Talking Through Schizophrenia

Schizophrenia is complex. A person living with the disease is easily overwhelmed by their surrounding environment. Their speech and behavior may be disorganized and delusional. Concentration is limited and appropriate emotional responses minimal. Communications with caregivers and medical providers are part of this chaotic dynamic. The best thing a caregiver can do before embarking on any important conversation is to make sure they are prepared. They must know when to communicate, what to communicate and how. A skillful communicator will be able to resolve issues and make daily living for their loved one with schizophrenia a much more pleasant experience.


A caregiver cannot force a loved one with schizophrenia into a conversation, especially if they are agitated or excited. Trying to calm them is a way many people may attempt to proceed, but only if the caregiver knows they can. Otherwise, let them settle on their own.Schizophrenia causes hallucinations, which become a barrier to rational conversation. If these are present, it’s best a caregiver wait to have a serious talk. The loved one is not in the right frame of mind, or mentally able to move forward.

The caregiver’s attitude at the time is just as important and has a big effect on the conversation’s outcome. The first thing to remember is to not take insults and verbal outbursts personally. A caregiver cannot change delusions, nor should they challenge them. A caregiver's logical thoughts will only further confirm that a loved one's schizophrenic delusions are real.

It's also not a good idea to speak with a loved one during a time of personal distress. A caregiver should not expect a person with schizophrenia to deeply care about their problems. This is almost certainly a result of the disease, which may cause frustration and sadness for a caregiver. The reality of schizophrenia is often brought to life at the expense of the caregiver’s emotions. This is why it’s important a caregiver really make an educated decision whether the time is right to have a conversation with a schizophrenic loved one. Preparation is vital to success for both parties, and eliminating undue conflict.


From family to physicians, a caregiver for someone with schizophrenia spends much time in medical appointments. The talk is usually of treatments, diagnosis, future concerns, etc. At some point, a caregiver must re-enter the world of their loved one and explain the details in laymen's terms. Discussing several issues at once will be overwhelming for a loved one, so professionals suggest a caregiver choose one area that is really important. It’s helpful to focus on a specific behavioral problem that needs addressing before transitioning to the next.

If the situation is negative, a caregiver should say exactly the concern, and how he or she would like it fixed. Those living with schizophrenia have a difficult time processing feelings of others, so this direct-talking skill is one a caregiver should master. It’s especially important when the situation could be dangerous, such as a medication need, or also is personal, such as making the caregiver feel scared during an upsetting episode.

Social withdrawal is also a top symptom of the illness, and keeping the conversation light and positive encourages friendship and connection. Everyone wants to feel like they belong, and it’s a caregiver’s responsibility to help their loved one feel that, regardless of the situation. This can be done by discussing, or doing things the person enjoys. What are their hobbies? Think of activities they find fun or help distract from the day-to-day life with schizophrenia. While medical talk is necessary, the friendship between caregiver and loved one is too.


The old adage stands true for a person living with schizophrenia: keep it simple.

Whether verbal or nonverbal, communication with too many elements or expectations of response will send a red flag to a loved one living with schizophrenia. They also tend to have a theory that they are above rational and normal logic. This can be challenging for a caregiver to cope with. Professionals recommend caregivers just not indulge the notions, but don’t disallow them either. Meet the person where they are, and accept this. It may not be a real concern to a caregiver, but to a loved one with schizophrenia, their manifestations are completely real. When trying to reason or make sense, it’s recommended caregivers use “I feel” statements rather than “I think” ones.

With non-verbal communication, here are some guidelines. First, stand close to a loved one, but do not crowd their personal space. Maintain eye contact and show interest in their ideas. This is accomplished through posture and engaging facial expressions. Last, speak calmly and clearly. Any extra confusion may be too much for a loved one to handle.

It’s easy for a person with schizophrenia to feel very isolated, especially with a challenge of normal communication. As a caregiver, a way to be a loved one’s advocate is to not think of them as someone with schizophrenia, but a person with an illness. They are not the illness. Communication is important in any relationship, but with a schizophrenic loved one, some learned and applied skills will help the relationship even more.

by Jennifer Bradley

Categories: Family Caregiving