A true story with altered characters’ names and relations to respect their privacy.
Vivek and Sunil are brothers. They live with their parents in a duplex house. Vivek, a teenage boy, lives downstairs with parents. Sunil has schizophrenia and lives upstairs. It was that horrific day when Sunil literally pissed from his floor in Vivek’s balcony downstairs, angry Vivek went out and got back with 5-6 of his friends holding hockey sticks. Vivek was tired of all the usual domestic drama that Sunil subjected him to and was all set to teach him a good lesson. They broke Sunil’s entrance door and fought with him. While Sunil was physically stronger than each of them individually, he was soon out-powered by the group and was left with a fractured knee and wounds on his body.
What do you think went wrong? The fact that Sunil pissed on his balcony, the fact that Vivek got him beaten up in order to teach him a lesson to stop the usual domestic drama, the fact that they lived in the same house or something else altogether?
Before I answer, let’s take a step back to understand the relation between violence and schizophrenia.
Despite the common notion portrayed in movies and media, not all people living with schizophrenia are violent! It is also found that people with schizophrenia are usually inclined towards harming themselves more than harming others. This is evident by their higher suicide rates.
To quote from an article via apa.org: 1
1. The vast majority of violent acts are not due to mental illness, and most people with mental illness are not violent.
2. When people with mental illness do commit violence, it is often due to contextual or background factors such as a history of childhood physical abuse, living in poor and/or dangerous neighborhoods, or using substances.
3. Factors that predict violence in general – antisocial behavior, substance use, and anger issues, for example – also predict violence in individuals with mental illness.
That said, it’s undeniable that mental disorders can drastically impact one’s behaviour, to the point of impacting their logical reasoning and thinking capabilities, which could lead to rash or aggressive stances they may take when doing poorly. So, as the stats point that all people with mental illnesses do not experience aggressive tendencies, in some cases they do.
From our experience, though, this aggression can be contained and prevented depending on how receptive and compassionate their living environment is, besides treatment as prescribed. It doesn’t just mean expressions of love, it means actions that show that someone around them cares, understands and stands by them in their hour of need. If you are taking care of a loved one with schizophrenia, the following pointers could help in building such an environment:
1. Ensuring an ongoing treatment
The aggression that is part of illness could improve with treatment. This is the bare minimum one should always ensure when caring for a loved one with mental disorders. In case you’re looking for ways to convince your loved one for treatment, read more here
2. Understanding that they don’t really mean the mean/vile things they say or do
This changes your perspective and takes you from resentment to empathy. Your loved one might have never expressed it, but they do sometimes go through a phase of deep guilt over their actions. It’s not so much in their control, and surroundings make it worse when people around them start reacting to their unwelcome behavior.
3. Digging deeper to understand what triggers them
A person is more than just their mental disorder. Everyone has a personality, value & belief system, life goals, likes, dislikes, and of course feelings. While schizophrenia may seem to completely delude them and make you believe that the person has become just a walking disorder, there’s nothing that could be more wrong than actually believing that. When you put effort in understanding them beyond their mental illness, you learn their likes and dislikes. While they exhibit certain behaviour that are irrational, they also react often times to certain dislikes, albeit in a manner you may find inappropriate. Identifying these dislikes could help you understand:
- The reason why certain things seem to trigger them
- Ways to avoid those triggers so that you can prevent them from exhibiting aggressive behaviour
4. Making more heart to heart conversation during their better days
This helps you understand them better, build a trustworthy relationship and for them to feel safer around you. These are also times when you could take the opportunity to ask how they like to be treated when they are in a flare up.
With these practices, you could build a better environment for yourself and your loved one with schizophrenia, resulting in less frequent aggressive situations to begin with.
Nevertheless, such situations could arise and it’s important to be prepared well for them. When your loved one with schizophrenia is being aggressive, here are some key steps you could take:
- There’s no need to act afraid, stay firm. But don’t be aggressive or harsh either.
- Maintain a calm voice and peaceful attitude from your end, no matter how disturbing your loved one seems to be.
- Do not take their actions or words personally.
- Sit down and ask them to sit down politely. But do not force them to.
- Do not react to things they are saying with logical reasoning or with anger/resentment/taunt. Sarcasm is only going to ignite things further, avoid it.
- Provide them physical space: do not touch them or get too close. Avoid physical and eye contacts if possible, maintain a certain distance while remaining calm and composed.
With these steps, you should be able to see some improvements in the tense situation. However, if things don’t improve, don’t hesitate in getting professional help on an emergency basis:
- Call the medical helpline in your locality as soon as you can.
- You could try to offer them water mixed with liquid haloperidol medicine which usually has a calming effect. However we do not recommend this without taking your loved one’s treating psychiatrist’s prior advice and approval. The psychiatrist should help you understand how much of it can be given and in which situations. An important factor to keep in mind is that your loved one might react poorly to this offer and aggression could get worse if they realise that you’re trying to covertly give them a medicine. This is why, it’s better to get professional help by calling medical emergency helpline.
We sincerely hope that by building a supportive environment, you don’t get to encounter the extreme situations as often.
For those of you wishing to know more about Vivek and Sunil case: it’s obvious that the family didn’t have a good education about schizophrenia, its impact on Sunil’s behaviours and was simply not well prepared to take better care of him. It’s harder to blame one person in such situations. One cannot ignore the fact that Vivek is just a teenager who might have gone through mental frustration experiencing these incidents on a regular basis without a proper explanation. It’s due to the lack of any mental health education that he tried to fight what he perceived as evil in his own ways.
Thankfully, Sunil did get his fracture healed and the family is on the process of getting more equipped with the knowledge that is required to care for him without harming him or themselves.
In this sense, it’s the collective failure of our society that there is so little awareness about serious mental disorders. We hope by reading this article, you’d take one step forward in building this collective awareness. Remember, a society is formed of individuals and when each one of us move forward, the society moves forward!
References and further readings:
- Reading recommendation: Helping Someone with Schizophrenia
