Schizophrenia And Mental Illness - Separation From Nuclear Family Critical To Success
Separation and correct understanding are the cornerstones of successful treatment and recovery from serious emotional disorders.
But there are additional factors and modalities, of course, including the judicious use of medications, the occasional administration of ECT, the cross referencing of adult and infant realities, the immediate identification of relapses each time there is a contact with a family member, the use of day programs, of work, school and community services, the therapeutic alliance and the personal interaction with the patient.
CROSS REFERENCING THE REALITIES The therapist must become an anchor in adult reality, a person with whom the patient can relate at such a firm adult to adult level that contact with the therapist immediately brings the patient back to the adult reality.
One catatonic, in the excitement phase, was thrashing about uncontrollably as four police officers tried to restrain him.
When the first author appeared, the patient continued to struggle in violent thrashing motions resembling the thrust of the infant in the birth process.
While he could not stop the thrusting motion of the body, the rational part of the mind responded to the sight of his therapist and he explained in lucid fashion everything that happened to him that day that led up to the loss of control.
Just as his family represented his anchor in the infantile mind/brain, his therapist represented his anchor in the adult.
The identification and cross referencing of realities is a very important aspect of treating schizophrenia, and especially the paranoid.
Wil Menninger (personal communication) once cautioned "always start with the reality the patient is experiencing.
" This is sound advice.
One approach is to say "I absolutely believe, 100%, that what you are telling me is exactly what you experience to be so.
" "You are experiencing that people on television are talking about you," etc.
Once this is fully acknowledged, it may be possible to move on to: "The way we experience things varies somewhat from time to time and from person to person.
If ten people witness the same event, they experience it ten different ways.
If one person experiences something at ten different ages, he experiences it ten different ways.
If you are asleep and dreaming and a bear is chasing you, it is real until you wake up.
If you are hypnotized and told you are a rooster, that is real until you are no longer under hypnotic suggestion.
Likewise, when persons shift to earlier ages, they may be experiencing what is real to them at an earlier time.
"What you experienced to be real yesterday is not what you experience to be real today" (this interpretation is vitally important as the patient's delusional system begins to change with the advent of hospitalization, separation from family and the administration of neuroleptic medication).
"Perhaps what you experience tomorrow will be different from what you experience to be real today.
" As treatment progresses and the patient comes to recognize the shifting realities, he can begin to recognize where the other realities come from.
One recovering schizophrenic woman complained that when she returned from shopping she would put the groceries on the floor instead of in the refrigerator.
She did this even though she knew the food would spoil.
She, therefore, wondered why she did it.
It was easy to point out that the baby plays on the floor, puts everything on the floor and never puts anything away.
In a similar fashion, each symptom that is a replay of the reality/ behavior of the infant can be interpreted.
When the patient lists countless reasons why he cannot move away from his parents' home, this is the infant mind speaking.
The adult will find just as many ways to make the separation possible.
Every thought, word, action, and feeling can be identified as to its source.
Eventually the patient learns to cross reference his thoughts and learns to recognize which part of his mind they are coming from.
Treating the Patient What is real to the person depends on the reality the person is experiencing at the time.
Only with special attention to cross referencing various realities can the patient begin to recognize "I've been here before.
" One of the best times to do the cross referencing is when the patient is coming out of the delusional system and the realities are changing on a daily basis.
This is also a good time to identify how the particular reality or behavior relates to that of an earlier age during infancy.
One schizophrenic high school student whose mother just left home, partially returned to age 18 months when she left him at that time.
His means of getting her to pick him up during infancy was to have a smelly diaper.
His later symptoms were the same.
He did not become overtly delusional, but his affect was flat and the stench from unclean underwear was so strong that no one could sit next to him.
(Note: this first symptom was regarded by the first author as "schizophrenia until proven otherwise," and an aggressive treatment approach prevented development of the full disorder.
) Each symptom such as this needs correct interpretation until the patient has good understanding and comprehension of his illness.
With schizophrenia of very early origin, interpretation can be more difficult since rigidity, concrete thinking and inflexibility are greater at earlier ages.
More of the interpretations have to be made when the person is not in the acute state.
To achieve positive results with the more disturbed, the total separation from family is absolutely essential otherwise there will not be sufficient return to the adult brain to allow for insight and recovery.
But there are additional factors and modalities, of course, including the judicious use of medications, the occasional administration of ECT, the cross referencing of adult and infant realities, the immediate identification of relapses each time there is a contact with a family member, the use of day programs, of work, school and community services, the therapeutic alliance and the personal interaction with the patient.
CROSS REFERENCING THE REALITIES The therapist must become an anchor in adult reality, a person with whom the patient can relate at such a firm adult to adult level that contact with the therapist immediately brings the patient back to the adult reality.
One catatonic, in the excitement phase, was thrashing about uncontrollably as four police officers tried to restrain him.
When the first author appeared, the patient continued to struggle in violent thrashing motions resembling the thrust of the infant in the birth process.
While he could not stop the thrusting motion of the body, the rational part of the mind responded to the sight of his therapist and he explained in lucid fashion everything that happened to him that day that led up to the loss of control.
Just as his family represented his anchor in the infantile mind/brain, his therapist represented his anchor in the adult.
The identification and cross referencing of realities is a very important aspect of treating schizophrenia, and especially the paranoid.
Wil Menninger (personal communication) once cautioned "always start with the reality the patient is experiencing.
" This is sound advice.
One approach is to say "I absolutely believe, 100%, that what you are telling me is exactly what you experience to be so.
" "You are experiencing that people on television are talking about you," etc.
Once this is fully acknowledged, it may be possible to move on to: "The way we experience things varies somewhat from time to time and from person to person.
If ten people witness the same event, they experience it ten different ways.
If one person experiences something at ten different ages, he experiences it ten different ways.
If you are asleep and dreaming and a bear is chasing you, it is real until you wake up.
If you are hypnotized and told you are a rooster, that is real until you are no longer under hypnotic suggestion.
Likewise, when persons shift to earlier ages, they may be experiencing what is real to them at an earlier time.
"What you experienced to be real yesterday is not what you experience to be real today" (this interpretation is vitally important as the patient's delusional system begins to change with the advent of hospitalization, separation from family and the administration of neuroleptic medication).
"Perhaps what you experience tomorrow will be different from what you experience to be real today.
" As treatment progresses and the patient comes to recognize the shifting realities, he can begin to recognize where the other realities come from.
One recovering schizophrenic woman complained that when she returned from shopping she would put the groceries on the floor instead of in the refrigerator.
She did this even though she knew the food would spoil.
She, therefore, wondered why she did it.
It was easy to point out that the baby plays on the floor, puts everything on the floor and never puts anything away.
In a similar fashion, each symptom that is a replay of the reality/ behavior of the infant can be interpreted.
When the patient lists countless reasons why he cannot move away from his parents' home, this is the infant mind speaking.
The adult will find just as many ways to make the separation possible.
Every thought, word, action, and feeling can be identified as to its source.
Eventually the patient learns to cross reference his thoughts and learns to recognize which part of his mind they are coming from.
Treating the Patient What is real to the person depends on the reality the person is experiencing at the time.
Only with special attention to cross referencing various realities can the patient begin to recognize "I've been here before.
" One of the best times to do the cross referencing is when the patient is coming out of the delusional system and the realities are changing on a daily basis.
This is also a good time to identify how the particular reality or behavior relates to that of an earlier age during infancy.
One schizophrenic high school student whose mother just left home, partially returned to age 18 months when she left him at that time.
His means of getting her to pick him up during infancy was to have a smelly diaper.
His later symptoms were the same.
He did not become overtly delusional, but his affect was flat and the stench from unclean underwear was so strong that no one could sit next to him.
(Note: this first symptom was regarded by the first author as "schizophrenia until proven otherwise," and an aggressive treatment approach prevented development of the full disorder.
) Each symptom such as this needs correct interpretation until the patient has good understanding and comprehension of his illness.
With schizophrenia of very early origin, interpretation can be more difficult since rigidity, concrete thinking and inflexibility are greater at earlier ages.
More of the interpretations have to be made when the person is not in the acute state.
To achieve positive results with the more disturbed, the total separation from family is absolutely essential otherwise there will not be sufficient return to the adult brain to allow for insight and recovery.
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