Continuing this series about the seven recovery skills, I'll talk about "invested." To be invested in your recovery is to understand the role you play in the process. You need to understand the actions you take have consequences. If it's sunny out and you fail to wear sunscreen, you can get skin cancer. So, too, with SZ: what you do or fail to do has consequences.
How can someone develop awareness of how his actions help or hinder him? Those with anosognosia will possibly not come to this independently, yet can be guided to treatment by someone they trust. The technique of motivational interviewing can be used to find out what a loved one's goals are and gently suggest that staying in treatment could enable him to achieve them. At a NAMI convention Ask the Doctor session, one woman said her son who refused to take meds wanted to find a wife. Ken Duckworth, the medical director of NAMI, told her to tell him that if he took the medication, he would be able to be in a relationship.
Sometimes, all it takes to turn around a person with SZ is having someone who listens to him. For a peer's perspective on understanding delusions, click on this link to one of my earlier blog entries: http://www.healthcentral.com/schizophrenia/c/120/31844/understanding. The process of becoming aware can be aided when someone sits with a person for an hour and listens, even if no words are exchanged in that hour. The point is not to question the belief system, even if you fear your silence will indicate you believe what's going on is true. Walk in their shoes for a mile.
A great way to be invested in the outcome of your recovery is to throw yourself down a challenge. In my own life, because I believe that people can recover, I have a lot at stake, so that motivates me to stay healthy, take meds, and practice what I preach. You can be a role model once you have a measure of stability, or seek out a role model or mentor early on when you're struggling. I feel deeply that people with SZ need role models. If we see people who have successfully managed their illness living out in the world, there can be no shame in taking medication. To be invested in your recovery means that you take an active part in creating your treatment plan and setting goals that make sense to you and that are chosen in consultation with you.
The idea of denial I'd like to return to here, as a community member at the Connection wondered how I was able to develop the insight that I needed life-long treatment. Denial is a coping mechanism, a way of processing information when the truth is too painful to confront. When I found my first job and moved into the studio by the beach, I was the first person I knew to do these things, so I didn't believe I was sick. Even today the ones doing well don't want to disclose because the stigma is too great. I recommend a sister's blog, http://gaining-insight.blogspot.com, where she talks about this in detail. She describes the effect of stigma on the choices we make: to go off meds, to not seek treatment, and to not want to have SZ because of the stereotypes of people diagnosed with this condition.
When I relapsed, it was a come down. I had to accept rather quickly that if I didn't take the meds my brain would revert back to chaos. I connected the dots; I realized that would be my life: revolving in and out of the hospital. I got hip faced with this reality. Certainly it is harder if someone has anosognosia, which is a symptom of the SZ that affects the brain. Possibly I had this awareness because I could link cause-and-effect. I knew that I alone was responsible for the decision to go off the meds, and I knew that I got sick again because of this decision.
I'm motivated to tell my story because the cost to society, the burden on families, the lost potential of individuals due to untreated SZ is too high. How could I turn a blind eye? I knew from my own experience that treatment works. Getting people into treatment is another story. It's the great good fight we fight every day.
In coming blog entries, I'd like to feature guest bloggers, caregivers and peers who are at a different place who can offer their own viewpoints and share their experiences. I would like to shift the focus and talk about strategies that could be helpful to people who are just starting out as well. Kindly e-mail me at the Connection if you'd like to be considered.
Published On: February 22, 2009