Tips on communicating with a mentally ill person

By Brigitte Boulard (summer student)

By: Brigitte Boulard, summer student

Communicating your needs and limits can be a challenge for anybody. Communicating with a person you know that suffers from a mental illness can definitely be challenging. Fortunately, there are many tools you can use that will help you and your loved one understand each other.

The most important tool in communicating with anybody – mentally ill or not – is respect; treat the other person like you would like to be treated. Also, when someone feels respected and heard, they are more likely to be respectful and consider what the other person has to say, quid pro quo. Here are a few tips on communication that will help get your point across and understand what the other person is saying;

DO
• Relax and stay calm.
• Start a conversation with the expectation that things will go smoothly.
• Minimize distractions; ask if you can turn off the TV for example.
• Listen and make eye-contact (unless this is threatening).
• Simplify. One topic at a time.
• Use “I-statements” not “you-statements”.
• Acknowledge what the other person says and how they feel, even if you don’t agree.
• Paraphrase; “If I understand you correctly, you and I…” “Is that what you’re saying?”
• Engage the person in the process by asking for opinions and suggestions.
• Watch out for contradictory messages between verbal and non-verbal messages.
• Look for common ground. Focus on observable facts; things you both saw or heard “You say you have trouble concentrating at school if you don’t take your medication?”
• Honestly sharing your own feelings can reduce defensiveness on both sides.
• Stick to present issues.
• Use humor in easy situations.
• A touch on the shoulder can be comforting to some, but anxiety-provoking to others. Just ask; for example, “Can I hug you?” or “Can I hold your hand?”.
• Acknowledge your own responsibility; don’t wait for the other person to do it first.

DON’T
• Don’t start a conversation expecting a confrontation. Approaching a person with your defenses up will likely make the communication difficult.
• Don’t take it personally; remember that your loved one’s illness can affect their behavior and communication skills.
• Don’t criticize, accuse or blame.
• Don’t assume. Clarify by asking questions.
• Don’t expect the other person to “just understand it” if you cannot explain it.
• Avoid bringing up the diagnosis.
• Don’t raise your voice or attempt to intimidate or “discipline” the person.
• Don’t use general and loaded words such as “always” or “never”. Use specific words instead.
• Don’t use sarcasm and avoid humor in difficult situations
• Avoid sounding patronizing or condescending. If someone treated YOU like a child, would you take them seriously?

It is possible that your loved one might react to your new way of communicating. If this happens, honesty is the key; for example, you can tell them how important it is to you to understand them, and you would like them to understand you better if that is your case. Of course, each person is different and unique, so some tips can be used with different people and some might work better than others. Thus, it is very important not to give up. Try a technique a few times and if it doesn’t work try it in a different way or in combination with another one. Satisfying communication can take time and lots of practice, but will be rewarding and improve everybody’s quality of life.

Here are a few books available on loan at Friends For Mental Health, where you can find more information.

Stop Walking on Eggshells: Taking your life back when someone you care about has borderline personality disorder, Paul T. Manson & Randi Kreger, New Harbinger Publications, 1988.

I Am Not Sick I Don’t Need Help, Dr. Xavier Amador, Vida Press, 2nd ed, 2007.

When Someone You Love Has a Mental Illness; A handbook for families, friends and caregivers, Rebecca Woolis, M.F.C.C., G.P. Putnam’s Sons, New York, 1992.