How to communicate with loved ones who suffer from mental disorders?

According to WHO, almost 1 billion people in the world suffer from mental disorders. Now, in the context of the COVID-19 pandemic, it is especially difficult for them. “We are already seeing the negative impact of the pandemic on the mental health of the population, and this situation is expected to only get worse,” said WHO Director-General Tedros Adhanom*. On October 10, International Mental Health Day, we want to remind you that taking care of your mental health is important for each of us.

Some have experienced isolation with loved ones suffering from mental illness, and it was not easy for them. Often we are embarrassed to speak openly about the fact that our friends or relatives suffer from mental disorders, and for good reason. And so it turns out that not only those who are faced with diseases of the soul suffer from stigmatization, but also their environment. Social stereotypes associated with mental disorders and saying that it is a shame to have them have a negative impact on the quality of life of those who are in such a condition and those who try to help them.

Relatively few people in the world can use the services of psychotherapists and psychiatrists. According to WHO, more than 75% of people with mental and neurological disorders in low- and middle-income countries do not receive the necessary treatment at all. And in this unbearable situation, relatives and friends become the last hope for those whose mental health is unstable. What happens to us when we communicate with a person whose mental state requires special attention? We find out together with experts.

Invisible Influence

Contact with another affects us, even if we do not notice it. Communicating with a loved one whose mental state is unstable, we cannot but “respond” to his state. This phenomenon is called symmetrical induction.

“Trying to convince the paranoid, the interlocutor gradually begins to produce overvalued ideas. Trying to convince the hysteric, a careless interlocutor often does not notice how he “starts up”. Making attempts to discuss with a depressed person, the interlocutor may not immediately notice that he has become imbued with a feeling of hopelessness and helplessness. So arguing with the mentally ill is not only useless, but also dangerous, ”writes Gestalt therapist Denis Andryushchenko.

And if disputes with people suffering from severe forms of mental illness are not so frequent, then we constantly meet with “border guards”, whose condition is balanced on the verge of normal. These are our colleagues, perhaps partners, parents or ourselves.

Have you noticed how polarity intensifies in political debates as emotions rise? As if in order to convince a radical opponent, even a person of moderate views has to exaggerate, strengthen his position – and in the end he himself (sometimes with surprise) finds himself already in a radically opposite position. This is well known to parents who have had occasion to argue with teenagers.

A dispute in which the goal of the interlocutors is not to express their opinion and learn someone else’s, but to “overcome”, argue, convince, is a dubious occupation. And yet there are situations when it is necessary or when ordinary conversation gradually becomes an argument. So what should be considered when communicating with loved ones suffering from certain disorders?

“People with mental disorders cannot be persuaded”

Gurgen Khachaturian, psychotherapist

Both for communication with mentally unhealthy people, and for communication with those who suffer from borderline personality disorders, common patterns are characteristic.

Paralogics

Communicating with conditionally normal people, we proceed from the fact that in a conversation they adhere to formal logic. That is, the logic of the construction of thought. One follows from the other, and even if the point of view of the interlocutor is not close to us, the way in which he came to it does not go out of the context of formal logic. And even if we disagree, the logic itself is not violated. We can either accept his constructions and change our point of view, or not accept and leave our position unchanged.

For people with mental or borderline personality disorders, paralogic becomes a characteristic phenomenon. A vivid example is communication with jealous people. Jealousy is ordinary – one that contains a manifestation of the fears of an immature personality. But it also happens that it takes the form of an overvalued idea or nonsense.

I’ll give you an example. The husband comes home and finds his wife in the kitchen with a man. If a person with an immature but healthy psyche is inclined to be jealous, he can see: there is a wife and a certain man with whom she is alone. The conclusion that a conversation in the kitchen is possible both with innocent friendships and with adultery does not go beyond normal logic.

It happens that a husband, when he comes home, sees a candy box in the trash can and with its help receives confirmation of an overvalued idea: if there is a box, then some man came to his wife and they had a date. On the whole, such a line of reasoning does not seem to go beyond the general logic. It is important that of all the possible options (a friend brought the candy or the wife herself bought it, or this box has been lying in the closet for a long time, and the wife just finished the last candy), only the one that “confirms” the idea of ​​uXNUMXbuXNUMXbtreason is considered. This is already an indicator of an overvalued attitude to some phenomena.

When we talk about people with mental disorders, the form of constructing a thought will not obey any laws of logic. Case study: A husband comes home and sees that his wife’s shoes, which would normally be toes away from the door, are now turned heels towards her. Based on this, he concludes that his wife cheated on him. Within the framework of ordinary logical construction, this conclusion seems absolutely absurd.

The above examples demonstrate that the main problem in dealing with people whose mental state is unstable is the inability to accept the logic of their thought. Since this logic can be regularly imposed on us in everyday communication, at some point we run the risk of ceasing to look at reality with our own eyes, and not from the point of view of a close person with mental disorders. This is a big risk to our own worldview.

Keeping our point of view

People with mental disorders cannot be persuaded. Violation of the psyche goes through certain stages: people come to their overvalued ideas for a long time and quite painfully. And therefore, inside their own heads, their point of view is gained through suffering, justified and as rigid as possible, unshakable. They will not listen to any arguments, even logical and reasonable ones. This is their way of thinking.

Each of us must have met people who have their own point of view on the processes taking place in the world. Often it is grandiose, contains a claim to an undeniable understanding of certain issues. And not necessarily a person with a serious disorder. Our life experience tells us that arguing with such people is useless. This is where the very symmetrical induction can arise.

For example, your interlocutor may believe that the coronavirus is the development of mysterious enemy intelligence agencies. You can have any position on this. The main thing is to maintain your own connection with reality and preserve the boundaries of your own worldview.

An easy way to communicate with people who actively force their point of view on you is to agree with them and at least formally show curiosity about what and how they say. You can ask leading questions, clarify something, but at the same time not leave the boundaries of your own perception of the world or your own logic of events. This will save you. If it seems to you that you are losing touch with reality, that your logic is “floating away”, and the conversation is becoming too aggressive, you need to end it under any pretext.

Why is it important? There is a concept of “personal autonomy”. And there is something that determines the core of the personality – in particular, it is about values, the basic perception of the world. By stopping the attempts of others to change your values ​​or influence your worldview, you maintain your resilience. Namely, resilience is necessary for us in order to find a way to communicate with loved ones even in the most difficult moments of our common history.

^* https://www.who.int/ru/news-room/detail/27-08-2020-world-mental-health-day-an-opportunity-to-kick-start-a-massive-scale-up-in-investment-in-mental-health