Being able to communicate how you feel can help others to understand you better – and we all want to be understood. However, mental distress can affect communication, so there are times when it can be much harder to find the words – even for articulate people.
"Effective communication is essential in building rapport and developing therapeutic relationships."
Even when not distressed, and fully able to explain feelings and emotions, recall how it feels when you tell someone something that’s really important to you, but they just don’t ‘get’ it. Or they’re not listening or giving their full attention. Or quite simply, you’ve been listened to, but not heard. Experiences like that can make you feel diminished, unimportant, misunderstood, alienated, without value, and alone. It can hurt, whether it’s coming from a friend, a family member or a healthcare professional.
Active listening
The latter – doctors, nurses, social workers and others working in health and care – ought to know better, because they’re trained to listen and empathise. That’s part of their job: actively and mindfully listening, and showing that they’re listening.
Listening is a key component of communication, and a substantial body of research has demonstrated how good communication can help produce positive patient/client/service-user outcomes. Writing in ‘Nursing and Mental Health Care: An Introduction for All Fields of Practice’, Reuben Pearce said: “Being able to communicate and relate to people and their unique experience of mental distress is vital for meaningful and effective nursing intervention." Effective communication is essential in building rapport and developing therapeutic relationships. Where communication between patients and staff has been good, and where communication between professionals on the multi-disciplinary team is effective, the service-user experience is significantly improved.
Relationships
Good communication can even help speed both physical and mental recovery. Writing in ‘Engagement and Therapeutic Communication in Mental Health Nursing’, Sandra Walker says: “Research has consistently shown that it is the human relationships we develop that have the biggest impact on recovery in mental healthcare; successful engagement and therapeutic communication are essential in order to help people find their way out of the maze of problems that may have beset them.”
Conversely, poor communication by professionals can hinder recovery by adding to mental distress and feelings of isolation. It is incumbent upon healthcare professionals to know how to communicate with a wide range of people and their conditions, including those who are experiencing mental health difficulties. Of course, everyone is different and should not be defined only by their condition. Health and care staff need to recognise this too: a ‘one size fits all’ approach will fail.
When someone is anxious or distressed, the things that help humans warm to others – a smile, a friendly greeting or appropriate eye contact – may be missing. This can sometimes affect how professionals react. I have seen healthcare staff regard a patient’s distressed behaviour as a sign of hostility, and they have responded in a hostile fashion in return. This is unprofessional in its own right, but it also gets the therapeutic relationship off to a bad start that may never be repaired. Even well-meaning professionals can get it wrong, perhaps by talking too much and not listening enough. Never underestimate the positive therapeutic effect of being listened to.
Generosity
Simple things can make a big difference: a genuine smile, an empathetic look, a cup of tea… small, human gestures than can mean so much in times of crisis. Be non-judgmental. Try to understand. Create time and space. Listen actively and show that you’re listening, using nods and encouraging gestures. Use open body language. These things come naturally to some, but need to be learned by others. Reflect on your own attitudes and behaviours and commit to making a difference by using the therapeutic value of communication when working with all clients, whether affected by mental health issues or not. Good communication works, full stop!
Moi Ali has acted as communications advisor to a number of NHS hospitals and healthcare clinics, to two children’s hospices, a voluntary sector hospital, the Royal College of Nursing in Scotland, and to healthcare charities. She is a former Vice President of the Nursing and Midwifery Council and former chair of a healthcare charity/social enterprise. Moi Ali’s book, How to Communicate Effectively in Health and Social Care: A practical guide for the caring professions, costs £28 from Pavilion Publishing:
//www.pavpub.com/how-to-communicate-effectively/
Mental health
Many of us forget that we all possess one of the most effective tools to aid someone experiencing a mental health crisis: Listening.
Here are 4 ways you can make a difference through your power of listening.
-
Informational Listening (Listening to Learn)
Listening to learn something new or unfamiliar.Whenever you listen to learn something, you are engaged in informational listening. The focus of informational listening is taking in new facts and being receptive to new information.
-
Active Listening (Listening to Respond)
Listening and responding to another person to improve mutual understanding.One of the most common forms of listening we come across, active listening usually includes engaging and responding while listening. As an active listener, we often listen to respond.
-
Non-judgmental Listening (Listening to Understand or Empathize)
Listening with the intention to understand another.For situations where someone is experiencing symptoms of a mental health crisis, there is another kind of listening that can be more effective: empathetic listening. For a person experiencing a mental health problem, having an empathetic listener can be calming and reassuring – even healing.Empathy, unlike sympathy, does not mean we agree with the other person or see things from the same point of view. Instead, it requires taking a moment to step outside of our normal patterns of thinking and feeling to imagine what it feels like to be the person in front of us.
- Hear with your heart, learn what to look for.Mental health challenges, like all physical health conditions, have their own specific set of symptoms that show up during challenging seasons. An important part of being supportive through listening is understanding how the symptoms impact people we love and trying not to judge them because of it.
Source: Mental Health First Aid & American Psychological Association (APA)
There is nothing more frustrating than people not listening to you. I mean actively listening, when their body language matches their facial expressions. Where they don’t interrupt you and make eye contact with you while you speak. I don’t tell my story or speak about my depression to that many people, and if I do I gloss over most of it. It’s not because I am ashamed, but because I believe most people don’t want to know — they are just asking to be polite.
You might know the kind of people I am talking about: the ones whose eyes gloss over before you have even finished the first sentence. The ones who walk into another part of the house but say “I am still listening, keep talking!” The ones who blatantly interrupt you, or worse, make patronizing agreement noises while looking at their phone or staring into space.
Being able to speak to people openly about mental illness is cathartic for the person telling the story, if someone is genuinely interested and cares about you and wants to know. To everyone else who is just making conversation, please heed this advice (and I don’t believe I am the only person with mental illness who thinks this).
Before you ask somebody (who you know struggles with depression) how they are — make sure you really want to know the answer and really want to know how they are because you genuinely care. I believe there is nothing worse than telling somebody how you feel with total honestly (which takes a lot of courage in the first place), only to be met with an inactive listener whose body language and verbal actions are completely incoherent. And when somebody finishes telling you how they are, please don’t reply with something like, “You should be thankful, other people have it worse.”
For people like me, who don’t talk to that many people about their struggles, a person who doesn’t listen makes me feel as if I shouldn’t be sharing my story. It makes me doubt myself, and it makes me anxious and worried I burden people.
Listening is an art form. Not listening is not only incredibly rude, but it can be dehumanizing, as it makes you feel like you aren’t worth the time, effort, or air you breathe.
We want to hear your story. Become a Mighty contributor here.
Thinkstock photo via Ridofranz