Sunday, February 27, 2011

Community myths about schizophrenia recovery

I came across the sad story the other day of Tom Cavanagh, a young, Harvard graduate and professional hockey player who killed himself.

For those closest to Cavanagh, his illness became apparent in November 2009 when he suffered his first psychotic episode. He was briefly institutionalized and, in what would become a pattern, responded well to medication and was released. He even joined the AHL's team in Manchester, N.H., later that season, playing in 17 games before suffering a shoulder injury.

He was hospitalized again in April after becoming violent and breaking furniture in a doctor's office. But he was well enough to begin this season with an AHL team in Springfield, Mass.

"It's amazing how he was able to perform at such a high level, knowing what we do now," said Riley, Cavanagh's coach at Springfield. "But God only knows what he was dealing with outside the rink."

One can marvel at the fortitude of this young man to keep himself together enough to get out and play professional hockey despite the diagnosis of schizophrenia, or one can wonder what was everybody thinking? I'm in the latter camp. Schizophrenia is a major crisis point, and it's not business as usual. The business as usual approach to schizophrenia seems positive and encouraging, but it is not. I call it false positivism.

When we first consulted a psychologist about Chris's strange behavior, Chris was two weeks away from going back to university a continent away from where we lived. Everybody's expectations, including ours and Chris's, were focused on that goal.  The psychologist seemed  to think that it was just a matter of getting the right meds and then Chris would be back on track at university. He suggested that we arrange an appointment with a psychiatrist connected with Chris's university before classes resumed for the fall term. When Chris was admitted to hospital a few months later (still not on meds at that time), the doctors and social worker talked of the possibility of Chris resuming his classes, being on meds, and having a social worker drop in to check on him once a week. That dream was short lived as Chris actually got worse while in the hospital. He dropped out of university when he was released three months later.

A rosier outcome than was Chris's at that time can happen, but how often does it? How realistic is it for someone to pick up their hockey, their studies or their job so quickly after receiving an earthshaking diagnosis? We know that people get short changed in mental health care because of the expense of time in Western cultures. We are told that pills will make us productive. Schizophrenia, diagnosised or otherwise, means that something isn't working and it's time for a time-out, a long time out. Perhaps this young man, Tom Cavanagh, was living out the dreams of his father and the rest of his family, and it got to the point where he couldn't go on as he had been doing because he didn't know who he was. "He would tell me that he can't feel any emotion, that he can't engage with people, that he felt disassociated and that this was the way he felt his whole life," Joe Cavanagh said. 

Author Joseph Campbell sees a schizophrenia breakdown as an inward and backward journey to recover something missed or lost, and to restore a vital balance.  Don't cut the individual off, work with him, Campbell advised.

People like Tom Cavanagh are given drugs and told the falsehood that the drugs are the best and the quickest way to manage the life you had before you got side-swiped. Your parents will be relieved and optimistic and you will become part of the larger community myth of recovery. There is no mention of spiritual and existential problems that need to be addressed. This scenario works until it doesn't. Tom Cavanagh couldn't sustain the myth. What he needed was a lot of therapeutic help and understanding up front. He would need intensive support for a long, long time, but he could recover. This is not part of the medication based myth of recovery.

Exposing the business as usual myth of recovery should put the spotlight back on real recovery as a long, slow process needing periods of rest and reflection and minimal to no use of medication. The basis of being told this should come from a place of optimism, that there is a brighter tomorrow and it will come, with effort, just not now. Sometimes doctors will explain recovery this way, but often what you are told comes from a base of pessismism. Doubt is interjected because the medical community, by and large, doesn't believe in the drugless optimistic approach.  When the myth of the speedy recovery by drugs is exposed, the mental health community lies to the public again by telling us that there was never any chance anyway. They now tell us that schizophrenia is a life sentence. In Tom Cavanagh's case, the doctor painted a picture to the parents that death may be the only release for a diagnosis of schizophrenia. The obvious question that I would raise would be then why did you lie to me about speedy recovery?

Cavanagh's doctor sat with the family later to explain why Tom might have done this. He told them how the schizophrenia can manifest itself in males in their mid to late 20s. It can be, he said, a raging fire that grows out of control."He painted a rather dismal picture of what the future is for someone with this disease," Joe Cavanagh said. "That's why we're happy that he didn't hurt someone and he's not in jail."

The myth of the medical cure and speedy recovery is once again being use to prop up the community myth of the unhealable schizophrenic.

10 comments:

  1. "He would tell me that he can't feel any emotion, that he can't engage with people, that he felt disassociated and that this was the way he felt his whole life,""

    What is the expected response here? Examine the alternatives to find a truth.

    So, by the sufferer, is this an expression of joy? happiness? relief? a statement of fact from a robot? or I think really - a complaint?

    A complaint? Then there is something to work with. "How do you wish to engage?" Etc. The work begins, doesn't it?

    Even a butterfly dreams, I think there is always something to work on.
    Nobody is not a person, if SZ are not people then just dope 'em up - no point. Biomed shrinks think they are not people. Everybody is a desiring organism there is always something at the root. Possibly something that is frustrated. Suicide is the frustrated desire for life.

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  2. While society at large, drug companies, and psychiatrists all possess their own myths regarding schizophrenia, be mindful that you and I and others who have rejected their common beliefs also have our own myths and beliefs.

    For example you have a belief that recovery is a ten year process and you are professing this myth. Sometimes we take our own experience and generalize it. Is this fact? Not necessarily. Some people recover quicker than this and others never recover. I think a lot of time is wasted while we fumble around for something that works and while we undo and overcome the damage imposed by the limiting generalized beliefs of psychiatrists and society.

    While there may be similarities in the behavioural patterns of individuals who have been classified as schizophrenic we need to respect that each individual is in fact just that, an individual and they deserve to be treated as such, with compassion and love. I believe that the relationship that develops during the recovery process is more important than the methods employed to aid recovery.

    I also believe that every individual who recovers does several common things:

    1) They reject their diagnosis and the limiting beliefs imposed by psychiatrists, society, and their formative experiences.

    2) They decide they deserve and want a functional, happy, and prosperous life and a relatedness to themselves, their families, and other human beings in society.

    3) Most importantly they take responsibility and their thoughts and actions are consistent with being responsible and pursuing and achieving goals.

    I am inclined to think that we spend too much time overanalyzing the past and too little time focused on the present, and creating the future, absent the limiting beliefs derived from the past.

    I am reminded of three Inuit men who were out on the land in northern Canada and who had lost their way. When one said to the others "We're lost!" Another replied "We're not lost. We're here!"

    We are never lost in the present moment. We are here. We are only lost in how we relate the present to the past and the future.

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  3. Anon: There is no commonly agreed upon definition of "recovery" and the word is often used deceitfully by pharmaceutical propaganda> The loose knit "survivor" community started to use this word in the 1980's before that it had no common meaning associated with mental health - if it did I don't think many people heard it, including myslef.
    I have no idea why people would want to use that word with the "RE-", any kind of healed person from mental illness would be something new, something that hasn't existed before. I think the Pharma companies promoted the use of this word because their definition of "recovery" means "stabilized on meds" - but even in that the consumer has not gone back to anything - it is something new - a different sort of dragged down or lop-side consciousness, for most, anyway.

    Even though you stated some attributes of you definition of recovery I have no real idea of what you mean by "recovery because you did not define it.
    ...
    Defining this word for those that use it is a step forward in growth.

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  4. Recovery, to my mind, is the ability to overcome the confining context, the social stigma, the limitations, the condition, and the medication, to live an empowered, productive, satisfying, and self-sufficient life, absent any dependence on medical or pharmaceutical care.

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  5. Often when I think of people with a schizophrenia diagnosis I try to put myself in their shoes, and I think, God, what if I would actually want drugs?! I can imagine that.

    But what I often fail to recognize is that while the psychic reactions or delusions are apparently stronger than anything I’ve ever experienced, perhaps so too are the reserves and creativity of the people having them. Meaning that I have from time to time been subject to anxiety and indecision, but I have over time come to feel equal to it. Therefore, is it not possible that those who have received the schizophrenia diagnosis are not similarly equal to their challenges?

    So when people say, ‘imagine if you went into a manic phase,’ or ‘imagine if you had delusions,’ as a way of pushing the drug scenario, it might not be a fair analogy.

    Just one of my thoughts today.

    -B'ham

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  6. I think it's quite impossible to say how someone, even if that someone is oneself, will experience any given situation, and how they will react to it, as long as they aren't in that situation. If anybody had been able to tell me what I was going to experience, I'd probably said, OMG! I'm not going to survive that! I believe that we grow with and through our experiences, in the sense that the challenging ones open our eyes to how strong we actually are. Everyone of us. Wanting drugs is probably more a result of others telling us how weak ("sick") we are, and us believing in this, than of an actual lack of inner strength, or reserves and creativity.

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  7. Anonymous said :"I also believe that every individual who recovers does several common things:

    1) They reject their diagnosis and the limiting beliefs imposed by psychiatrists, society, and their formative experiences.

    2) They decide they deserve and want a functional, happy, and prosperous life and a relatedness to themselves, their families, and other human beings in society.

    3) Most importantly they take responsibility and their thoughts and actions are consistent with being responsible and pursuing and achieving goals."


    I one hundred percent agree with this, Anonymous, for this process led to my recovery as well. With such insight into real recovery, I have to wonder why you are anon :). Hopefully you will spread that wisdom to others, if not here in the blog world, than in your day-to-day life.

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  8. Anonymous,

    I'm on the same page as Jane.
    Your thoughts are right on the mark!

    Thank you,

    Duane

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  9. Recovery... a poem -

    http://kaleidoscopes.co.za/html/recovery.html

    Duane Sherry

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