BY LOIS MAHARG
“I am not sick, I don’t need help.”
Many of us have heard that line before. Here’s the likely context: We’re convinced that medication and/or psychotherapy will help a loved one’s mental health condition, but they want nothing to do with it. In fact, they seem to be in denial that a problem even exists.
But that’s not really the case, according to Barb Higman and Patricia Doyle, who conducted a training session on the LEAP approach to helping people manage mental health challenges on March 9. Our loved ones aren’t actually in denial; studies have shown that instead they’re experiencing “anosognosia,” a brain-based symptom that impairs their ability to recognize their illness.
“Anosognosia is a neurological term coined in 1919,” Doyle said, meaning lack of awareness “of neurological deficits and what’s going on with your body.”
Why the LEAP Approach Came About
The LEAP approach was developed several years go by psychologist Javier Amador. Amador created it at a time when he was seeking a more harmonious and fruitful relationship with his brother, who, although he underwent several hospitalizations for schizophrenia, did not believe he was sick. The set of communication tools Amador came up with greatly improved his relationship with his brother.
“We never ‘win’ on the strength of our argument,” Doyle said, quoting Amador. “We win on the strength of our relationship.”
While the tools work well for people trying to communicate with others experiencing anosognosia, they can enhance communication in other situations, too.
“I like to think these communication tools will have a ripple effect,” Higman said. “We train more and more people, and pretty soon the world is a better place.”
Four Main Tools of LEAP Training
LEAP is an acronym that stands for Listen, Empathize, Agree and Partner. Here’s a very brief summary of what those steps refer to, fully explained and illustrated in Amador’s book, “I Am Not Sick, I don’t Need Help.”
Listen. The first step toward developing a trusting relationship involves learning to do something called “reflective listening.” When your family member or friend offers their perspective on a problem they’re having, you essentially parrot that statement back to them as accurately as possible. For example, “I hear you saying that the people upstairs are building bombs. Do I have that right?” The point is that you must first understand the situation from your relative’s perspective before you can start exploring the problem in a mutually acceptable way.
Empathize. The second step is to respond empathically to your loved one’s concern. For example, “If I thought my upstairs neighbors were terrorists, I’d be frightened too.”
Agree. You may not agree that your relative has a realistic grip on the situation or with the way they’re proposing to handle it. But there will usually be some aspect of the situation that you can agree on. For example, “I don’t want you feeling unsafe, either.”
Partner. Once trust is established, there’s a better chance that your relative will allow you to partner with them to address whatever concerns the two of you have. You may be able to agree on some goals — but don’t be in a rush to link your goals to treatments. Take plenty of time, thoroughly discussing the disadvantages and advantages of whatever plans are proposed, before landing on what will be tried and for how long.
Taking a LEAP approach to talking with a loved one will make communication feel more relaxed and productive, Higman said. “And the person feels respected rather than demoralized,” she added.
To find out more about this novel approach to communication, visit the LEAP website and/or take the LEAP course yourself on Saturday, June 1, from 9 a.m. to 2 p.m. at the NEW Center. Please RSVP to firstname.lastname@example.org with LEAP in the subject line if you would like to attend. A recommended donation of $30 to NAMI Washtenaw County will be appreciated. Lunch will not be provided so please feel free to bring a bag lunch or snacks.