How often do you stop to consider the relationship between your communication style and the responses you get from others?
This week I attended a meeting as part of the mental health team supporting a young man called Eric*. Eric is a very intelligent and creative individual who has a diagnosis of paranoid schizophrenia; believing that others are conspiring to accuse him of crimes he has not committed. Unlike the majority of people with schizophrenia, who tend to experience restricted verbal abilities as part of their mental illness, Eric’s verbal expression is copious. His sentences are long and grammatically sophisticated, the concepts he discusses complex, and his vocabulary extensive. But why is this relevant to our story?
The purpose of the meeting was to assess the current severity of Eric’s delusional beliefs, and to make management decisions based on his presentation. Whilst listening to the conversation between Eric and his Psychiatrist it became evident that Eric’s expression of delusional beliefs was directly linked to the language his Psychiatrist was using; the more abstract and complex the language used, the more likely Eric was to respond with reference to his delusional beliefs.
Skilled mental health professionals will recognise the need to modify their communication when it is obvious that the person they are talking to experiences communication difficulties, but what about when these difficulties are less obvious? When someone can speak to you in an eloquent manner we will tend to match this level of linguistic complexity, but what if the person’s comprehension does not match their expressive ability?
If, as I suspect, this is the case for Eric, then he will have found himself in a situation where he was confronted with a person in a position of power, who was discussing things that he could not fully understand. If so, how will this have added fuel to the flames of his paranoid beliefs, and how will it have impacted on the way Eric presented in a situation where his mental state was being assessed?
I am not suggesting that we “dumb down” the way we communicate with the people we see in mental health services, however, there is a lot to be said for speaking plainly, clearly and in a manner that cannot be misinterpreted. As Eric’s Psychiatrist said in response to my analysis of their interaction, “When someone can talk to me about ‘chaos theory’ I don’t think about the way I am expressing myself – but maybe I should”.
*Eric is a pseudonym to protect client confidentiality