Monday, October 29, 2018

Don’t Sell Yourself Short if You Have a Psychiatric Disability


Serious psychiatric illness (other than a few developmental disabilities) entails, by definition, a reduction from earlier in the person’s lifetime of the capacity to think, in my observation both as insight into myself and as viewer of others (whom I’ve been thrown in with or see on the streets) who have the problems. The chief difficulty that the person faces in getting better, it seems to me as I look back and as I look around today, is that there isn’t from family and mental health clinicians enough trust that the person can regain autonomy. Yes, there is a recovery movement in full swing; yes, treatment today is deemed to be patient-centered, but the behavior held as potential and prospective for the patient is uninteresting as it is much less than she has previously achieved. Whatever that may have been.

The “human potential movement” of the Sixties had excesses like swimming with dolphins (which latter sounds hard on the hijacked dolphins, but fun for the people), but like many aspects of cultural history had a good point to make. People are more than they present with. Even patients with serious mental illness.

Yes, there is a certain reduction of autonomy inherent in being a psychiatric patient with such a level of disability, but no, that reduction should not be accepted and even colluded in by clinicians.

As someone with ten years of informal and thereafter 34 years of diagnosed status through 2018, I do know that there is “disrespect” given by the world--even by clinicians, as well as the actual provocations given by the patients. (And, yes, I’ve given more than my fair share of trouble, such as reneging on commitments and being hostile to my brother in particular,)

Things are far better today than in the early Eighties, when for example I was turned away from care at a dentist’s office due to having filled in on its medical history form that I had mental illness (the Americans with Disabilities Act and various anti-stigma campaigns have helped). But there is still too much painting today of people who are psychiatric clients as though they are unworthy of dignity.

One aspect of this situation that I believe should garner more attention is that hope for a return to full prior personality  (not for the patients to be obsequious, which seems to be clinicians’ desire for patients at least in hospital and clinic settings still today) should be what is most strongly urged for patients by clinicians, especially for depressed patients--and in my observations, almost all patients have at least episodes of depression. If the clinicians can’t give respect now, they should communicate that respect is around the bend for patients who can hang in there.


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