In a majority of cases people approach me, in my counseling practice, for their loved ones- who have a mental illness diagnosis. Their hope is two-fold: to understand recovery and to meet someone who is recovered and then present the same to their diagnosed loved one. Secondly they hope to help their loved one. I am not saying this is the order of intention, but somewhere a few certainly find comfort in the fact that I have a past of bipolar and I may understand better.
Often, I have seen the buck stops with them. Their loved ones do not want to deal with their mental ‘distress’ in any significant way. Now there are at least three variants of this
- They are reconciled to the idea that they have a mental illness and it is beyond ‘cure’/ treatment;
- They tell their caregivers that they do not need any help as they have all the help for the moment- it may be a therapist or a new hobby, occupation, academic degree or anything else. In general they stick to their medical regimen and their daily routines, not questioning their mental ‘health’ status.
- They do not agree that there is a mental ‘distress’, ‘suffering’ or anything else.
The funniest is when people tell others ‘how can a past patient, deal with another’s psychosis?’
Anyhow, so in these three variants- there is one thing in common- maintaining status quo, or having a stable narrative built around the theme of mental ‘illness’. Psychiatry has told them they are ill and they agree with it and that is it. Sorry, in the last variant- there is no agreement of mental ‘distress’. In other words, I am just fine and I do not need any medicine- you take medicine if you want to! Right, I know for I have been there.
It takes time for people to step out of their zones of action (which are in psychosis) and step into zones of consciousness- understanding what they are doing and what they have done. Only in that zone can a change, via therapeutic conversations happen.
When a house is on fire, you only have to douse the flames- you cannot worry about the sources of the fire or whether it can happen again OR ANY KIND OF ANALYSIS. Analysis is for a stage when one is ready to examine the process, the archaeology of the construction of the fire- what were the options, who did what, where were the inflammable items, who was vulnerable and so forth. For analysis, you need your rational, functional intellect in place and not un-hinged, the way it is during breakdowns of psychotic episodes.
Therapy is not fire-fighting- psychiatric medication is. It is meant to douse the initial flares and calm down the person, by sedating them or whatever else is required.
Therapy or counseling is about a willingness to understand the roots of our suffering, see how they cause triggers and what can be done to deal with those- as stimuli or as provocations. Knowing and understanding our patterns of thought, actions and behaviours- this is the goal of therapeutic dialogues.
Only with a calm, ‘sane’, undisturbed mind can we talk these out- not during episodes of ‘hypomania’ or any other category of inner chaotic agitation. And that has to begin as everyone’s personal quest, not their caregiver’s; for the caregivers can push and encourage you, but you still have to walk the road yourself. Wherever the personal quest is evident and earnest, results are fastest to emerge.