Self-Help for Schizophrenicsby Ann Reitan, PsyD | July 18, 2014
In spite of the existence of stigma, the first crucial step in dealing with schizophrenia is acceptance by that individual that he or she has a mental illness.
This acceptance will allow him to deal more effectively with his life and move on with a lifestyle that is perhaps different from that of an ordinary person. Acceptance of one’s mental illness and the life task modifications that are involved in existing as a schizophrenic in the world are essential to dealing with schizophrenia with a modicum of success. Noteworthy is the fact that denial of having a mental illness is likely to be a significant step toward delusional thinking, and acceptance of having a mental illness is a step toward sanity.
At this point, it’s worth addressing the fact that there has been a fair amount of criticism directed at me for labeling and pathologizing those who have perceptual differences in the articles I’ve written so far for this website. Much of this criticism has described my articles as “reductionistic” and “stigmatizing”. By no means do I intend to denigrate schizophrenics or those with perceptual differences. Rather, these articles represent efforts to illuminate schizophrenia, and they have been intended to help the individuals suffering from the condition of schizophrenia.
Many of the suggested treatments for mental illness have reflected traditional approaches. But I believe in the importance of self-help. This article is intended to offer helpful advice, not only to schizophrenics, but to their treatment providers, as well.
Although not usually construed as a self-help related behavior, taking one’s prescribed medication is also an important aspect of self-help. Medication has been empirically studied from the perspective of science, amounting to predicting and controlling behavior by means of medication. There are a multitude of very reliable studies that have been done, equating with the efficacy of medication in treating schizophrenia and myriad other diagnosed conditions, such as depressive, anxiety and bipolar disorders.
Often schizophrenics wax delusional in that they feel that taking medication makes them mentally ill, or that stopping their medication will make them sane, or that taking medication is synonymous with being mentally ill, and they should throw their pills away. They may discontinue taking their prescribed medications as a direct result of their delusional stance, or they may discontinue their medication use simply because they do not like the side-effects of medications.
Accepting psychiatric treatment by taking prescribed medications and attending appointments with one’s psychiatrist are perhaps the single most important aspects of self-help that a person with schizophrenia can enact. The use of medication to treat diagnosed psychiatric conditions may be reductionistic, but taking medication might also lead to subjective well-being on the part of the mentally ill individual.
Mental illness, and schizophrenia in particular, entails social isolation. Stigma to a great extent causes this type of alienation, and combating alienation from others is essential in dealing with mental illness. This can be achieved by attending group therapy or support groups. Speaking to other schizophrenics about one’s symptoms and participating in dialogue about mental illness aids one in seeing one’s own problems in the experience of others.
For example, revealing to other mentally ill people one’s delusional ideation, and then asking others how they think it feels to think these thoughts, is a way of reaching for a union with others. Even though they may or may not agree with one’s expression of one’s delusional framework, group therapy or support groups may allow one to feel less isolated. Moreover, the realities of dealing with poverty or childcare, experienced by the mentally ill, may allow one to feel less alienated, as well. Just talking to others and getting out of one’s internal ruminations about one’s psychosis is helpful to the mentally ill individual. As a consequence, seeking interpersonal activity is an extremely important aspect of self-help regarding mental illness and schizophrenia.
In addition to relational activity, vocational activity – whether this involves paid or voluntary employment – is extremely helpful to those dealing with mental illness. Freud said that happiness resides in love and work. In addition to meaningful relationships, work is essential in providing an individual with feelings of self-worth. Many individuals who suffer from serious mental illness are currently engaging in vocational activities, more so than in past decades. These include peer support specialists, who are consumers of mental health services who work in the mental health system, often assisting other consumers with their positive treatment related activities. Even filling the roles of greeters at large stores can help some mentally ill individuals by providing with both relational and vocational activity.
One should remember that it is often not the status entailed by a particular job that is important to job success. Success in vocational activities relies on whether the individual, in this case, one with schizophrenia, fits the niche of that job. Often, the atmosphere of one’s workplace and how the individual feels while he is working will determine her success or her failure. For example, the atmosphere of a fast food restaurant may be too fast-paced for a mentally ill person. This type of stress may lead to failure for the schizophrenic almost inevitably.
The individual schizophrenic should perhaps start slowly by first volunteering at a work venue, where he feels comfortable, for a minimal period of time each week. Then, as he gains confidence, gradually works toward a goal of what he seeks in terms of vocational success. One should realize, however, that a schizophrenic should not exaggerate or minimize what one foresees as his ability in this regard. One must proceed at a slow pace and a exercise a trial and error approach to succeeding in work.
Overall, there are many avenues to better psychological health regarding schizophrenia. These include but are not limited to the use of psychiatric medication. Discovering these avenues may be approached sensibly in terms of understanding the needs that all people have in their lives, and, as mentally ill individuals, trying to modify their approach to fulfilling needs that are universal.
“Love” and “work” are concepts that represent needs for all people. We all need relational and vocational activity in order to combat interpersonal alienation and proceed in activity that gives us a sense of purpose. We all need vocational activity in order to feel worthwhile. We all need relationships with others who perceive us as we are.
Often, the mentally ill stray from the productive avenues of life, due to the fact that no one thinks that they can participate in love and work. Perhaps their symptoms cause a lack of fulfillment of these fundamental needs, even while this lack of need fulfillment may cause their symptoms. The purposes of love and work should be sought with persistence and faith in one’s own ability to fulfill needs in this regard. But first, the mentally ill individual should accept her mental illnesses and accept her use of psychiatric medication.
Lastly, the mentally ill should not embrace or reject the label of schizophrenia without reservation. The danger of stigma and usefulness of this diagnosis should be navigated using good judgment and self-awareness. No one can define what a mentally ill individual may be able to accomplish, and the diagnostic label of “schizophrenia” is not a self-fulfilling prophecy. Ultimately, it is largely to the schizophrenic’s lack of self-esteem, entailed by stigma that is accepted, ambivalently or not so, that determines whether stigma has any power.
One should not allow the terms for mental illness to define them. Stigmatizing labels may make one angry, defensive and degraded, but the word “schizophrenia” has no power. Labels can amount to name-calling by people who have the psychological sophistication of children. Perhaps that is why this author will not acknowledge stigma even to the extent of not using these labels that clearly seem reductionistic.
The choice to be stigmatized by a label is a decision made by the individual who is mentally ill, and the choice to be limited by a diagnosis may be their choice, as well.
Mental Context – A Delicate Subject
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