Recovery and Functionality
At 3:30 in the afternoon on Sunday, April 8, 1956, Satan spoke to me for the first time. At 11:00 in the morning on Friday, April 13, 1956, I saw Dr. Levy, my first psychiatrist, for the first time. Within the hour, I had taken my first dosage of the only neuroleptic then available. Unbeknownst to me, at that moment, my life-long struggle to establish and maintain my recovery had begun.
There is no cure for schizophrenia; it is a chronic condition. Recovery is best viewed as a journey, not a destination. It's a process, not a product. Recovery is a way of managing our illness.
Although all of us with schizophrenia experience many of the same types of symptoms, such as delusions or hallucinations, the precise affects of this chronic condition on each of us is unique. This means the process of recovery, the means we use from day to day to manage our illness, also has many common elements, and yet for each of us, the journey of recovery is unique.
The acceptance of the fact that we have schizophrenia seems to be a prerequisite for creating our own recovery. The essential tools needed to construct our recovery seem to be medications and cognitive behavioral therapy. The medication or combination of medications that work for some may not work for others, so although we all take medications, the mix varies widely. The systematic and purposeful processes of changing our thinking and behavior provided by cognitive behavioral therapy permits us to overhaul or recreate ourselves in profound ways that promote functionality.
If the process of recovery for each of us is unique, how do we measure our progress in this important endeavor? Functionality seems to be the most widely accepted "unit of measurement." But how much functionality is enough? And what specific features of our functionality are essential to our recovery? As it turns out, the answer to these questions can vary widely depending not only on whom you ask but also on why you are asking. Ten separate inquiries may produce forty different answers. I believe this is as it should be.
As I've said in previous blogs, society largely grades in absolute terms (scores of 90 and above get an A, scores from 80 to 90 get a B), while I believe consumers should be graded on the curve relative to their capacity for functionality (a consumer that performs to the best of their ability gets an A; one that slacks off gets a D or even a F.)
In many incidents common sense requires society to grade in absolute terms. I'm not interested in taking a commercial flight when the pilot and copilot both flunked flight school, or are not certified for the type of airplane they are flying. And I'm not interested in having surgery done by a surgeon who was the last in his class at medical school, despite the fact that he is called "doctor."
On the other hand, the person that I described in previous blogs, the one that delivers coffee every morning to residents of a local nursing home, I would give an A. This young man is treatment resistant (there are no medications that provide him with any relief from his agonizing symptoms of schizophrenia), yet he gets up every morning and brings cups of joy to over a hundred persons in the twilight of their lives. He is living up to his capacity for functionality and is doing so in a most compassionate way.
But what happens when those of us with schizophrenia (who grade ourselves on the curve) and society (which grades in absolute terms) intersect? This will be the topic of my blog next week.
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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.