how to communicate through distress

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© Teepa Snow, Positive Approach, LLC – to be reused only with permission.


How to Communicate

through Distress

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Top Five Human Needs andEmotional Indicators of Distress

Five Human Needs

IntakeHydration, nourishment, meds

Energy Flowtired or revved up

directed inward or outward

OutputUrine, feces, sweat, saliva, tears

Comfort4 Fs and 4 Ss

PAIN Free!!!Physical, emotional, spiritual

Five Expressions of Emotional Distress

Angryirritated – angry – furious

Saddissatisfied – sad – hopeless

Lonelysolitary – lonely – abandoned/trapped

Scaredanxious – scared – terrified

Lacking Purposedisengaged – bored – useless


Scale of Emotional States –THREAT Amygdala - Distress

Low – Amygdala ActiveAlert

Medium – Amygdala Stressedat Risk

High – Amygdala in ControlEndangered

IrritatedBothered

AngryFrustrated

FuriousEnraged

Dissatisfied Blue

SadUnhappy

DevastatedHopeless

Missing it – Not getting itMissing freedom/control

Lonely – DisconnectedConfined/restricted

Abandoned – IsolatedImprisoned

NervousAnxious

ScaredWorried

TerrifiedPanicked

DisengagedAntsy

Bored Roaming

Useless –PurposelessFrantic

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To Communicate When Someone is DISTRESSED:

First - Connect!Then - Use Supportive CommunicationFinally - Move together to NEW


To Connect When Someone is Distressed:Send a visual signal of connection:

-Look concerned

Send a verbal signal of connection:

-Use the right tone of voice

Send a physical signal of connection:

-Give light hand squeeze or sandwich the hand

-Offer an open palm on their shoulder or back

-Offer a hug if the person is seeking more contact

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What is Supportive

Communication?

• Repeat a few of their words with a

question at the end

• Avoid confrontational questions

• Use just a few words

• Go slow

• Use examples

• Fill in the blanks

• LISTEN, then offer empathy:

“Sounds like…” or “Seems like…” or “Looks like…”


Once You’re Connected and Communicating:Move FORWARD• ADD new words• MOVE to a new place or

location• Add a NEW Activity

Early Stage: Redirection• Same subject, different

focus

Later Stage: Distraction• Different subject,

unrelated BUT enjoyed

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If You Don’t Know Why They’re Upset:Be a Detective, not a Judge!Try to figure out WHAT is being communicated:

• Words• Thoughts• Actions• Needs• Beliefs

DON’T assume or presumeDON’T discount the message because of HOW

it is delivered


Top TEN ‘UNMET NEEDS’!

Unmet Physical NeedsHungry or ThirstyTired or Over-energizedElimination – need to/didDiscomfort – not right for me• Temperature, texture, fit, senses

IN PAIN!!!• Joints - skeleton• Inside systems (head, chest, gut,

output)• Creases or folds & skin• Surfaces that contact other

surfaces

Unmet Emotional NeedsAngry

Sad

Lonely

Scared

BORED

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Five Ways to Say

�I Am Sorry!�

- I’m sorry, I was trying to help

- I’m sorry I made you feel (emotion: angry,

irritated, frustrated, sad, isolated….)

- I’m sorry I made you feel (intellectual

capacity or relationship unequal: like a

child, stupid, like an idiot…)

- I’m sorry that happened, it shouldn’t have

- I’m sorry, this is HARD!


INTENTI'm sorry I was trying

to help

EMOTIONI'm sorry I made you

angry

INTELLECTUAL CAPACITY

I'm sorry, I had no right to

make you feel that way

THAT HAPPENED

I'm sorry, it should NOT

have happened

THIS IS HARD

I'm sorry, this is hard, I

hate it for you

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Do:• Go with the flow• Use Supportive Communication techniques• Use objects and the environment as cues• Apologize• Use gestures and pointing• Acknowledge and accept their emotions• Use empathy and validation• Use familiar phrases or known interests• Respect values and beliefs• Avoid speaking negatively


Don’t:• Try to control the flow• Correct for reality orientation • Tell BIG lies• Correct their errors• Reject topics• Try to distract UNTIL you are well connected• Use negative visual cues

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For ALL Communication:If what you are trying is not working:StopBack offThink it through

Then re-approach and try something slightly different!


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