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Diana B. Denholm, Ph.D, LMHC
Diana B. Denholm Ph.D, L.M.H.C.

Just Yell at Them!

How to communicate with someone who’s sick and mean

Deborah’s mother, Janice, wasn’t just terribly ill; she was terrible. Deborah, now 55, virtually gave up her life to care for her mother. Janice was unappreciative and downright ugly in her manner. She yelled obscenities, threw things at Deborah and frequently told her what a terrible daughter she was. Though beaten down and seething inside, Deborah kept her mouth shut and did what she was told. After all, this was her mother! However, stuffed humiliation and anger took its toll on her in lost sleep, binge eating, feelings of agitation, and frequent headaches – not to mention some pretty negative mental dialog about mom.

Seeking relief, she visited a psychologist who told her, “Just yell at her! Shock your mother into treating you properly.” I’m sure that’s quite tempting for many caregivers. While it might do the trick, more likely it won’t; and will just escalate the animosity. And, what if this “shocking” outburst is the last communication you have with your loved one or relative? What effect will that have on you for the rest of your life?

Rather than a verbal counterstrike, a life coach suggested something non-confrontational to relieve her symptoms. Deborah should take a baseball bat, go into her nearby lake and repeatedly and ferociously hit the water with it - until she got the anger and humiliation out of her system. Theoretically sound, but wow; an accident waiting to happen.

What do you want to accomplish?

What’s your end game? Are you just trying to make a point? Are you trying to release anger? Do you really want to change your relationship with the terrible person? Hopefully the latter two. Fortunately, there are effective and safer ways to accomplish these things.

Emotions are neither good nor bad, they just are. Deborah’s feelings and thoughts are common for caregivers. Though guilty about her thoughts, she learned that the conversations in her head were helping her survive. That's because they allowed her to let off some steam. This kept her from screaming things out loud, or worse - becoming violent like her mother.

Too much pent-up anger or too many disturbing thoughts not only create negative outcomes, they steal your energy. Among many healthy ways to release anger, you may simply write down, for your eyes only, all the uncensored things you’d really like to say - but shouldn’t and won’t. Also, by employing imagery you can hit the water, or an inanimate object like a boulder, with a baseball bat without endangering yourself. To do this, imagine that you are actually hitting the object, rather than watching yourself do it. Say all the uncensored things, in your mind, while you do it. Physical and emotional relief can be so profound that you end up exhausted or in tears.

You may think that these exercises are all well and good, but they won’t change your situation. Actually, they can. By getting these things out of your system, you’ll be less reactive and farther from the “last straw”. And using these tools can prepare you for the next important steps that will change the way your relationship works. These activities will put you in a healthier mental and physical state, setting the stage that allows you to make those changes. But, if you’re not ready to makes changes in the relationship, you can at least enjoy the benefits of releasing anger.

Two steps toward changing the negative relationship

First, learn to stop enabling the sick person’s inappropriate behavior. Second, move from being an adversary to a collaborator.

1. Stop enabling the terrible behavior.

Parent/child and marital power structures pose different challenges when tackling terrible behavior. Most likely the terrible behavior continues because you’re enabling it. What does that mean? Also called "codependence", the term “enabling” comes from the field of addictions. Used here, it is doing for others what they should be doing for themselves and supporting their inappropriate behaviors. The remedy: your behavior must change.

Deborah learned a simple (but not easy) method to use with her mom. When Janice started yelling and demanding, rather than fulfilling her mom’s request, Deborah calmed herself. (Note: Never withhold anything, like medications, if it puts the sick person at risk.) Then she quietly and politely said, “Mom, I’ll come back when you can speak civilly to me”. Then she left the room. Janice’s behavior temporarily worsened, but when she finally became civil, Deborah returned to the room. When Janice started her inappropriate behavior again, Deborah left again - politely repeating the condition under which she’d return. Of course, this is going to take many tries, with lots of limit pushing by the sick person; but it will work with situations where mental capacity isn’t diminished.

2. Learn skills to move from adversary to collaborator

If you want a good outcome, you’ve got to collaborate. In my book, you'll learn how to raise issues, have problem-solving discussions with the ill person, and create useful understandings. These will diminish stress and household battles, leaving a more peaceful and happier environment in its place. Communicating effectively with the ill person is the single most helpful way to improve your mental health.

To do this, Deborah decided what she wished to discuss with her mom. Then she learned to approach her using “I statements” and “closed-end” questions, saying: “Mom, I'd like to talk to you about getting more help. Would Tuesday or Thursday be a better day for you to talk?” She was used to her mom contradicting her, so was glad to learn it was all right to agree to disagree. Janice was very logic oriented, so Deborah spoke to her in her “language,” asking her mom what she thought about an idea rather than how she felt about it. By following specific steps, they learned to collaborate and function as two adults.

For more tips on self care, read my article Who Helps the Caregivers? To learn more about enabling and codependency, read: When Caregivers Care Too Much. And for more details on communication, read May Is Mental Health Month: What to Do When Caregiving Threatens to Destroy Yours. Stay tuned for more helpful caregiver hints.

About the Author
Diana B. Denholm, Ph.D, LMHC

Diana B. Denholm, Ph.D., L.M.H.C., is a medical psychotherapist and the author of The Caregiving Wife's Handbook.

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