How to Talk to Someone Who Has a Mental Illness

When you love someone who has a mental illness, you talk to them. Or, in many cases, you talk at them. Using elements of therapeutic communications, such as reflective listening and I statements, can make the conversations more successful.

Using I Statements

Many of us have heard about using “I statements.” This approach is less threatening to a person with mental illness, who can easily interpret comments as attacks. Rather than saying “You make me mad” or “You did a stupid thing,” you would first identify your own feelings as you express your viewpoint.

I statements usually follow this format: “I feel … when you do …”

  • I feel sad when you ignore me.
  • I feel glad when you take your medicine consistently.
  • I feel angry because you broke our agreement.

It’s doesn’t hurt to practice these statements with others in the family. You may find that your overall communication improves.

Applying Reflective Listening

Reflective listening is a pattern of communications that social workers and counselors often use. It can help you understand what your loved one is saying. It also allows you to comment on their statements without agreeing with them.

The reflective listening formula has four steps:

  1. Start with a tentative opening. (It sounds like … or What I hear you saying is …) This gives your loved one an opportunity to tell you if there’s a misunderstanding.
  2. Identify the feeling involved. The main categories are mad, sad, glad and afraid.
  3. Use a connection word such as about, because or when.
  4. Identify the thought you see.

So the sentence is:

Tentative opening + feeling + (about/because/when) + thought. Such as:

It sounds like you are feeling sad about what she said to you.

I hear you saying that you are feeling mad because of what he did.

If I am hearing you correctly, you are feeling afraid because your friend has cancer.

You seem to be saying that you are feeling happy because your sister is coming over.

I’m not sure I’m following you. Are you feeling ashamed about wanting to move back with your parents?

Using Body Language

Nonverbal communications is powerful. Most of the impression that someone gets from talking to you comes from your body language. When you are talking to your loved one, you want your body language to convey your caring and concern. Some ways to do that are:

  • Hold the person’s hand.
  • Make direct eye contact.
  • Place your hand on their shoulder.
  • Pat the person’s back.
  • Sit close to the person.
  • Lean forward when the person is speaking.

Ask Good Questions

Some things that you can say to keep the conversation going are:

  • Tell me about what happened to you.
  • Go on. Tell me more.
  • What do you see as the problem?
  • What do you mean when you say that?
  • Give me an example of what you mean when you say …
  • How did it feel when that happened?

I’m not sure what the sources are for this overview, as I’ve used it for years. But this is

Have trouble with reality.Be simple & truthful.
Are fearful.Stay calm.
Are insecure.Be accepting.
Have trouble concentrating.Be brief. Repeat as needed.
Are overstimulated.Don’t force discussion.
Easily become agitated.Recognize agitation. Allow escape.
Have poor judgment.Don’t expect a rational discussion.
Have changing emotions.Disregard the changing emotions.
Have changing plans.Keep to one plan.
Have little empathy for you.Recognize that as a symptom.
Believe delusions.Ignore it and don’t argue about it.
Have low self-esteem.Stay positive.
Are preoccupied.Get their attention first.
Are withdrawn.Initiate relevant discussion.

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