Autonomy the Goal

Autonomy should be the goal of every psychiatric encounter. Too often, the goal instead is some form of restraint or overcoming of a symptom of a diagnosis—quite the opposite. Every human being has the potential for greatness in some skill or art, and it should be the goal of his or her psychiatric clinicians to draw it out.

To me, autonomy means being self-directed. This parses out to:

·         Being a connoisseur of the glory of the world;

·         Being an evaluator of what is presented to you; and

·         Not being a pawn of the last stimulus.

Being a connoisseur of the glory of the world:

Appreciation of the greater world around you is central to being able to be alone. In a world of screens, being able to be alone is to be able to reach one’s spiritual center. You need a rich inner life, and this is developed only through having lived a varied life of many sorts of experiences.

Being an evaluator of what is presented to you:

All stimuli are not created equal. That which enhances self-direction is preferable to that created as a (mass-market) meme on the web.

Not being a pawn of the last stimulus:

Self-direction requires having parsed out and thus knowing your own values and seeking to promote them.

This involves looking to your own goals and objectives.

It also requires not being susceptible to outside influences, beyond the needs and wants of any peson or creature central to your values.

Autonomy segues into living a life that you direct. Not responsive to what outside influences say is to be valued, unless you have examined those values and found them worth integrated into your life. Instead, you need to live according to your own values and encourage others to support you in that endeavor—as you will reciprocate for them.

Never, Ever Give Up!

You can find many inspirational stories about never giving up hope. Just search for perseverance among entrepreneurs, inventors (such as Thomas Alva Edison for one,) and artists in any medium. Such a biographical précis of your choice can inspire you to hang in there. A better day will come. No matter what your present circumstances. Only death obviates hope.

I suggest that every therapist put emphasis on collecting songs, or if the patient is interested, poems, on not giving up. My favorite is Edgar A Guest’s “It Couldn’t Be Done.” It’s followed me from bulletin board to board these many decades, tacked up as flag of hope.

Whether or not you have a therapist, you can help yourself immensely by collecting stories of positive thinking. I found something similar to the following in a fortune cookie once:

If you are not satisfied because you didn’t get what you wanted, think of all the things that you did not want that you did not get!

Never giving up is key to recovery, because a return to yourself as you were before your illness became severe—better! actually, due to having matured—can take many years and sometimes a number of decades. Nobody else will constantly be present to nudge you to mental health, so you must manufacture by yourself reminders that will always be there. Motivation has to be within you.

And the only way that I’ve found to persevere through all the normal trials of life, let alone the extra slings and arrows of mental illness, is to have reminders in front of you always. Maybe on your smart phone, maybe written down and posted wherever you go—bathroom mirror, laptop computer, bicycle handlebars….