Communicating with a loved one who has schizophrenia and experiencing delusion is challenging, frustrating and even frightening. This is especially when schizophrenics get paranoid. When schizophrenics say things like they refuse treatment, you may feel the need to force communication.

That should not be the way! But, how can you help?

Why Forcing Your Idea or Opinion Does No Good

You may want to correct a delusion or force your opinion because it may seem better for your schizophrenic loved one. Instead, it leads up to further misunderstandings or arguments. Because we feel more anxious and frustrated.

Schizophrenics’ moods are often affected due to the delusions that are being experienced. Our brains are wired differently from others. When we are in our delusion, it’s difficult to see things from a different point of view.

Think of the delusion as a belief that is so strong that it is impossible to get rid of. Such feelings are immensely hard to manage. Adding your opinion will add to further suspiciousness, misunderstanding or anger.

How Does Schizophrenia Affect One’s Speech and Communication?

When schizophrenics are experiencing symptoms we usually talk lesser. I often find it difficult to convey my meaning to others. It’s always a struggle to make others understand how I think.

It requires great effort for schizophrenics because our thoughts are scattered. Intrusive thoughts that pop into the mind keep cropping up without warning. Subsequently, this makes it uncomfortable for us to be in the company of others.

At times like that, we may not present many emotions or feelings as we talk. This condition is also known as alogia or flattening. Our emotions may appear to be dull and flat as we may feel mundane when making conversations.

Talking To Someone With Schizophrenia Is Challenging

When times are tough, we don’t feel calm in our minds. That’s why we just want to feel safe. On the outside, you may be frustrated because your loved one is now communicating differently from their usual self.

It’s okay to feel confused, angry or even scared. Most importantly, take a step back and calm down. In my home, we have the mantra to “Always Deescalate”.

How to Deescalate a Schizophrenic Episode?

From a caregiver‘s perspective, it is very hard especially if you are a parent. The instinct to help or control the situation will be so strong that you might take the wrong steps.

Always practice these 10 points when speaking to a schizophrenic.

Have an open mind

Keep an open mind while listening to their delusions. It might be scary if you are hearing them for the first time. It could even be frustrating because they keep repeating their delusion (e.g. the government is spying).

Never be fearful of them because that will be hurtful. Most important, that will scare them even more, resulting in a more negative mood. It‘s crucial to also not force your point of view.

With my delusion, the voices can get very loud as a certain idea is repeatedly excessive. When that happens, it’s hard to convince me because my “truth” feels real.

So just listen to their thoughts as they express themselves because schizophrenics cannot help it because the delusion can be overpowering.

Trust

Never gaslight or lie to them. Having trust is crucial. Sometimes, you might be desperate and will try to tell them things that aren’t real to make them feel better.

If you are being told a delusion (e.g. I’m being tapped), it‘s best to just accept and say that you understand. Then, ask if they need something to feel better and show your support.

Once caught lying or gaslighting, it will be difficult to trust again. Schizophrenics deal with a lot of suspiciousness. Lying makes things worse. If you deceive them on purpose, they might assume that you are asking everyone else to lie to them too. It can spiral down badly.

Be the space of trust and comfort. You should be the person they can always go to when times are hard.

Patience

You usually will not get the response you want when communicating. There may be just silence or even anger. Never take it personally. Instead, continue talking in a calm manner. Schizophrenics don’t want to feel judged for the delusions that they are experiencing. 

It’s already traumatizing to feel like they are ‘losing their mind’. So, a little patience will go a long way. Listen patiently and try to understand what they are expressing. Give them time to explain what they are feeling or thinking and don’t rush them.

You can ask questions like, “How are you feeling?” or “Are you ok?”. Offer to talk further but if it is declined, respect the decision and check in again at a later period.

Acceptance

With patience comes acceptance. Whether they are unexpressive, unwilling to talk or simply releasing anger, just be there. There isn’t a need to form an opinion because it will never be accepted. 

It’s always easier for them to believe the voices than your opinion although it’s true. By forcing your opinions strongly, they will feel even more confused or pressured. This will churn out negative emotions that lead to increased paranoia. 

So, statements such as “You are fine, it’s just stress.” or “It’s just you being fussy. You don’t have a mental illness” shouldn’t be said. It’s hurtful. Trust and listen if they say that they aren’t feeling good. Never label them as crazy.

Avoid telling them what they used to be or what they could have been if they try harder. Understand that this mental health issue does affect their motivation and ability to work on things.

Precise communication

In most cases, the thoughts of a schizophrenic may already be scattered. It’s not easy to pay attention while conversing. Much effort is needed to hold a conversation. Therefore, it’s beneficial to be specific with your sentences or messages. 

Don’t beat around the bush. Use short sentences to make them easily understood or else it will be too burdening and confusing for them to listen and comprehend. 

Retreat

Allow them to calm down in their safe space. A safe space is simply an area they can have full control. It‘s a place they are familiar with where they can welcome you, only if they are comfortable with it. This space will allow them to calm down and not get further triggered.

In my room, I have a ‘happy chair’. It‘s a lounge chair that is large enough to make me feel ‘wrapped up’. Moving into this space with a blanket makes me feel comfortable and peaceful.

As they say, time heals. Over time, they will feel calmer when the emotions are settled. You can then carefully reach out again to try and have an effective conversation again.

Calm

It’s a common reaction to feel hurt or slighted by the way a schizophrenic might reply to your questions. The conversation may be blunt. That’s when you might be frustrated and angry. Please don’t take it personally.

However, asserting dominance by demanding them to reconnect with reality should be avoided because it will never end up with a positive outcome.

Scolding, being rude or speaking in a condescending manner must be avoided at all costs. Always stay calm and do not let your emotions get the better of you. Otherwise, it will stress both parties up. Approach with patience or retreat, if needed.

Guilt-tripping by expressing disappointment or sadness will only make them more anxious. Understand that how they feel is not related to how you experience your emotions. 

Encouragement

Schizophrenia can make you feel very lonely. It feels like the whole world is against me when I’m fighting with my delusions. Support in the form of encouragement is helpful.

Let them know that you are always there for them to cheer them on even if they feel like the world is falling apart. Encourage them to work towards therapy, vitamin intake and regular medication. If they are on medication, advise and ensure they take their medication regularly regardless what they may feel. Introduce helpful habits like practising Cognitive Behavioural Therapy exercises.

Most importantly, reflect on the goodness of themselves. Speak about their growth to remind them how far they have progressed.

Inclusion

Although schizophrenics generally prefer to isolate themselves, they have the same desire as any others to feel wanted. Extend an invitation to them even though you know there will be rejection.

Provide the possibility for them to join any fun activity you’ll be planning. Just giving them a chance to join for a meal or maybe even go to the movies will make them feel less alone.

Oftentimes, I feel anxious whenever I need to go out. Whenever I get an invitation from my family or friends, I feel grateful and happy. I struggle with the insecurities that I am not good enough. So invitations as such will come as a reminder that I am remembered and loved.

Love

Nobody should be defined by their illness. The same goes for schizophrenics. We should not be loved any lesser. Shower them with love and provide them with the safe space they need.

Positive affirmations remind them that they are better than how they view themselves. 

Most importantly, understand that it’s okay to sit together in silence. Words aren’t always necessary. If they are comfortable, sit close by or hold their hands to signal that you are there. 

Caregiver note: Emotions often flare up during conversations because we often take Jane's actions personally. It took us lots of tears and patience to be only slightly better at conversing. 

We are still learning. If you are here feeling lost and frustrated, you aren’t alone. Try again. It’s never their fault and it’s never our fault.