Communication tailored to the patient's capacity

In order to be inderstood, it is not only important what we communicate but how we do it. Communications with a schizophrenic patient may be impeded by disturbed cognitive functions (neurocognitive disorders).

They make a significant feature, indicating how functional are the persons with diagnosed schizophrenia and treated and include the following parameters:

  • working memory,
  • attention,
  • vigilance,
  • verbal learning and memory,
  • visual learning and memory,
  • problem understanding and solving,
  • information processing rate,
  • social cognition.

These deficits, at least with regards to many persons, are serious, what is demonstrated by results of studies, in which the observed disfunctions are at the level of 2-3 standard deviations from the norm below. Among others, difficulties may appear with continuation of talk or in following the recommendations, concerning therapy or work, while simple activities, such as reading a book or watching television, require much effort or are simply unfeasible.

Therefore, communication of relatives with the ill person should take into account the existence of the above-mentioned limitations. Communication, based on clear, short and unequivocal transfer of information, may significantly improve mutual communication between ill persons and their relatives.

The information that the expressions, which are too long, complex, multifaceted and not unequivocal, will not be effective to convey any message to the person with diagnosed schizophrenia, may be an important element of psychoeducation, improving communications in the family and, consequently, mutual understanding and relations. It may also help understand adquately the difficulties, which the ill persons come accross in conversation, social contacts or in attempts of mental activity.

The role of stress and the predictability of behaviours


Many schizophrenics demonstrate reduced resistance to stress. Minor events, stress of mild or moderate severity cause in such patients a disproportionately strong and long emotional response.

It is good to remember about such hypersensitivity when we contact a schizophrenic person. Such a person often interprets words and behaviour too intensely and you must take it into account. When dealing with a schizophrenic person, it is often important to maintain certain predictability of behaviour, rhythm of the day, activities.

It is not about creation of a rigid plan of what to do and how to do it every day in exactly the same way. However, it is important to ensure predictability and the the patient's capability to understand what is going on. This reduces the severity of stress and enables the patient to remain calm.

What should be avoided in the conversation with a schizophrenic?

First, it is good to avoid expressing very strong, negative emotions of irritation, discontent, anger and unequivocally negative assessments of the ill person. As mentioned above, schizophrenics often reveal reduced ability to cope with stressful situations. If they are often confronted with very strong emotions of anger and dissatisfaction, they take it very emotionally.

They may become introverted, or it can contribute to their nervousness, anxiety or sleep problems. Sometimes behaviour of an ill family member arouses anger and discontent. Everyone has the right to become upset. However, it is important how this nervousness is expressed. The manner of expressing feelings should be reasonable and considerate of consequences.


Reacting by the family members of the ill person by immediate, strong, violent outbursts of irritation and anger usually does not lead to anything good. Words, said in anger, rarely build something good, and often destroy and are remembered.

If there appear negative feelings towards the ill person, it is good to think about the following:

  • how to behave to express your feelings, but without hurting the ill person with words and emotions,
  • how to say what we mean without hurting the emotions of the ill person,
  • what goals do we want to achieve in the conversation, for example, make the ill person perform his or her duties, but without accusations like: "you are hopeless" and "you never do anything right".


In general, it is good NOT to react by a sudden squabble, immediate outburst of emotions. It is better to think about and figure out what we want to say, how we want to say it, what words we should use and what we want to achieve in conversation.

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