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Coping With Schizophrenia Requires Effort...
The following is an adaptation by the Menninger Letter of ?Twelve Aspects of Coping for Persons with Schizophrenia? by Frederick J. Frese, Ph.D. (Innovations and Research, Vol 2., No. 3, 1993, pp. 39-46.)
I am a person with schizophrenia. I am not currently psychotic, but I have been in the state of psychosis often enough to be somewhat familiar with the trips there and back.
A few years ago I decided to talk openly about my experiences with schizophrenia. My initial talks on the theory and politics of caring for the mentally ill were well received.
But I soon learned that most nonprofessional audiences prefer to learn how families can cope with the condition. I now focus on 12 aspects of coping with schizophrenia: denial, knowledge , medication, delusional thinking, social deficits, replaying, expressed emotion, stress, music and hobbies, stigma, revealing, and networking.
Denial and acceptance
I can?t tell you how difficult it is to accept a diagnosis of schizophrenia. Humans are governed by logic and reason: the unreasonable is unacceptable. But this disorder disrupts brain chemistry and fools you into believing that your thoughts are rational when other people can usually tell that they?re not.
Psychosis is a ?catch-22.? If you understand that you are insane, then you?re thinking properly and are therefore not insane. You can be psychotic only if you believe you are not. It is generally best not to confront denial outright, but rather to chip away at it. Acceptance of the diagnosis can help motivate us to learn more about the disorder.
With people who deny that they have the disorder, it is helpful to point out to them that they are being treated by others as though they have a mental illness. Once they concede this point, they may be more willing to seek medical treatment.
Knowledge of the disorder
Schizophrenia is now widely accepted as a brain-based imbalance in the biochemistry of the neurotransmitting systems. On a practical level, it disturbs thought and belief systems and affects confidence in what is truthful. It can even evoke mystical experiences that seem very real, but which mus be viewed as a symptom of an illness that requires treatment.
Medication
People who are physically disabled can be helped by artificial supports such as seeing eye dogs, hearing aids, or crutches. Schizophrenia requires the chemical ?crutch? of neuroleptic medication. Without it, I would not be able to function as I do today. True, some medications have serious side effects, but new drugs are constantly being developed, and many of them are more effective with fewer side effects.
Delusional Thinking
Our psychological systems were designed to protect us from reasonable amounts of stress. Stress affects everyone, but different individuals react in different ways, and sustained stress affects various physiological functions and thought patterns.
When normal brain functioning is disrupted, our brains revert to responding from our emotional center rather than from our center for rational thought processing. It is important for us to recognize that stress can overload our rational capacities and make us react in an overly defensive, vigilant, or delusional way.
Social deficits
People with schizophrenia tend not to look at the person they?re conversing with. There is a good reason for this avoidance of eye contact. We?re more easily distracted, and the other person?s facial expressions can make it difficult to focus on what we are trying to say. Because we?re slower to process information our recognition of what the other person says is often delayed.
These tendencies throw off the rhythm of conversation because they disconcert other people. We also have trouble knowing when and how to end a conversation. But, if we can get other people to understand these social deficits, then we can work together to overcome them.
Replaying/rehearsing
In psychiatric hospitals patients often appear to be talking to people who aren?t really there. Sometimes these patients are responding to voices, but not always.
Those of us with schizophrenia are quite sensitive to having our feelings hurt. We may seek to protect ourselves by replaying past painful experiences and then rehearsing responses (often out loud) that might be useful in the future.
But we need to recognize this tendency and understand that it may upset other people. Since my own inclination to talk out loud annoys my wife, I try to confine myself to doing so only in the shower of while mowing the yard.
Expressed emotion (EE)
The EE concept focuses on the relationship between family and other environmental characteristics and the likelihood of relapse by persons recently released from hospital treatment. Researchers have found that patients who go back to live with family members who frequently express emotional over-involvement or negative emotions (resentment, hostility) are much more likely to relapse than those who live with families who are les emotionally expressive.
Those of us with schizophrenia need to avoid persons, place, and activities where we are likely to encounter high expressed emotion. We also need to learn how to let others know something about the nature of our disability and what triggers a relapse.
Stress and excitement.
Stressful and stimulating situations tend to cause relapses. My own breakdowns often occur while I am attending conferences or shortly thereafter. Even visits to s shopping mall can be too stressful. I find it helpful to limit my exposure to, or withdraw slightly from, such situations. Adjusting medication dosage might also be made in consultation with one?s doctor.
Music and hobbies
Because the ability of persons with schizophrenia to sustain rational processes is damaged, activities that do not tax logical abilities are often helpful. Music, art, and poetic forms can all be used as a way to communicate.
These aesthetic expressions can release pressures and be most and be most therapeutic. Such activity has been called ?woodshedding,? from the jazz musician?s custom of experimenting in isolation until the sounds form patterns that others can appreciate. Woodshedding in any expressive art can build bridges back to the world of normality.
Stigma/discrimination
Traditionally, persons judged ?insane? were summarily dismissed as unimportant by the general population. When we started returning to society, we were often unwelcome. The media have mostly portrayed mentally ill persons as monsters. Although such conditions as cancer and heart disease can be openly discussed, the topic of schizophrenia elicits emotional reactions of fear or derisive humor.
Those of us who find ourselves unwelcome in what I sometimes call ?the chronically normal community? must work together to change our image. We can promote greater understanding and acceptance by being open about the nature of mental illness.
Revealing/covering
Recovered mentally ill persons often contact me about whether to reveal their condition to others, especially employers. I usually encourage them to show their boss an article about me or another recovered person as a way to gauge that person?s receptivity?and then to be guided by the reaction they elicit.
As a practical matter, however, many people should probably not be too open about their past. ?You can usually account for time spent in the hospital or spells of unemployment in creative ways that involve no real falsehood?such as by indicating you were doing freelance work, consulting, or writing.
Networking
When I was released from the hospital, I had trouble connecting with other former patients. But that?s changing because organizations such as the National Alliance for the Mentally Ill (NAMI) have established a national network with groups in all large cities and many smaller ones nationwide. It has been my experience that recovering persons benefit greatly from associating with others with similar disabilities.
To locate a NAMI affiliate in your area, call their national office at 1-800-950-6264.
___________________________________________
Frederick Frese, Ph.D. is coordinator of Recovery Services for Summit County, Ohio. He has a website: fredfrese.com and can be reached online at fresef@admboard.org.
Article source is from Dr Frese's website here:
http://fredfrese.com/?q=node/view/2
The following is an adaptation by the Menninger Letter of ?Twelve Aspects of Coping for Persons with Schizophrenia? by Frederick J. Frese, Ph.D. (Innovations and Research, Vol 2., No. 3, 1993, pp. 39-46.)
I am a person with schizophrenia. I am not currently psychotic, but I have been in the state of psychosis often enough to be somewhat familiar with the trips there and back.
A few years ago I decided to talk openly about my experiences with schizophrenia. My initial talks on the theory and politics of caring for the mentally ill were well received.
But I soon learned that most nonprofessional audiences prefer to learn how families can cope with the condition. I now focus on 12 aspects of coping with schizophrenia: denial, knowledge , medication, delusional thinking, social deficits, replaying, expressed emotion, stress, music and hobbies, stigma, revealing, and networking.
Denial and acceptance
I can?t tell you how difficult it is to accept a diagnosis of schizophrenia. Humans are governed by logic and reason: the unreasonable is unacceptable. But this disorder disrupts brain chemistry and fools you into believing that your thoughts are rational when other people can usually tell that they?re not.
Psychosis is a ?catch-22.? If you understand that you are insane, then you?re thinking properly and are therefore not insane. You can be psychotic only if you believe you are not. It is generally best not to confront denial outright, but rather to chip away at it. Acceptance of the diagnosis can help motivate us to learn more about the disorder.
With people who deny that they have the disorder, it is helpful to point out to them that they are being treated by others as though they have a mental illness. Once they concede this point, they may be more willing to seek medical treatment.
Knowledge of the disorder
Schizophrenia is now widely accepted as a brain-based imbalance in the biochemistry of the neurotransmitting systems. On a practical level, it disturbs thought and belief systems and affects confidence in what is truthful. It can even evoke mystical experiences that seem very real, but which mus be viewed as a symptom of an illness that requires treatment.
Medication
People who are physically disabled can be helped by artificial supports such as seeing eye dogs, hearing aids, or crutches. Schizophrenia requires the chemical ?crutch? of neuroleptic medication. Without it, I would not be able to function as I do today. True, some medications have serious side effects, but new drugs are constantly being developed, and many of them are more effective with fewer side effects.
Delusional Thinking
Our psychological systems were designed to protect us from reasonable amounts of stress. Stress affects everyone, but different individuals react in different ways, and sustained stress affects various physiological functions and thought patterns.
When normal brain functioning is disrupted, our brains revert to responding from our emotional center rather than from our center for rational thought processing. It is important for us to recognize that stress can overload our rational capacities and make us react in an overly defensive, vigilant, or delusional way.
Social deficits
People with schizophrenia tend not to look at the person they?re conversing with. There is a good reason for this avoidance of eye contact. We?re more easily distracted, and the other person?s facial expressions can make it difficult to focus on what we are trying to say. Because we?re slower to process information our recognition of what the other person says is often delayed.
These tendencies throw off the rhythm of conversation because they disconcert other people. We also have trouble knowing when and how to end a conversation. But, if we can get other people to understand these social deficits, then we can work together to overcome them.
Replaying/rehearsing
In psychiatric hospitals patients often appear to be talking to people who aren?t really there. Sometimes these patients are responding to voices, but not always.
Those of us with schizophrenia are quite sensitive to having our feelings hurt. We may seek to protect ourselves by replaying past painful experiences and then rehearsing responses (often out loud) that might be useful in the future.
But we need to recognize this tendency and understand that it may upset other people. Since my own inclination to talk out loud annoys my wife, I try to confine myself to doing so only in the shower of while mowing the yard.
Expressed emotion (EE)
The EE concept focuses on the relationship between family and other environmental characteristics and the likelihood of relapse by persons recently released from hospital treatment. Researchers have found that patients who go back to live with family members who frequently express emotional over-involvement or negative emotions (resentment, hostility) are much more likely to relapse than those who live with families who are les emotionally expressive.
Those of us with schizophrenia need to avoid persons, place, and activities where we are likely to encounter high expressed emotion. We also need to learn how to let others know something about the nature of our disability and what triggers a relapse.
Stress and excitement.
Stressful and stimulating situations tend to cause relapses. My own breakdowns often occur while I am attending conferences or shortly thereafter. Even visits to s shopping mall can be too stressful. I find it helpful to limit my exposure to, or withdraw slightly from, such situations. Adjusting medication dosage might also be made in consultation with one?s doctor.
Music and hobbies
Because the ability of persons with schizophrenia to sustain rational processes is damaged, activities that do not tax logical abilities are often helpful. Music, art, and poetic forms can all be used as a way to communicate.
These aesthetic expressions can release pressures and be most and be most therapeutic. Such activity has been called ?woodshedding,? from the jazz musician?s custom of experimenting in isolation until the sounds form patterns that others can appreciate. Woodshedding in any expressive art can build bridges back to the world of normality.
Stigma/discrimination
Traditionally, persons judged ?insane? were summarily dismissed as unimportant by the general population. When we started returning to society, we were often unwelcome. The media have mostly portrayed mentally ill persons as monsters. Although such conditions as cancer and heart disease can be openly discussed, the topic of schizophrenia elicits emotional reactions of fear or derisive humor.
Those of us who find ourselves unwelcome in what I sometimes call ?the chronically normal community? must work together to change our image. We can promote greater understanding and acceptance by being open about the nature of mental illness.
Revealing/covering
Recovered mentally ill persons often contact me about whether to reveal their condition to others, especially employers. I usually encourage them to show their boss an article about me or another recovered person as a way to gauge that person?s receptivity?and then to be guided by the reaction they elicit.
As a practical matter, however, many people should probably not be too open about their past. ?You can usually account for time spent in the hospital or spells of unemployment in creative ways that involve no real falsehood?such as by indicating you were doing freelance work, consulting, or writing.
Networking
When I was released from the hospital, I had trouble connecting with other former patients. But that?s changing because organizations such as the National Alliance for the Mentally Ill (NAMI) have established a national network with groups in all large cities and many smaller ones nationwide. It has been my experience that recovering persons benefit greatly from associating with others with similar disabilities.
To locate a NAMI affiliate in your area, call their national office at 1-800-950-6264.
___________________________________________
Frederick Frese, Ph.D. is coordinator of Recovery Services for Summit County, Ohio. He has a website: fredfrese.com and can be reached online at fresef@admboard.org.
Article source is from Dr Frese's website here:
http://fredfrese.com/?q=node/view/2
