How should I talk to someone about psychosis symptoms?
It’s always best to begin by asking broad, open-ended questions. Avoid in any way “labelling”or judging what the individual may describe—for example, don’t use words like “hallucination” or “schizophrenia” unless they have first.
Likewise avoid any statement that calls into question their experience, e.g. “that can’t possibly be happening” or “that isn’t true/real”. By following the individual’s lead and expressing open-mindedness and interest, you’ll be in the best position to learn as much as you can about what’s going on from the individuals’ perspective.
If there are specific concerns you have, such as a friend not attending a class you’re enrolled in together, or a child who has completely stopped communicating with their closest friends, consider waiting until you’ve heard more about their experiences and perspective before gently asking questions about anything that concerns you. Keep your voice calm, and avoid appearing to judge their decisions or actions.
Based on what you hear, you might consider different options: if you’re a friend, it might be best to reach out to the individual’s parents or other family (ideally with their permission, especially if you don’t already have an established relationship).
If you’re a parent or family member you might want to hear the perspective of friends, co-workers or peers in order to gain a fuller understanding of what’s been happening. During the course of your conversations with the person possibly experiencing psychosis, try to assess whether they might need more immediate supports (e.g. because they’re talking about withdrawing from all their classes without warning) or whether it seems viable to take a more cautious ‘wait and watch’ approach—for instance, if someone expresses sudden, obsessive ideas about a religious or political theme, but otherwise seems okay. No matter what your own assessment is, it’s always a good idea, if possible, to check in with an experienced clinician.
When talking to the person about what they are experiencing, follow the communication tips below
- Use every day language—don’t ‘talk down’.
- Use the language that the individual uses—for example, if they describe their experiences as a “breakdown” use this term; if they call it “stress”, follow suit
- Do not use clinical labels unless the individual is or has—for example, don’t label their experience of voices “hallucinations” unless this is the language they’ve chosen to use
- Ask open-ended questions and express interest in what the individual is saying
- Convey empathy when communicating with the person
- Acknowledge what the person is saying and how they are feeling (e.g. “That sounds really upsetting” )
- Listen carefully to the person, reflect what you hear, and ask clarifying questions
- to show that you are listening.
- Recap what the person has said to check that you have understood correctly
- Adapt to the person’s needs or wants as they are communicating them – if they want a hug, give them a hug, if they want space, give them space
- In general, it’s a good idea to convey a sense of calm with your tone of voice and body language
- Minimise body language that shows distress, discomfort or nervous behavior (e.g. jiggling
- legs, fidgeting or nail biting).
- If the person is sitting down, do not stand over them or hover