supporting the delusions
- Be respectful. Use “I feel” statements instead of “I think” statements
- Explore their motivation
- Use the motivation so you have something on which to agree
- Do not argue, even if your family member or friend argues
Talking about schizophrenia and treatment
Talking to a family member or friend with schizophrenia about schizophrenia is not easy. There are many challenges. For example, sometimes people managing schizophrenia do not wish to participate in social activities that they once enjoyed. Trying to approach the topic—while maintaining meaningful, open communication—can also be difficult. Talking with others about schizophrenia can be difficult because they may not understand what schizophrenia is.
You may also feel ashamed to talk about the disease, but there is no shame in having a person with schizophrenia in your family or being their friend. Talking about it may help you cope. It may also help educate people about the disease. This will help them understand that no one causes schizophrenia, just as no one causes arthritis or migraines. It is not the fault of the person with schizophrenia. And it is not the fault of that person’s friends or family. Schizophrenia is a disease that can be managed. Deciding whether to talk about schizophrenia with others is a personal decision that caregivers and the individual with schizophrenia should make together.
Talking to your family member or friend with schizophrenia
Situation: Michael had his first psychotic episode 2 years after starting at a technical school. He just returned home from the hospital. He would rather sit quietly in his room than take part in family activities.
His father, Tom, feels responsible for what is happening. He wants things to get back to normal. Tom feels upset because he remembers all the things Michael and he used to do together, like tossing a football in the backyard and watching games with the guys in the neighborhood. He thinks that if he can just get Michael “pumped up” about life, they could start enjoying these things again. Tom has not accepted that Michael’s mental illness is a chronic disease. Tom does not know how to talk about it.
Tom: “Hey Michael. I was thinking of calling up some of the guys. We could all head down to the basement to watch the game this evening. What do you think about that?”
Michael: “I don’t want to be with other people right now. I don’t want them to know about my condition. I just need quiet.”
Tom: “Come on, Michael. They’re like family. And they don’t care about what you have. In fact, you’re fine” They just want to see you and spend time with you. How about it?”
Michael: “Dad, I just can’t deal with people right now.”
Tom: “OK, Michael. So, what if we forget the game with the guys. How about you and I just toss the football around outside? Want to give that a try?”
Michael: “Please, Dad. I just want to be alone right now!”
Analysis: Although Tom means well, he is giving his son the wrong kind of encouragement, and he is talking about his son’s illness in the wrong way. In fact, Tom is trying to act as though it does not exist.
People with schizophrenia may have trouble with sensory overload. That means there is too much going on and they feel overwhelmed. Sometimes the best thing for them is “alone time.” Although Tom does not know it, the activities he wants to do with Michael can be stressful for Michael.
Tom should try to understand that Michael’s condition is not anyone’s fault. Tom should not try to make things the way they once were.
It might be better if Tom admitted that his son is ill, supported Michael’s need for peace and quiet, and joined him in some low-key activity. Not everyone needs to know that Michael has schizophrenia. Tom should respect Michael’s wishes that he does not want the guys in the neighborhood to know of his condition.
A better way to approach the situation:
Tom: “Hey Michael. I just wanted to check in on you and see how you were doing.”
Michael: “I’m sick. I guess that’s how I’m doing. And I just want to be alone.”
Tom: “Michael, I know you have schizophenia. And I know it can cause you to fell many things, including not wanting to be around too much activity and too many people. Right?”
Michael: “Yeah. Thanks. I guess I just need some quiet time.”
Tom: “I can understand why you would need some quiet time. Would it be OK if I joined you later this afternoon? I was thinking of reading the sports pages. If it’s OK with you, I could sit quietly with you while I read them.”
Michael: “Sure, that yould be fine.”
Talking to other family members
Situation: Samantha was diagnosed with schizophrenia at the age of 22 while enrolled part-time at a community college. She was recently hospitalized and will be returning home soon. She has a younger sister, Jennifer, aged 18. Jennifer is concerned about Samantha’s well-being. Jennifer also worries that she might get what her sister has. Then she would be sent away, too. Their mother, Liz, is trying to protect Jennifer from what has happened. And Liz does not have the energy to explain it all because she is stressed, angry, and scared.
Jennifer: “Mom, when is Samantha coming home?”
Liz: “Hopefully in about a week.”
Jennifer: “Why has she been gone for so long?”
Liz: “Because she needs to get well.”
Jennifer: “Is she almost well now?”
Liz: “She’s almost well, Jennifer. Why don’t you hand me the phone? I’ve got to call Mrs. Weber back about the church potluck.”
Analysis: Liz may think she is protecting Jennifer by not answering her questions. But Liz may actually be confusing Jennifer more. The unanswered questions may cause Jennifer more anxiety and fear. Of course, it is understandable that Liz would be stressed, angry, and scared about what has taken place. No parent wants anything to happen to his or her children. But Liz may find that explaining things as best she can may help Jennifer and their entire family to cope better.
A better way to approach the situation:
Jennifer: “Mom, when is Samantha Coming home?”
Liz: “Hopefully in about a week.”
Jennifer: “Why has she been gone for so long?”
Liz: “Because your sister has an illness called schizophrenia. This makes it hard for to think straight. The doctors are helping her to learn how to work with her ilness.”
Jennifer: “Will she be the same when she gets back? will she be able to think straight?”
Liz: “Samantha will always have to work hard at thinking straight. And she may not be exacly the same when she gets back. But she will still be Samantha, whom we love very much.”
Jennifer: “Will I get it next?”
Liz: “Jennifer, this is not something that you can catch like a cold or the flu. And theres is little chance that this could happen to you.”
Jennifer: “So what is going to happen when Samantha comes home? Will things change?”
Liz: “When Samantha comes home, it will be a tough time for her and for us. But if we all hang in there together. I think everything will turn out OK.”
Talking to friends and coworkers
Situation: David had a psychotic episode during his sophomore year of college. He was diagnosed with schizophrenia and admitted to a psychiatric hospital. The news traveled fast through the campus he attended with his older brother, John. Friends frequently asked John about what happened to his brother. John is embarrassed by what happened. He does not want to believe that anything has changed. Above all, he does not want to talk about his brother’s illness with friends.
Ted: “Hey John, I heard your brother was sent off to the loony bin. Did the pressure of school just make him crack?”
John: “He’s not in a freakin’ loony bin. He’s fine and will be back next semester.”
Ted: “Really? I thought he was never coming back.”
John: “He’ll be back. Same as ever. You’ll see.”
Analysis: Denial that his brother has schizophrenia can make it difficult for John to cope in the long run. There is no shame in a family member having schizophrenia. It may help John to accept schizophrenia for what it is— a chronic disease that is manageable. John may feel better and get more support if he talks about it. Although he does not have to tell people if he does not want to, John may be surprised to find that many people will sympathize with him.
A better way to approach the situation:
Ted: “Hey John, I heard your brother was sent off to the loony bin. Did the pressure of school just make him crack?”
John: “He’s not in a loony bin, Ted. He’s in a hospital with a chronic but manageable disease.”
Ted: “Really? I thought he went bonkers.”
John: “No, He didn’t go bonkers. He has schizophrenia. It’s a disease that affects the brain.He will be fine, but we don’t know yet if he will coming back to school.”
Ted: “I’m sorry to hear that. I hope he gets better.”
John: “Thanks. It will be tough, but he will get better.”