CHOICES: #10 - Functionality & Society

Robin Cunningham Health Guide

    In previous blogs in the Choices Series, I have suggested that there are three milestones in the Journey of Recovery from schizophrenia: Functionality, Wellness, and Fulfillment. I've also suggested that the starting point for this journey is Acceptance of the fact that we have a serious brain disorder. We've also addressed the idea that evaluating an individual's level of functionality has to be determined on a person-by-person basis and in relation to the person's capacity for functionality. [I believe this should apply to everyone in society, not just those of us with mental illness.] And finally, we talked about the fact that society's definition of functionality often differs from ours to such an extent that it can place us at a disadvantage. From our perspective as people suffering from schizophrenia, grading can only be done fairly on the curve. One size does not fit all. Society, however, does not grade on the curve, and this makes society a tough task master.

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    In this blog we will look at how Functionality as we think of it becomes a part of the Journey of Recovery, and how this compares with society's view of Functionality. And again, because for me and some like me, a picture is better than a thousand words, I'm going to use a couple of charts.


    The chart below (which was addressed in CHOICES: #9) summarizes how, in our Journey of Recovery, with medications and therapy used in tandem, our Functionality can slowly but steadily improve over time.






    In the following chart, I've extracted from the previous graph the black line that represents the increases in Functionality that are possible because of medications and therapy and overlaid with shadings of several colors showing how I believe society tends to define Functionality.



    The first thing to observe about the above chart is that the shadings (red, blue and green), which represent different levels of functionality from society's point of view, are static, i.e., they remain relatively constant with the passage of time. You will also note that the characteristics that describe society's expectations of a person in each level of functionality become increasing difficult to achieve. For example, Basic Stability in the red zone turns to Reliability in the blue zone and Self Starter in the green zone. Similarly, Dependent in the red zone becomes Decision Maker the blue zone and Creativity in the green zone. These terms reflect my belief that society measures functionality primarily in terms of economics - "Can you do the job efficiently?" and "How much are you going to cost me?"


    Some definitions should be helpful.


    Definitions of Basic Stability and up:


    Basic Stability is to be free of the "break-through" of major symptoms, particularly demonstrative behaviors that are disruptive to those around us.


    Reliability is to enjoy Basic Stability along with the additional abilities to be somewhere we are expected, and to do the things we promise to do, both well, on time and without a significant amount of support from others.


    Self-Starter is to enjoy Reliability, but to also to be spontaneous, to initiate things, to be a leader.



    Definitions of Dependent and up:


    Dependent describes a consumer that needs assistance with the challenges of everyday living.


    Decision Maker describes a consumer who is functioning independently and is able to make all the decisions that affect their life.


    Creativity describes a consumer that is capable of making innovative contributions to the lives of others or society as a whole.



    Definitions of Basic Social Skills and up:


    Basic Social Skills include the ability to communicate and interact with others.

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    Social and Job Skills include the ability to function in the workplace alongside others and demonstrate proficiency in the functions of one or more types of jobs.


    Social Skills and Education includes the skills and formal education to work in higher level positions of employment or a profession, such as the general manager of a retail outlet, or even a company as a whole, or in a profession requiring special education and even certification.


    In truth these different levels of functionality may rise or fall over time within a certain range and often overlap. In education for example, there is also an upward trend over time in the expectations characteristic of each zone. While a high school diploma might have sufficed in our parents' time, a college degree is now required.


    This representation of society's view of functionality is also complicated by the fact that, for example, different jobs within a given level of functionality may require different levels of specific types of skills. Social skills are often more important in a sales position than for a machine tool operator. And, a professional athlete must have greater physical strength and dexterity than the typical telephone operator.


    It is important to understand that wellness and fulfillment, the second and third landmarks on the Journey of Recovery, can be realized by consumers at all levels of functionality regardless of what society may think. [Look for the happy faces in the chart.]


    In this blog we have started with a representation of increasing Functionality that I believe is appropriate for those of us with schizophrenia and overlaid what I think is the view of Functionality that society embraces. In my next blog, we will begin to discuss differences between and the interaction of these two definitions in greater detail. Then, more importantly, in future blogs we will look at how we can not only meet the demands of both viewpoints, but use our view of Functionality to advantage.

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    Make a brief comment. Give us your reaction, good or bad. Enter your own SharePost. Your response can be of any length, short, long, whatever, and you can do this anonymously if this makes you more comfortable. But whatever you do, join in our dialogue. We're beginning to develop a running dialogue about all sorts of issue as more and more of you join into the "Choices" series of blogs. We need your insight, your point of view. Remember, you can speak with experiential authority.


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    Please remember, this writing reflects my own experience and opinions. If you, or a loved one, are experiencing the symptoms of schizophrenia, or any other mental illness, you should seek professional assistance.



Published On: November 26, 2007