5.2. SUBSTANCE USE AND TRIGGERS
Discussing substance use and potential triggers with someone who has schizophrenia and a substance use disorder (SUD) can be more effective when approached with compassion and a non-judgmental attitude.
Such an approach can create a safe environment where the person feels comfortable reflecting on their substance use and its impact on their mental health.
Open-ended questions about disorders connections
Open-ended questions can provide your loved one with an opportunity to share their experiences in a way that feels safe and free from judgment.
This technique, often used in motivational interviewing (MI), encourages reflection and insight about their thoughts and ambivalence around change.
These kinds of questions may help your loved one draw connections between their substance use and mental health, fostering self-awareness and insight.
Understanding triggers and patterns
Exploring triggers and patterns can play an important role in dual schizophrenia care. Triggers often stem from stress, emotional challenges, or environmental factors.
This kind of dialogue can open up a chance to talk about alternative coping strategies and ways to handle those vulnerable moments.
Normalizing the experience without minimizing the problem
During difficult times, choosing words that normalize and validate one’s experience can help ease feelings of shame or guilt. At the same time, it’s important to make sure they know their struggles are taken seriously. Validation creates a safe, supportive space where they feel comfortable opening up.
According to the Substance Abuse and Mental Health Services Administration (SAMHSA) guidelines, acknowledging their experience – without approving harmful behavior – can lower resistance and encourage more open, honest conversations.
Reflecting and summarizing to clarify
Reflecting on what your loved one shares can be a meaningful way to show empathy and ensure their experiences are understood. Summarizing their thoughts can also help bring clarity to the conversation and provide space for further reflection.
This approach, often emphasized in trauma-informed care, can be especially helpful when supporting someone with complex mental health and substance use needs.
Gently exploring the consequences
Talking about how substance use might be affecting different aspects of life can be a thoughtful way to encourage reflection.
Asking about areas like sleep, mood, or relationships in a caring tone allows space for them to consider the impact without feeling judged.
Example conversation about substance use and triggers
Caregiver: “I was just wondering how things have been feeling for you lately. How are you doing?”
Individual: “It’s been up and down. Sometimes I just feel like everything’s too much, you know?”
Caregiver: “That sounds really overwhelming. Do you feel like using helps during those times, or does it make things harder?”
Individual: “At first, it makes things easier, like I can handle it. But later, everything just comes back, and sometimes it feels worse.”
Caregiver: “I hear you. It sounds like it gives you some relief initially, but then things get more intense afterward. Is that right?”
Individual: “Yeah, I guess so. It’s hard to manage sometimes, especially when I’m feeling stressed.”
Caregiver: “I can only imagine. Are there times when it’s harder to resist using, like when certain things are happening or you’re feeling a certain way?”
Individual: “Definitely, especially when I’m stressed out or can’t sleep.”
Caregiver: “Thanks for sharing that. It’s really helpful to understand when things feel most challenging. Maybe we can think of other ways to manage stress too, so it feels a little easier.”
