My husband will be moving back to where he’s from tomorrow. I have all his worldly possessions in boxes in my closet because he’s been homeless for a year. He asked me to look for some paperwork he thinks he will need when he returns to CA and I came across the evaluation he had at Emory psych ward when he was in GA a few months ago. They mentioned his disorganized thinking and said they had trouble following his story because he rambled on.
I realized, reading this, that I have become so used to his speech patterns over the past nine years that we’ve been together that I understand (to a degree) what he’s saying. These were professionals interviewing him. Emory, an esteemed hospital in Atlanta, was where he was. Yet they didn’t understand him.
It got me to thinking…have I become too used to his way of talking? Do I forget that he is severely mentally ill at times? Of course, the answer is yes. It has become the norm for me that he will ramble on and change the subject multiple times in one answer. But I follow it.
I have noticed in the past few years that he tells strangers too much about himself and that he likes to exaggerate aspects of his life, sharing what celebrities he has briefly met or whose neighborhood (a celebrity) he used to live in, that he’s been in prison and been legally insane and at a state hospital for many years. I advised him that when he returns, he should only share the minimum of history with people, that they will like him for who he is, not who he knows or who he has met. He has an engaging personality already and he doesn’t really need to exaggerate; I feel sorry for him in that way. I told him about this today and I could tell he was giving it a thorough consideration.
He told me today that he doesn’t want to deal with social services aside from the soup kitchen and food banks, so I am hoping that he puts his good energy into looking for work and finding a home and getting off the streets.
Anyone else out there feel that they learned to understand their loved one’s disorganized thinking? That you can understand them when the average citizen, at the grocery store, bank, gas station, etc., does not? Please share your stories.
Yes, I usually understand what my son is trying to say. Even when he spoke in what doctor’s called “a word salad” (all words tossed up and landing anywhere) I could pick out the nouns and verbs and get the gist of what he was saying.
Well, I tend to recognize my son’s disorganized speech for what it is, but try to listen for the content that is at the core of whatever he is saying. He often uses much more formal and what I suppose he would consider ‘intellectual’ language that a person would generally use in conversation.
It’s a struggle - when he is non-expressive, I think people sometimes consider him mentally disabled; when he speaks, people often comment on his intelligence though in reality what he is saying is big words that don’t really come together to express something logical, or is completely irrelevant to what the current circumstance is.
BTW, my son also like to impress total strangers by talking about people he has known especially about his dad. He lives with this strangely altered version of his dad, some true, some false.
I have similar troubles with a sibling who has bipolar disorder. He often embellishes and needlessly aggrandizes and intellectualizes things. He also has a tendency to live in the past. He often repeats stories and themes with slight variations, and since I’ve heard much of it before I can follow it as a sort of shorthand.
Since I know him, I’m able to question some of the more outlandish and seemingly incomprehensible stuff, because I’m aware that there’s always some tenuous idiosyncratic thread of references he’s making-- and he seems unaware that most people can’t follow, because they don’t have the same working set of trivial or non trivial knowledge. In some ways the repetition helps, because occasionally I can get a word in edgewise and uncover the background of his more cryptic connections.
It’s especially bad when he’s been drinking. But even when he’s sober his ramblings resemble stories a drunk or stoner might tell.
There are many variants in Formal Thought Disorder. John Hopkins lists 20! Thought Disorder | Johns Hopkins Psychiatry Guide
Our son had about 8 of these symptoms…Sometimes I could figure out why he used the words he did but overall his conversation had very little discernable meaning. I can’t be certain if the FTD came on as a result of repeated catatonia or too much ECT (ECT was helpful to him to a point especially because he refused all meds at the time). But the FTD disappeared entirely not long after he started on Clozapine.
When my mother is not on her medication, she becomes withdrawn. When I try and talk to her, she will ‘shush’ me, because she doesn’t want to miss what one of the voices is telling her. Otherwise, when she interacts with me directly, she speaks in well organized sentences. As far as showing off, when not on her meds she will believe that she’s a princess, and a few days later, queen of the world, and eventually empress of heaven or whatever fantastic title she comes up with, that cannot be topped. She also has 3 Alien husbands. Honestly, it doesn’t bother me. What does get me down, is if her paranoia gets really bad and then she thinks that she is in danger and she becomes afraid.
I do have a friend with Dementia, who is a year younger than my mom, and his speech is very disorganized, but since I know him so well, I can usually fathom the gist of what he is saying. We often jump to several different talking points over lunch, and as long as we are chatting, I feel we are both getting something out of it. He has several favourite subjects, so if I feel that conversation is faltering, I will bring up the dinosaurs, or whatever. He still has his dry sense of humour and interest in currently events and love of dogs. He’s still my intelligent friend with the PhD. For a short time (8 months), I was his go to person until such time as he got daily assistance, and it is much easier (for me) being ‘friends’ rather than caregiver. I don’t have to try and convince him to bundle up on a cold winter day.
My heart goes out to everyone with a loved one with a neuropsychiatric disorder, and dementia/Alzheimer’s.
How to Respond Therapeutically to Disturbing Beliefs (link below) Google other articles, also, for tips. Better yet: Enroll in a no cost NAMI Family to Family Class which includes excellent coverage on Communication skills.