I am often asked by the managers I train what to do if a coaching session uncovers a significant psychological problem. It seems a common occurence for a coaching conversation that starts on a business issue to suddenly reveal a deeper issue.In some ways such managers should feel encouraged: people would hardly reveal deeper issues unless they felt comfortable doing so, but I also advise managers to develop a broad understanding of what is known as abnormal psychology if only so as they can point people towards the right kind of professional help. Consider for example, that most commonly diagnosed form of mental disorder; thought to affect about 1% of the population at some point - schizophrenia.

It is a popular misconception that schizophrenia means a split personality. This is not true. It is actually a generic term for a group of psychotic disorders characterized by disturbance of personality, loss of contact with reality and so on.

Let's look at how the condition might be described and the symptoms one might expect to be present.

Firstly we'll consider Schneider's first rank symptoms (1959):

Thought Disturbances:

Typical symptoms under this heading include Word Salad - bizarre verbal association and Clang Associations - linking words by sound rather than meaning

Auditory Hallucinations:

This is the classic "I heard voices", where the sufferer believes some external force is directing them to do something over which they have no control.

Primary Delusions:

Delusions are misrepresentations of what most people would regard as the reality of situations. Common schizophrenic delusions include:

Delusions of influence - the sufferer believes they at the mercy of external forces Delusions of grandeur - e.g. "I am Napoleon" Delusions of persecution - "They're out to get me", i.e. paranoia

Next let's consider the symptoms outlined by Slater and Roth (1969):

Disturbance of Affect:

This is characterized by schizophrenics expressing emotions that are inappropriate to the situation e.g. giggling on receipt of bad news

Psychomotor Disorders:

Including odd hand gestures, twitching and peculiar facial expressions

Lack of Volition:

Those that suffer from schizophrenia often have trouble maintaining a normal day to day life. They can find simple activities difficult and can often become reclusive and withdrawn.

Schizophrenia is a term that has perhaps become cheapened by misuse at the hands of satirists and thriller writers. In truth it represents an horrendous burden for sufferers and their families both of whom deserve our sympathy.

It is unlikely that the coaching manager would be the first to stumble upon such symptoms, but it is not unheard of. Schizophrenia sufferers may well be able to carry on in their job roles with perhaps some minor adjustments or be moved to other duties. A coaching approach to communication amongst the colleagues of the newly diagnosed schizophrenia sufferer should also prove a sensitive way to enable everybody to adjust.

Some studies indicate that schizophrenia - like many abnormal psychological conditions - can be triggered or exacerbated by stress, and work is the most common arena for experiencing stress these days. We coaches may be in a very good position to notice early signs of stress and where it might lead.