I talk about the bipolar conversation in all of my books. It's a concept I created to help family members and friends communicate with people who are in a mood swing. (You can read more about this technique in the Health Cards and my Loving Someone with Bipolar Disorder book.) This truly is a technique that can improve your relationships immediately.
A Change is Needed
I think it's time we change the way we treat mental illnesses. It's time to stop talking to them and listening to them. It's time for US to tell these illnesses how to behave. It's time for friends and family to learn how to respond to the illnesses instead of reacting to them. Here is an example of the bipolar conversation and how this much needed change can take place in your family.
Scene one: A mother is talking to her daughter who is psychotic and depressed due to bipolar disorder. The daughter had to move into a half way house as she was no longer able to take care of herself and her two little girls. The mother is very scared and upset with her daughter. She is a bit angry too. She just can't understand why her daughter can't see that she is losing so much because of how she is acting. The daughter just told her that she wants to die.
Mom: I just don't understand how you can say you want to kill yourself. There are so many people who need you! What about your two kids at home? Don't they mean anything to you? Why are you crying? Why are you doing this to us? We love you and we want you to come home. Why would you want to kill yourself? What about your little girls?
Daughter: Are you telling me again that I am a bad mother? I love my children. I love them! I just do not want to live here. I want you to get me an apartment so that we can all live together.
Mom: (Starts to cry) I can't afford an apartment! You know that. I would like to, but I can't. We have to economize right now. We have to be careful.
Daughter: You always tell me we can't do this we can't do that. It is because you are drinking every night!
Mom: (shocked) What? What? Drinking? What are you talking about? I am at home with your kids!
Daughter: I know that you drink mom. Every night. I know what happens!
Mom: Why are you saying these things to me? Why? What have I done? I am taking care of your children! Why are you doing this?
Daughter: We need to know the truth. You are an alcoholic.
The mother looks at daughter and suddenly slaps her hard in the face. When she realizes what she has done she runs out of the room crying. |
Scenes like these happen every day in families where a member has a mental illness. It has happened in my family and has probably happened in yours. When a well person REACTS to an ill person there is only one outcome: anger, frustration, sadness and ultimately a ruined relationship.
I believe that we can and must train ourselves to respond to people with a mental illness. I believe we can respond in a way that HELPS the ill person instead of pushing them further into illness.
Here is an example of how this conversation would sound if the mother were trained in what is normal behavior for a person with schizophrenia and was taught to respond accordingly.
Scene two: A daughter who is in a half way house for people with schizophrenia tells her mom she wants to kill herself. The mom is scared and worried, but she knows that this is normal behavior for schizophrenia and is the reason her daughter had to leave her two young girls with her so that she could get the treatment she needs.
Mom: I know you want to kill yourself. You have had so much stress lately and you have an illness that causes you to say these things. It scares me when you say them, but I understand you. Tell me what your doctor says when you say you want to kill yourself. Are you getting help?
Daughter: He says I will get better when I take the medication. But I don't want to take it mom. I want to get out of here. I want an apartment! (She is crying)
Mom: (Crying) That really makes sense. (She hugs her daughter) It must be so hard for you to live here, but you are here because you have an illness and you have to get help. The girls are fine with me and we are waiting until you get out so that we can be together.
Daughter: But I need an apartment. I will just kill myself if I have to stay here!
Mom: I know that you are so frustrated. But we do not have the money for another apartment. I would get you an apartment if I could. What can we do as an alternative?
Daughter: We have no money because you drink mom. You drink all the money. Every night.
Mom: (Very shocked and upset by this lie from her daughter, but she remembers that this is normal when her daughter is psychotic, so she does not react to what her daughter says.) I know your mind is telling you that right now. But I know that you have lived with me and you have not seen me drink. I know that you are not really saying those things. It is the illness. Are you stressed right now? How can I help you?
Daughter: Help me get out of here! Help me get an apartment!
Mom: We have talked about that once and that is enough. Now I want to talk about something else. I am here to see you because I love you. What are you having for lunch today? |
This is the only way to respond to someone who is mentally ill and in the middle of an episode. If they were able to reason and have normal conversations, they would not need treatment. So why do we expect the mentally ill to be normal? Why do we talk with them as though we would talk to a normal person? We have to remember that the time to TALK is when they are well, it is not the time to have a life conversation when they are ill. Those conversations just have to wait until they get better.
I have used schizophrenia in this example, but this technique works with all mental illnesses. When someone is depressed and says they have no friends, it does not help at all to respond with, "But you do have a lot of friends! They call you all of the time! Why are you saying these things?" The better response would be, "I can see that you are depressed. And depression really does make you feel you have no friends. I am your friend. How can I help you with your depression?" That works. That gets results. That is how we need to respond.
I created the Health Cards because I realized one day that mental illness is separate from who we are as people. It is its own entity and needs to be treated like the cancer it is. It is not talked to, cajoled, or reasoned with. It only responds to action. I discovered that those of us with bipolar disorder can change the way WE respond to the illness in the same way the mother changed in the above examples. The illness may not always respond in the way we want it to- but WE can decide how we respond. And that will help us stay healthy. Friends and family members of people with bipolar disorder can also learn to respond in a way that helps the person get better. This saves lives and saves relationships. Bipolar disorder has taken enough from us. Let's not let it take ANY MORE!
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