Affective Validation Therapy: Communication With People With Cognitive Impairment

When we are close to a person with cognitive impairment, a great concern arises: how do we interact with them? How can we convey what we want to say to you? What can we do if forgetfulness, sudden anger, lack of orientation are increasingly evident? There comes a time when we feel so frustrated that we don’t know what to do or how to act with that person.

But there is certainly always a way, and a great way to do it is through affective validation therapy. This therapy is a wonderful method of communication with patients with Alzheimer’s or other types of cognitive impairment, especially when it becomes a difficult matter. Both for themselves and their caregivers.

This type of therapy is a great support when dealing with people who are in advanced stages of cognitive decline. Through this article you can find out what it is about, the main principles it addresses and some communication techniques.

What and what were the origins of affective validation therapy?

The affective validation therapy consists of a form of communication for the advanced phases of cognitive deterioration.  In addition, it is a way of approaching people who suffer from it in an assertive way.

Through this therapy, feelings of frustration decrease, this is because the way to treat people with cognitive impairment is understood, which facilitates communication and care. At the same time, it is guaranteed that they are less disturbed thanks to the appropriate approach.

The creator of this therapy was Naomi Feil. Naomi, was related all her life with the elderly thanks to the jobs of her parents. On the one hand his father ran a retirement home in Cleveland. And, on the other hand, his mother was in charge of the social services of the center.

In addition, thanks to the close coexistence she had with the elderly, Naomi Feil, devised a way to treat elderly people who were quite disoriented, which was constituted as affective validation therapy.

Principles of affective validation therapy

Affective validation therapy promotes deep respect and empathy for the beliefs and experiences of the person with cognitive impairment. It does not matter if the ideas and experiences are real, you have to give them credibility.

It is about approving the reality of people who are in advanced stages of cognitive decline. To do this, the following principles must be taken into account:

• There are reasons. Behind any behavior, idea, or feeling of people in advanced stages of cognitive decline, there is a reason. This is maintained even if the changes involve irritability and aggressiveness. Therefore, we must stop before judging and be more understanding and compassionate.
• Authenticity. Affective validation therapy promotes that each being is unique. Each person has their value, and for this they deserve respect.
• Acceptance. That is, leave criticism behind and interact from love with people with cognitive impairment. There are behaviors typical of what happens to them that they cannot avoid, therefore, it is important to be more tolerant.
• Empathy. Putting yourself in their place is a good strategy to perceive how they feel and understand what they are going through. This will help develop sensitivity to interact with them with patience, respect, and affection. Also, empathy could increase confidence and reduce anxiety.

• Expression. By expressing emotions and thoughts, feelings of anger, hurt, and frustration may be reduced.

Keeping these principles in mind and applying affective validation therapy techniques will help increase feelings of self-worth and decrease depressive symptoms in people with cognitive impairment. In addition, these actions improve relationships with caregivers and, therefore, reduce the emotional overload of the caregiver.

Techniques for communication from affective validation

Affective validation therapy is available to everyone. Practicing it supposes a greater well-being both for people with cognitive impairment and for caregivers. Some of the techniques to achieve your goals are:

• Redefinition. It’s about keeping the topic of conversation by changing the focus. That is, it consists of saying things differently when you do not understand them.

• Reminiscences. It is beneficial for people with cognitive impairment, to stimulate memories through the senses. For example, using photos or songs that are familiar to them.
• Voice tone. Using a clear, low and loving tone of voice favors the well-being of people with cognitive impairment. Also, you need to remove any threatening tones or words.
• Contact. It is about maintaining eye contact and physical contact through caresses, hugs, etc. This is essential in the first experiences of disorientation of the person.
• Find a relationship between behavior and need. That is to say, look for the link between what the person feels and the behavior they present. To do this, it is useful to ask yourself: why are you complaining?

These techniques validate the person with cognitive impairment. In this way, they favor a higher quality of life. This is due to the fact that feelings of discomfort decrease in both caregivers and people with cognitive impairment.

It is a useful therapy since it makes one stop to think about how the person with cognitive impairment feels and thinks. In this way, it invites you to put yourself in their shoes. However, it is not a method that replaces others. It is a form of approach to people with cognitive impairment that can be integrated or used as a complement to other types of treatment.

Many times, it can cause frustration and irritability to see those closest to you disoriented, with vague memories, aggressive, with easy crying, or any other symptoms. Therefore, it is a task of care and, therefore,  requires working both in the way of relating, as in oneself. 

Let’s connect with ourselves and establish relationships that nurture those with cognitive impairment from love. Without a doubt, affective validation therapy is a wonderful tool to validate, understand and reduce stress. A position of affection, respect and tolerance always makes those around us feel better.