Relatives and friends of a schizophrenic patient, and people close to the patient usually find themselves at a loss as to what to do. The difference between the real world and the world of these patients, who are unable to distinguish between imagination and reality, also has a negative impact on the patient’s relationship with other persons. People close to the patient may suffer psychologically during this process, and may even stop associating with the patient. They may not know how to help the patient, and may not be able to prevent problems relating to a job and lodging which are needed by the patient.
One of the most common problems encountered is persuading the patient is to seek professional help. A schizophrenic patient usually does not recognize that he has a problem and believes in the reality of what he experiences. In such a case the patient’s relatives play an active role in ensuring that the patient seeks help from an expert. Persuading the patient to seek help can be a challenging process. If the patient is reluctant, it can be helpful if a person close to the patient talks to him, approaching him with empathy and without pressurizing:
“I saw that for some time you are having some difficulties. I feel concerned about this and am unable to help you. I believe it would be helpful to consult and expert. ”
“When I think about it, we are having arguments for some time now. You have difficulties understanding me and I have difficulties understanding you. These arguments wear us down. I believe that consulting an expert and getting his opinion would benefit both of us. What do you say to this?”
“I know that there are certain thoughts which you are unable to clear out of your head. These are affecting your whole life and are making you unhappy, angry and anxious. I find myself unable to help you, but I can assist you in going to see someone (an expert) who can help.”
These examples can be shaped according to the content of the conversation. What is important is that you summarize the situation objectively, without blaming anyone, that you refer to his emotions and state sincerely how you feel, and that you let the patient know there is someone that can be consulted about this situation in which you find yourselves helpless.
At the first consultation with the expert it is helpful if there is someone with the patient who can give correct information. This will ensure that the expert gets more reliable information and a more appropriate treatment can be selected. Recommendations to the patient’s relatives, who play an important role in this process, can help them to better coupe with problems that can arise during treatment and in daily life:
First of all, it is very important that you make the patient feel that you are on his side and will support him under any condition. Your emotional support will contribute to the commencement and continuation of the patient’s treatment. You have to distinguish between your love for the patient and the patient’s disease. Do not forget that some behavior which you do not like and which you have difficulty understanding is caused by the disease.
Another important point is to know what one should do when the patient tells you he experiences hallucinations or hears voices. At such times one should not discuss with the patient whether or not the experiences are real, nor should one try to persuade the patient. Because the patient experiences the hallucination as real, it can be harmful to try and persuade him that they are not real. However, going along with what the patient says is also a wrong choice. Instead it will be appropriate and sufficient to tell the patient that you do not hear or see the things he hears or sees, that you do not perceive situations the way he does.
Schizophrenic patients who apart from hallucinations also have deterioration in the content of their thoughts may have unreasonable ideas. For example, they may think that people could harm them at any moment. When the patient has such unreasonable thoughts you should approach him with empathy telling him how saddening it is that he feels that way.
Regular use of the drugs prescribed by the doctor for the schizophrenic patient is very important in the treatment process. However, the patient may even be unable to carry out his daily routine. Therefore it would be of benefit if the patient’s relatives monitor his drug regime. On the other hand, it would also be unfavorable to do everything for the patient. It is important that he continues to do the things he is able to do and that this behavior is reinforced. Monitoring the course of the symptoms will help to observe the effect of the drugs and therefore the effect of the treatment.
It is helpful to reduce the stress level in daily life and ensure that the patient deals with activities with a low stress level. Furthermore, to encourage the patient to set small and achievable goals will increase his self-confidence.
During a crisis you must not raise your voice, threaten or display physical aggression. If the patient’s relatives keep calm, display a reassuring attitude and reduce the sensory stimulus in the surrounding, it will soften the crisis. In more aggressive situation do not forget that your own safety is also important.