Therapeutic Communication: The Basics

Communication is a key aspect to everything in life! It helps bring awareness and understanding. Being aware of others and practicing what is called “therapeutic communication” can help break the stigma surrounding mental health. Not only that, it can help you succeed personally/professionally, open up new perspectives, and bring you closer to others. 

Have you ever had a conversation with someone who is upset and not know what to say? That’s natural and there are many different ways of communicating back to that person to let them know you are there for them and listening. Learning about “therapeutic communication” can help you help others around you! 

So what is “therapeutic communication”? I am fortunate to have learned this in nursing school as a way of talking to different patients. However, I honestly believe everyone can benefit from it. I decided to share this knowledge so we can all learn and grow together! Everything I write in these blogs I have learned from my undergraduate BSN degree from Temple University. I also obtain information from professional nursing books that I have kept and refer to in my career.

According to Merriam Webster dictionary “Therapeutic” is defined as “having a beneficial effect on the body or mind.” And “Communication” is defined as “a process by which information is exchanged between individualsthrough a common system.”

Therefore you can define “Therapeutic Communication” as “the exchange of information between individuals that has a beneficial effect on the body or mind.” In other words, the exchange will benefit the physical and emotional well-being of persons involved.

Communication is something that has been studied for a long time, and in many healthcare disciplines. Per “Communication for Nurses- Talking wtih Patients” book by Lisa Kennedy Sheldon, it is believed that communication occurs on two levels: the relationship level and content level. How two participants are bound together and the words, language, info exchanged. Conversations are more effective/message is relayed more clearly when relationships are healthier. 

The first step to effective communication is actually SELF awareness. “Self awareness” refers to the active process of learning about the components and parts of oneself. Humans are complex. We are the product of many things-genes, environment, experiences, etc. in order to communicate effectively you first need to acknowledge what makes you you essentially. What are you characteristics and behaviors? It’s important to reflect back on yourself and try to understand yourself before being able to understand others and communicate in a positive way. 

“Self” refers to a personal definition of oneself that is different from other people’s. “Self concept” is the judgements and attitudes you have about oneself. “Known self” refers to the parts that are consciously acknowledged. When choices are made within this then self-identity and self-worth are affirmed. 

Just like in nursing, in the real world understanding and acknowledging oneself can help facilitate therapeutic communication between one-another and therefore benefit that persons physical and emotional well-being. This is especially important today as mental illness is so prevalent.

Let’s now take a look at some fundamental concepts regarding human behavior and interaction. The first thing I want to share with you is the “Stages of Psychosocial Developement”. This was developed by a psychologist and psychoanalyst Erik Erikson in the 1950s. The stages are built upon Freud’s concepts and focus on age and what virtue will be obtained if the stage is successfully fulfilled. The eight stages of human development are all influenced by the biological, psychological, and social factors throughout the lifespan.

How do the Stages of Psychosocial Developemen work?

Erik Erikson described them as personality stages that are a lifelong process. The stages arise as individuals grow and face new decisions and turning points during childhood, adolescence, and adulthood. Each stage is defined by two tendencies-one positive and one negative. From this you develop a strength or maldevelopment. If the virtue is taken on then it can help resolve the current conflict and help in subsequent stages of development. This will result in a stable foundation in relating to the self and outerworld. 

Erikson’s Stages of Psychosocial Developemnt and Virtues:

1. Infancy Period: Trust v. Mistrust (Virtue=Hope)
2. Early Childhood Period: Autonomy v. Shame/Doubt (Virtue=Will)
3. Play Age Period: Initiative v. Guilt (Virtue=Purpose)
4. School Age Period: Industry v. Inferiority (Virtue=Competency)
5. Adolescent Period: Identity v. Identity Confusion (Virtue=Fidelity)
6. Young Adulthood Period: Intimacy v. Isolation (Virtue=Love)
7. Adulthood Period: Generativity v. Stagnation/Self Absorption (Virtue=Care)
8. Old Age Period: Integrity V. Despair (Virtue=Wisdom)

The next fundamental concept was developed by Abraham Maslow. He was psychologist who created the “Hierarchy of Human Needs.” They are stacked like a pyramid with the most basic physiologic needs at the base (most important). If these needs are met then the person can achieve the second level and so forth. This is important to understand because if a person does not have their basic human needs such as food, water, shelter, then it will be very difficult for them to progress up the pyramid to achieve needs such as love and belonging. As someone achieves the higher needs it helps them to feel a part of a community and build their self-esteem. 

What is self-actualization? 

This is the highest level and does not mean that the human is perfect and free from emotional burdens. It means their needs are met on all other levels and they can use their personality traits, strengths, skills to the best of their abilities to benefit society. They are open. They allow others to see their strength and weaknesses and grow upon that-helping themselves and others. Honestly, isn’t that the goal is life? Nobody is perfect but we are all trying to be the best person that we can be.

Maslow’s Hierarchy of Human Needs:

Self-Actualization….Self-Esteem…Love and Belonging…Physical Safety and Security…Physiological Needs (food, water, air)

These concepts are great because they give us some basis to understanding the human psyche and how we develop within ourselves. However, some believe that this is not always the case. Many professionals think that self-concept is individual. Each person is unique and how they develop and achieve each stage or level of a pyramid sometimes does not always determine their outcomes! Some of these stages and needss are fluid and aren’t as prevalent for certain people. 

Have you ever heard of the controversial topic of Nature versus Nurture? This concept delves in to the way humans develop. It discusses the concepts of how genetics and environment affect individuals. For example, if someone were to have anxiety does that mean they are born with it or did that develop because of some environmental aspect in their life? Hey, it may even be both.

Regardless, understanding these few concepts about our human psychosocial development helps to educate us. It can help us understand different perspectives of others and what can benefit their physical and emotional well-being. It helps us develop therapeutic communication skills because we will be able to keep these concept in mind and be more aware of the other person’s psychosocial stage in life and what they may need to progress further. AND lets not forget…being aware of the fact that self-awareness, self-concept, self-esteem, and more are so important to this process will open your eyes to the needs of not only others, but also yourself. 

REMEMBER: Education and communication are so important to improving our chances in breaking down the mental health stigma we face today.

Resources used for this blog post include: Lisa Kennedy Sheldon, PhD, APRN, Communication for Nurses-Talking with Patients, Second Edition, Jones and Barlett Publishers, LLC, Sudbury, MAssachusetts, 2009; Orenstein A. Gabriel and Lindsay Lewis, Eriksons Stages of Psychosocial Development, https://www.ncbi.nlm.nih.gov/books/NBK556096/, 2020.