“Thirty years ago, I was given a diagnosis of schizophrenia and my prognosis was grave. I would never live independently, hold down a job, find a loving partner nor get married. My home would be a board-and-care facility, my days spent watching TV in a day room with other people debilitated by mental illness. I would work at menial jobs when my symptoms were quiet. After my last psychiatric hospitalization at the age of 28, I was encouraged by a doctor to work as a cashier giving change. If I could handle that, I was told, we would reassess my ability to hold a more demanding position, perhaps even something full time. And that was when I made a decision to write the narrative of my life. Today I have an adjunct appointment in the department of psychiatry at the medical school of the University of California, San Diego and am on the faculty of the New center for Psychoanalysis.”
“Over a period of time, I came to accept that I have schizophrenia and will have to be in treatment for the rest of my life. Excellent psychoanalytic treatment and medication have been critical to my success. WHAT I REFUSED TO ACCEPT, WAS MY PROGNOSIS and that made all the difference.”
“Conventional psychiatric thinking and its diagnostic categories believe that people like me don’t exist. Either I don’t have schizophrenia (please tell that to the delusions crowding my mind) or I couldn’t possibly have accomplished what I have. I have undertaken research with colleagues at USC and UCLA and I discovered others with schizophrenia with such active symptoms as delusions and hallucinations, who have significant academic and professional achievements.”
“Over the last few years, my colleagues and I have gathered 20 research subjects with high-functioning schizophrenia in L.A. They suffered from symptoms like mild delusions or hallucinatory behavior. Their average age was 40. Half were male and the other half female, and more than half were minorities. All had high school diplomas and a majority either had, or were working toward, college or graduate degrees. They were managers, technicians and professionals, including a doctor, a lawyer, a psychologist and the chief excecutive of a non-profit group.”
“At that time, most were unmarried and childless which is consistent with their diagnoses. We learned that in addition to medication, the participants had developed techniques to keep their schizophrenia at bay. For some, these techniques were cognitive. An educator with a master’s degree said he had learned to face his hallucinations.”
Another said; ‘I hear derogatory voices all the time.’ Another technique included controlling sensory input. for some, this meant keeping their living space simple. (bare walls, no TV, only quiet music ) while for others, it meant distracting music. ‘ I listen to loud music if I don’t want to hear things,’ said another. What has helped most of them was WORK “Work has been an important part of who I am, too.”
Elyn says that she reaches out to her doctors, friends and family whenever she starts slipping and gets great support from them. She finds it distressing when doctors tell their patients not to expect or pursue fulfilling careers. Far too often, the conventional psychiatric approach to mental illness is to see clusters of symptoms that characterize people. Accordingly, many psychiatrists hold the view that treating symptoms with medication is treating mental illness. But this fails to take into account individuals’ strengths and capabilities, leading mental health professionals to underestimate what their patients can hope to achieve in the world.
An approach that looks for individual strengths in addition to considering symptoms, could help dispel the pessimism surrounding mental illness. Finding the wellness inside the illness should be a therapeutic goal.
Doctors should urge their patients to:
- develop relationships
- and to engage in meaningful work.
- They should encourage patients to find their own repertory of techniques.
- They should manage their symptoms and aim for a quality of life as they define it.
- And they should provide patients with the resources – therapy, medication and support, to make these things happen.
‘Every single person has a unique gift or unique self to bring to the world,’ said one of the study’s participants. She expressed the reality that those who have schizophrenia and other mental illnesses, want what everyone wants: in the words of Sigmund Freud … to work and to love.”
Personally, I would like to add one more word that Elyn Saks has not mentioned here, and that is HOPE. I doubt whether anyone can live without hope.