Chapter 4 is all about communication. It is so important that we can communicate our needs and feelings to be able to have a balanced life, but this can be especially difficult when you are a carer. We have heard often that communication when someone is unwell can be challenging so we hope these tips for effective communication, which we discuss in the videos and summarise in the handout are helpful.
Watch the introduction into relationship with loved ones.
Then click on the sections below to open them.
We know that relationships are important for our quality of life and effective communication is important for getting and keeping good relationships and outcomes. In any given interaction, we will have at least one of the following three priorities:
Being effective - getting what you want
- Getting what you want or are entitled to – within reason.
- Asking someone else to do something.
- Saying ‘No’ when necessary.
- Tackle and try to resolve conflicts.
- Having your opinion or point of view taken seriously.
Questions to ask yourself:
- What result do I want here?
- What is most likely to work in order to get it?
Keeping the relationship
- Paying attention to the effect on the relationship of seeking what you want.
- Look after the other person’s wants and feelings.
Questions to ask yourself:
- How do I want the other person to feel about me after the interaction is over?
- What do I have to do to get (or keep) this relationship?
Self respect - your relationship with yourself
- Holding onto what you believe in and acting in line with your values and beliefs.
- Experience yourself as effective and in control.
Questions to ask yourself:
- How do I want to feel about myself after the interaction is over?
- What do I have to do to feel that way about myself? What will work?
A way to remember these skills is the word “GIVE”
Gentle
Treat the other person how you would like to be treated. Have a polite, respectful and patient manner.
Interested
Show interest in the other person’s thoughts, feelings, views, preferences – even if they are different from your own. Give the person your full attention. Actively listen to what they say. Show you are listening by making eye contact, nodding, etc. Don’t interrupt or talk over them. Communicate that their experiences and well-being matter to you.
Validate
Acknowledge the other person’s feelings and opinions.
Easy Manner
Be approachable – friendly and relaxed.Ease things along. Use a little humour.
A way to remember these skills is the word “FAST”
Fair
Be fair to yourself and the other person. Remember you both have equal rights. Respect your own feelings and wishes, as well as those of the other person.
(no) Apologies
No need to apologise for having opinions and preferences, or for making requests. Don’t invalidate the valid.
Sticking to your values
Let your actions be guided by your values. Stay true to what is important to you, how you want to act and the type of person you want to be.
Truthful
Be honest. Resist the urge to exaggerate. Don’t act helpless when you’re not. Don’t make up excuses.
It’s sometimes hard to validate our loved ones, especially when their experience can be different to ours, or when we want to help, and problem solve.
Noticing this and making an effort to validate their feelings can often be helpful in defusing a situation and managing someone with an unusual experience. Validating feelings is not the same as validating behaviour.
Examples of validating statements such as: “I know”, “of course”, “it makes sense”.
Boundaries are a key to looking after yourself and making sure that your caring role is safe and sustainable.
Setting boundaries with our loved ones, and other people, can feel difficult but is very important. You are entitled to set boundaries! Your health and life is just as important as your loved ones.
Think about:
- What are some examples of boundaries you have set (with anyone)?
- What boundaries do you find difficult to set with your loved one?
- What makes it difficult?
- What could the benefits of setting these boundaries be (for you and your loved one?)
- This image outlines some steps you can follow to help put appropriate boundaries into place with your loved one. Remember that we can only control 50% of the interaction – we may not be able to control their feelings or distress, or how they express it in the moment, but the way in which we set boundaries, and our reactions could make a big difference.
Let the person express how they feel
Actively listen (eye-contact, nod, reflect)
Try to understand things from their perspective
Use validating statements
Tips for managing
- Listen and try to find out why they are angry, e.g., ask them to explain or tell them what you think they mean and ask if this is right.
- Use your loved one’s name, and be prepared to repeat yourself.
- Try not to get defensive or argue back.
- Respect their feelings – do not tell them that they shouldn’t be angry.
- Use a calm voice and facial expression.
- If you have made a mistake, admit it and say sorry if appropriate.
Tips for managing
- Try to avoid directly challenging beliefs (telling them that is not true or not happening).
- Try to avoid agreeing with the beliefs.
- Listen and acknowledge their feelings e.g., “This sounds very distressing for you”
- Build trust, e.g., “I am on your side”, “I want to help”, “Maybe talking about it might help?”
- Being curious might help to highlight alternative explanations, but only do this if you feel comfortable to. E.g., “How do you know that?”
- Offer comfort and reassurance, help them to feel safe.
- Offer distraction – suggest they try something else to keep their mind off of things.
Tips for managing
- Listen and try to explore how your loved one is feeling; try to understand what is behind the behaviour.
- Tell your loved on that you are there to support them.
- If they are able to, talk about whether there are any particular triggers.
- Explore if there are any other things they can do to lower the physical damage to themselves.
- Seek medical help for wounds when needed.
We hope you have found this workbook and videos helpful. For further support please speak to your teams about their offering of carers support and of course please utilise the links provided within these pages.
This handbook has been developed by Dr Hannah Boustred, Consultant Clinical Psychologist, and Molly Gilbert, Trainee Clinical Psychologist, from an unpublished 6-week carers group Dr Boustred created in collaboration with Tamara Smith, Trainee Clinical Psychologist.
The materials within this workbook are adapted from well-known psychological concepts, frameworks and therapies including Dialectical Behaviour Therapy (Linehan 2015), Family Connections (Fruzzetti and Hoffman 2005) Cognitive Behaviour Therapy and Comprehend, Cope and Connect- Isabel Clarke.
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Hoffman PD, Fruzzetti AE, Buteau E, Neiditch ER, Penney D, Bruce ML, Hellman F, Struening E. (2005) Family connections: a program for relatives of persons with borderline personality disorder. Fam Process. Jun;44(2):217-25.
Linehan, M. M. (2015). DBT® skills training manual (2nd ed.). The Guilford Press.
Patterson (2000) The Assertiveness Workbook: How to Express Your Ideas and Stand Up for Yourself at Work and in Relationships New Harbinger Publications Siegel, D. J. (1999). The developing mind: Toward a neurobiology of interpersonal experience. Guilford Press
Westbrook, D., Kennerley, H., & Kirk, J. (2011). An introduction to cognitive behaviour therapy: Skills and applications. Sage publications.