Communication issues

Humans have evolved with a drive to develop relationships, as this increases our chances of survival. One factor of importance to our ability to form strong, successful relationships is communication; good communication brings us together, and enables others to understand how we feel and help support our psychological wellbeing.

We communicate with each other in many different ways. For example, we can communicate verbally through language, or non-verbally with body language. This can be as simple as reading the expression on another’s face, or hugging someone.

It’s easy to take the ability to communicate with each other for granted and not appreciate its importance unless there’s a problem. However, for many people and for various reasons, communication issues can be the source of challenges in  relationships and wellbeing.

Below are common types of communication issues, how it can affect people’s mental health, and methods to improve communication in daily life.

Types of communication issues

Communication issues can affect adults and children alike, sometimes temporarily, or as a symptom of a broader mental health challenge.

Communication skills that individuals may struggle with include:

Low empathy

Empathy is putting ourselves in the shoes of another to understand how they feel. Expressing this understanding underpins effective communication and our ability to build strong relationships. Without it, those around us do not feel understood.

Lack of assertiveness

Many people have difficulty asserting their needs. Instead, it’s quite common for people to:

• Avoid issues
• Behave passively and put others’ needs ahead of their own
• Tip-over to the other extreme with aggressive communication

Emotion-driven reactivity

It’s easy to become caught up in strong, negative emotions at times, particularly in the heat of an argument. In this emotional mindset, we might react to others in ways that are unhelpful or upsetting to others. This can damage our relationships.

Inflexible style

People are unique; we all learn and communicate in slightly different ways. We risk our message being misunderstood if we don’t adjust our communication to match our audience. For example, if we use overly complex language when speaking to a child, they are less likely to understand.

Assumption making

It’s easy to make a mistaken assumption about what’s being said, particularly as we use our devices to communicate more by text. We tend to race ahead in our own minds without really listening, reading, or comprehending the message.

Not listening actively

Active listening involves giving our full concentration to what’s being said and providing responses to show that we’re listening and understanding. People feel invalidated when we lose attention, get distracted, or interrupt when they are talking. We also run the risk of missing details and not understanding their message.

Prevalence of communication issues

Communication issues are very common, and often go hand-in-hand with problems in relationships, work, or school.

One study found that 45% of children referred to services with a mental health concern also had language or communication difficulties (1).

Communication issues earlier in life can stay with us through adulthood. A US study found that 22% of adults aged 65 and older experienced communication issues, and that this was linked to having:

• A smaller social network
• Fewer positive social exchanges
• Less frequent social participation

These factors are likely to increase our risk of mental health challenges (2).

Communication issues and mental health

Communication difficulties can sometimes be a part of a mental health diagnosis, including, but not limited to:

• Autism Spectrum Disorder
• Trauma
• Psychotic disorders
• Depression
• Substance abuse

When communication issues and mental health challenges are in the same picture, it’s helpful to have additional supports, skills training, and therapy.

The DSM 5 recognizes social (pragmatic) communication disorder as a childhood neurodevelopmental diagnosis that impacts on communication. This condition is characterized by persistent difficulty with verbal and nonverbal communication. You can read more about it in this PDF released by the American Psychiatric Association.

Ways to address communication issues

If communication issues are affecting your life, consider a combination of the following:

• Therapy: Most therapists have the skills to help improve communication and any associated or underlying mental health challenges. Depending on the aspects of your life affected, consider individual, couples, family or group therapy.
• Support or educational groups: You don’t necessarily have to go to therapy to learn communication skills. Group communication skills, social skills and assertiveness skills training classes can be a great way to learn and practice in a social, supportive setting. Search online for groups running in your local area.
• Social support: Communication issues can make it difficult to ask for the social support and help you need. However, it is important to stay connected. Reaching out to friends and family for help or to talk things over is important.
• Online resources: Explore self-guided psychological and communication skills resources online. Online research can also help you broaden your world view, which can help you to communicate with people of different cultures or identities.
• Speech therapy: If communication issues are related to language problems, working with a speech therapist can be a great help. The American Speech-Language-Hearing Association website is a good place to start.
• Helplines: If you need immediate support, call 1-800-273-8255, or go to the National Suicide Prevention Lifeline website.

Therapy for communication issues

Many therapeutic approaches can be tailored to help with communication issues. The best-fitting type of therapy depends on how communication issues are affecting your life. For example, think about whether it's having a broad impact on your life, or limited to family interactions or relationships. Consider the following therapy types:

• Mindfulness Practices help us become more aware of thoughts and emotions without automatically reacting to them. This is particularly helpful for communication issues relating to emotion-driven reactions and difficulties with attention and listening.
• Family Systems Therapy helps all family members to better communicate and support each other.
• Couples Counseling is a good choice when communication issues are affecting your relationship.
• Dialectical Behavior Therapy (DBT) is a skills-based approach that teaches communication skills in addition to mindfulness, distress tolerance and emotion regulation skills.
• Cognitive Behavioral Therapy (CBT)  helps change unhelpful thoughts and behaviors, and create more balanced perspectives.
• Trauma-Focused CBT can help particularly when communication issues stem from traumatic experiences.

Before choosing, consider how the different therapy types resonate with you. If you’re not sure, your prospective therapist is a great person to talk it over with and help with the decision-making.

What to look for in a therapist for communication issues

Factors to take into account when choosing a therapist for communication issues include:

• Specialization: Most therapists will be able to help with communication issues. However, when selecting a therapist, consider the context of the communication issues and then look for a therapist who has specialized training in that area. For example, if there is a history of trauma alongside the communication difficulties, look for a therapist with that specialization. If communication issues are affecting your relationship, look for a therapist specializing in couples counseling. Therapists often identify their specializations on their website or online profile.
• Qualifications: It can be difficult to decide which type of mental health professional to see, with so many different provider types available. Most importantly, look for a currently licensed mental health professional. You can work with any provider type, as most therapists will have training in communication skills. That said, if you think medication might be needed, make sure you see a psychiatrist. This particular type of mental health professional is able to prescribe.
• Relationship: The trusting relationship with a therapist is called the therapeutic alliance, and it’s the number one indicator of treatment efficacy. The best way to judge how you might feel about a therapist is to ask for a preliminary phone call. This also enables you to ask about their experience, what type of therapy they suggest, and what it will be like. Try to speak to a few different therapists before deciding on a provider.
• Therapy type: Alongside this, you’ll also want to prioritize the therapy type that appeals to you, as discussed in the section above.

Sources and references

• (1) I Can Communicate blog, Speech, language and communication and mental health: a complex relationship
• (2) Palmer, A.D., et al., How Does Difficulty Communicating Affect the Social Relationships of Older Adults? An Exploration Using Data from a National Survey
• The Communication Trust (PDF)
• American Psychiatric Association, Social Communication Disorder (PDF)
• American Speech-Language-Hearing Association
• Cohen, N.J., et. al., Higher order language competence and adolescent mental health