Communication
How you talk to someone with schizophrenia depends, not surprisingly, on who you are talking to. Tailor your speech so that the patient will understand and will not be threatened by what you are saying. People whose intellectual functions are high may require little, if any, adjustment on your part. Communicating with someone who has intellectual impairments in some areas of his life will probably require some adjustments, with more understanding and patience from you. Don't speak down or use baby talk. Speak gently and slowly with a normal tone of voice. Keep sentences simple if the person seems confused or has trouble understanding. Problems with memory and concentration may be countered somewhat by repetition and using simple, short sentences.
You will have to learn what works best for the person you interact with. A neutral tone that conveys your emotional steadiness and reassurance is always recommended.
Question
How can you communicate with someone who is in his own world?
You can try to get him to focus on you, but you may be competing with voices he is hearing or with excess and distorted sensory input that is overloading his brain. It is possible you will not be able to communicate with him when this happens. You may have to wait until he is more receptive.
Is Now the Right Time to Talk?
Your attitude will have a big effect on the tone of the interaction. Don't take insults and verbal explosions personally. This will help neutralize them. It won't be helpful if you force someone to engage in conversation if he is agitated or excited. If you know you can calm someone, try it, but otherwise let the person settle down emotionally before initiating a conversation.
It is not a good idea to challenge someone's delusion. You cannot change it. Your logic, reason, and argument may even be taken as more evidence that the delusion is real. It requires professional treatment to free someone with schizophrenia from delusions.
Don't expect a person with schizophrenia to think much about your problems. He has more to deal with than any person should have to handle. Any lack of concern for others is almost certainly a result of the disease. This is something else you should not take personally. It is normal to be saddened by this and other changes in personality, but it is often the unfortunate reality of the situation. Eventually you must accept it if you are to help the person you care for. You will need to rely on your own support group or network for friendship and companionship.
Offering Hope
It is unlikely that someone can face schizophrenia and not experience significant periods of depression, insecurity, and a diminished sense of worth. You won't cure anyone or bring him out of the gloom with cheery chatter, but you can reassure him that you are there for him. Remind him of any progress he has made in the past and tell him he will make progress again in the future. If the person is close to you, let him know that you love him and he will not be alone.
Essential
Without sounding condescending, congratulate a person trying to recover from schizophrenia whenever he achieves a goal or accomplishes something positive. Don't speak to an adult as if he were a child, but do speak simply and directly if he has cognitive difficulties. Avoid big words or convoluted sentences.
Social withdrawal is a common symptom of schizophrenia. It is a good idea to talk to someone to get him more engaged. A low-key approach may be preferable to a gung-ho call to action. Try framing the invitation as a way to regain some of the activities the consumer enjoyed before the illness, rather than as a way to combat isolation.
