Building Bridges Between Realities

Thanks for the great questions that came in yesterday!  I will respond to them in the order I received them.  That means I’ll begin with Beverly’s question about how “to be meaningfully present for people I care about who are sometimes not capable of holding-reality based conversations”.

This is a great question – as many of us have loved ones who deal with mental health issues ranging from Alzheimer’s to depression.

While I am not a mental health professional, I have dealt with the situation many, many times over the years both in my personal experience and in my role as a helping professional.  I thought I would offer a couple initial thoughts and then invite the rest of you into the conversation as well on this important topic.

My first lesson on this topic came at the end of my junior high years when my maternal grandmother moved to my hometown.  My grandmother, Rose, has a serious case of Alzheimer’s.  I spent at least 4-5 days a week with my grandmother over the course of 4 years, and I learned one thing:  it was impossible for me to get my grandmother to regularly enter reality as I understood it.  Whenever I would try to correct or argue with her, she simply became more agitated.

This meant if we were going to have quality time together, I would have to find ways of leaving my definition of reality behind and entering into her understanding of reality.   With that goal in mind, I learned to do two things.  Instead of me trying to explain my version of reality to her, I would ask her questions about the reality in which she lived so that we could share meaningful conversation.  I NEVER corrected her when her details were different than the ones I knew.

The other thing I did was engage in activities that held a long-term meaning for her: activities that preceded the onset of her illness.  My grandma, for instance, LOVED to play a board game called Aggravation: so we spent literally hundreds of hours each year playing Aggravation.  It was often during these times of engaging in familiar activities that some of our best times were had.

As a Pastor, I’ve experienced this dynamic in play many times.  I have had dozens of experiences with individuals who were considered non-responsive who – when I shared with them a beloved thing from their childhood such as the song “Jesus Loves Me” or the 23rd Psalm – came back to life.  There are many ways you can have a similar experience.  You could use an old family photo album, or play songs from the era in which they grew up.  You might be surprised what a bridge the efforts creates between the two of you!

Those would be my two most practical suggestions.  I will end with an observation I noticed about myself (and my loved ones) in these circumstances.

In the years I spent as a caretaker for my grandmother, I learned that it can be a tremendous challenge for an individual who is too close to the situation to get involved.  My mother, for instance, faced a tremendous challenge in interacting with her mother because she found it impossible NOT to correct her mother.  I’ve seen this same dynamic play out others in this situation.

Why is that?

A couple reasons.  First, the close family member has a deep investment in who they remember the person to be.  This makes it EXTREMELY hard for them to let go of who they knew the person to be and embrace the person as they are today.  Second, the close family member sometimes gets overwhelmed with feelings of shame or embarrassment when they take their loved one out in public.  Those feelings of embarrassment or shame are often indicators that we’ve allowed the situation to become about us – not about our loved one.

So – in summary – I’ve learned that the best way to engage a loved one who is not reality based (or at least reality-based as we understand reality) is to push ourselves to talk with our loved one in ways that invite us into their reality.  It’s also helpful in some cases to use other tools (i.e. pictures, songs, favorite books, etc.) to build a bridge that can help our loved one return to an earlier experience of reality.

When I keep those basics in mind, I’ve been able to spend meaningful time with those whom I care about who are not reality-based.

So what about you?  What has your life experience taught you in this area?

About Pastor Craig

I'm a 54-year-old who lives in Los Angeles, CA with his black Labrador Retriever named Max. I'm an ordained clergy person in the United Church of Christ. My passions include spirituality, politics, and sports (Go Houston teams, go!). I use my blog to start conversations rather than merely spout my perspectives and opinions. I hope you'll post a question, comment, or observation for me to respond - so we can get the conversation started!
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2 Responses to Building Bridges Between Realities

  1. Beverly Marshall Saling says:

    Thank you. This syncs up nicely with an article I recently read that advocated the concept of “holding space” for people, meaning giving them room to be their full selves and not intervening to correct, debate, advise, or assimilate them without first being still and truly listening to everything they need to say. As you mention, it’s hard to let go of our own agendas for other people, especially if we care about them and worry about the consequences of their “unreal” ideas and behaviors. But I’m trying to be more patient, and to realize that sometimes my efforts to help are really more about me wanting to feel helpful than about what the other person really needs.

    For example, my mother is currently suffering from vascular dementia with paranoid elements, and often thinks terrible things are happening. My instinct is to reassure her that they’re not and she’s safe, but when I do that what she hears is that I reject her feelings of fear and her request for protection. I am learning to ask her what she thinks we should do and agree to do that or something like it—even if I don’t really understand what she is asking for. Once she gets the validation, she has a better shot at moving on from the scary idea.

  2. Stevie says:

    Beverly, that is so wise. When my father was suffering from dementia, it hurt my heart so much. I wanted somehow to find “Dad” in there somewhere, and it frustrated me so when he didn’t understand. My daughter said to me quietly, “Mom, can you imagine how it feels to be discounted every time you say something?” That really resonated, and from then on I tried to meet him where he was, not where I longed for him to be.

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