CRISIS: s c h i z o p h r e n i a

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Our son hallucinated and suffered delusions during psychotic incidents: It took me a while to fully understand the difference between  hallucinations and delusions.

 Hallucinations are sensations that appear real, but are actually created by one’s own mind.

Delusions are false beliefs that are persistent and organized and that don’t disappear after receiving logical information. For example – my son believed that I was poisoning his food and even after we proved by eating it, that the food had not been tampered with, his delusion remained.

He also believed that the military were working against him and planting microphones in our house to broadcast his every word and thought. No amount of explaining managed to banish his delusions.

We learned to speak slowly to him and use short, simple sentences.

We learned to give him space to avoid making him feel trapped.

We learned to avoid sudden movements.

We learned to give clear instructions and directions.

And this was how we managed to live together in the same house for so long. Eventually, two psychiatrists assured us that he would do better on his own. We tried, but it didn’t work.

When he spoke about his hallucinations and delusions, we learned to talk about his feelings rather than the content of what he was saying.

We tried our best to really listen.

During this same period of time, we also learned WHAT NOT TO DO.

We learned not to take control if we didn’t really have to do so.

We learned not to argue with him when he was psychotic.

We learned to look elsewhere and not to stare at him.

We learned to interact with him rather than confuse him.

We learned not to touch him without prior warning. After all, parents like to embrace their children, don’t they? Even when they are no longer teenagers.

We learned not to give him multiple choices.

We learned never to whisper, to joke or to laugh in his presence as he took it all personally. But, if he questioned us, we learned to be  honest at all times.                                       

 

 

 

 

 

How should I speak to him?

This might sound unusual but I have found that most people dare not speak in a natural way to a person with a mental illness. They wonder for example, why he did not communicate with them when they once tried to make contact. But, speaking naturally is difficult for a person with a disorder like schizophrenia and there are people who feel embarrassed or actually fearful of holding a conversation or making contact with them – and they feel it.

I discovered how to do so, the hard way. It helped to speak slowly and clearly to our son and to keep my sentences short because the voices he was hearing in his head, drowned out parts of what I was tellihg him. There were times when he told me that he had trouble concentrating and often only absorbed half of what we were saying. If more than one person spoke to him or stood too close to him, he felt threatened. He preferred us to sit down when interacting with him. He needed a quiet place to chill out when necessary and that occurred often.

We tried to help him build some structure into his life as he did not like the unpredictable but we never succeeded. He spent his days sleeping till noon, walking for miles and miles and miles and wearing out a pair of sport shoes a month. He was unable to follow a schedule so we opted for trying to help him get into a routine, but, that did not work out either.

I learned never to approach my son while angry or upset and  tried to use phrases like:

‘It will make me sad if you …’

‘It will anger me if you …’

‘I would like you to …’

‘I would appreciate it if you ….’

I

Alzheimer’s – turn negatives into positives

My husband’s decline could be traced gradually.  When I looked out of the living room window and saw how long the grass had grown, deterioration was spelled everywhere. He had stopped mowing. He helped me clean up and rake the leaves a bit but tired fast. He also spent much less time sorting and working on his beloved stamp collection that he’d started when he was much younger.

My biggest frustration with his Alzheimer’s was my burning desire to coax him back to the way he’d been. He often started something and but soon after, switched to another task mid-way. He did not always finish sentences and our family learned to let that go instead of trying to finish the sentence for  him.  We tried not to correct his mistakes and ask for clarification. We spoke in clear, warm, caring voices. I think that the tone of my voice had more impact than the message I was trying to communicate. I discovered that lowering the pitch of my voice was more comforting and less threatening. I always spoke slowly and avoided long, complex sentences.

Basically, my husband’s nature did not change and he remained the same kind person he’d always been. I would like to pass on to anyone living with Alzheimer’s some of the things I learned along the way.

There was no point in arguing with him as it got me nowhere. It was preferable to validate his feelings by saying; “I see that you are angry and upset,” which made him feel that he was not alone. Then I changed the subject.

I endeavored to turn negatives into positives and instead of saying; “Don’t go there,” I tried to remember to say; “Let’s go here.” It was important to make eye contact and talk face to face. I used his name whenever I could and approached from the front after discovering that suddenly appearing from the side or the back startled him.

While having a conversation, I tried to keep my head at the same level as his so as not to intimidate him.

Firing questions at someone in his condition is hopeless. Ask one question at a time and refrain from asking; “Do you remember when we were at the mall?” or “Remember when Shelly visited?” Or “Remember when the children were toddlers?” Because most of the time, he did not remember.

I learned to deliver one instruction at a time and told him beforehand what I was planning. For example; ‘It’s time for a shower now. How about getting undressed and call me if you need help?’ which was far better than starting to help him when he had no idea why I was doing so.

It is imperative never to talk about the ill person in his/her presence. A person with Alzheimer’s Disease can sometimes understand what is being said and talking this way about him/her is humiliating.

Physical closeness like holding hands and caressing made him feel good and it was pleasurable for me too.

I felt that it was always important to treat him with dignity and respect and not to talk to him as though he were an infant.

The do’s and don’ts where mental health is concerned

WHAT TO DO IN A CRISIS CONCERNING A MENTALLY ILL PERSON. When our son was ill, we discovered that it was a good idea to: 

• Slow down when we spoke to David due to his schizophrenia. 
• Give him space and avoid making him feel trapped.
• Remain as calm as we could and give him all the support and concern we were able to give.
• We knew that it was a good idea to speak slowly and quietly.
• We used short, clear and simple sentences.
• We avoided sudden, quick movements as if he were startled, he became angry.
• We were as helpful as we possibly could be.
• When replying to one of his questions, we gave firm, clear directions. Of course, learning to do all this took time.
• We were told to respond to hallucinations or delusions by talking about his feelings rather than what he was saying.
• We showed him that we were really listening.

 WHAT NOT TO DO IN A CRISIS CONCERNING A MENTALLY ILL PERSON:

• We learned not to take control if we didn’t have to.
• We knew better than to argue when our son was psychotic.
• We never looked him straight in the eye as he considered that staring, and he became aggressive.
• We tried not to confuse him; rather, we tried to interact.
• I hugged him very seldom as he did not like being touched. It was better to ask first. 
• It was always a bad idea to raise our voices.
• We never gave him multiple choices.
• We didn’t whisper, joke or laugh as that would have made him  think that we were laughing at him or joking about him.
• We never told him an untruth. We were honest at all times even if we had unpleasant news to impart.

 

How should we speak to a person who is hallucinating ?

• If you suspect that someone is hearing voices, it’s okay to ask if he/she is hearing voices.
• If the individual says yes, then it’s okay to ask: “What they are saying?”
• Remember that he/she might be hearing voices at the same time. that  you are talking so the individual needs time to work out what you are saying due to the interference of the voices, as they can be rather noisy.
• Limit the number of questions you ask and speak slowly and clearly.
• Reduce the number of outside stimuli like music, for example.
• Allow the person to vent some of his/her frustrations.
• It’s a good idea NOT to tell the individual that the voices cannot possibly be real because a person who hallucinates is most definately having this experience, which is  indeed very real to that person.
• Patience is the operative word here.