The National Alliance on Mental Illness peer support model suggests that the experience of mental illness is traumatic in and of itself, and we are left in "shell-shock." Healing takes place when we recognize our feelings and work through them. NAMI's Stages of Emotional Responses to Trauma is a useful guide to doing just this.
The first stage is Dealing With Catastrophic Events. Crisis is often the word used to describe an acute episode, with chaos being how we describe our minds and lives, and the shock takes different forms, including disbelief or numbness. We go from denial to normalizing to hoping against hope.
Our needs here include support, comfort, and empathy for confusion, help finding resources, crisis management, reassurance, empathy for pain and permission to be numb. Indeed, like with any response to a loss, we are in shock and feel numb.
The next stage is Learning to Cope. Here, anger/guilt/resentment has a negative impact on self-esteem, and there is the beginning of recognition, and of grief. We have these needs: to permit and vent feelings, to keep hope, and for education, self-care, networking, skill training and letting go and learning the system.
In learning to cope, perhaps the first buds of hope begin to bloom. When I first got sick, I set simple goals: to buy a box of Tide to do the laundry; to shower five nights a week and wear appropriate, subtle makeup.
In this stage, we begin let go of the anger and sadness, and recognize that things can get better. As we deal with our grief, we replace regret with acceptance of what's possible. It may not be the life we wanted or intended, yet it can be a better life than we imagined.
As surely as pumpkins appear every Halloween, we go from denial to anger to recognition to grief. Too often we internalize the shame that we have an illness. Does a heart attack victim go through such agony? Guilt about having schizophrenia is reinforced by the media stigma and public misunderstanding about the nature of the illness.
The third stage, Moving Into Advocacy, involves understanding, acceptance and advocacy/action. We understand what has happened and what may be; we accept we have a condition and are okay with it; and we either advocate for ourselves by "quietly living well" or robustly serving others.
Our needs here include activism, restoring balance in life, responsiveness from the System, finding meaning, and a sense of empowerment. We gain strength and courage by seeking out others. Yet at this time to restore balance we need to set boundaries. We show respect for others and ourselves by setting clear limits on our time and energies.
My guiding motto is: "If it doesn't fit, I can't commit." I learned the hard way that doing too much in one day can lead to extreme fatigue: last Tuesday night I had such blurred vision I couldn't see.
According to NAMI, "Recovery does not mean getting to the last stage and never looking back . . . recovery means gathering the healed bits and the not-so-healed bits and doing the best we can in the moment to live with it all." That is self-advocacy: the assertion that we are okay as we are, taken in total, always doing our best to live well.
The stages of emotional responses to trauma also mirror the grieving process, when one works through denial, anger, bargaining, depression and acceptance. Any of these five tendencies can happen at any time in the process of recovery.
My belief is that anger is the catalyst for change, but it is never the solution in and of itself. We need to move from the anger to acceptance. Anger is an energy that can eat away at us if we don't halt it. Unchecked angry feelings are a great weight.
I hope this blog entry gets you to deal better with your illness by knowing where you are on the curve and in what stage, so you can come to some understanding and acceptance.
Healing is the process of forgiving ourselves for getting sick, making the choice to focus on wellness, and letting go of the pain surroundig the diagnosis.
I wish you good fortune as you start on the road to healing through feeling. Some things you can't keep inside. Try joining a support group if you need the place to work on your feelings.
Published On: November 09, 2007