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Note that this article has been written by Dr. Ann Reitan and under the pseudonym, Dr. Ann Olson. A book written by Ann Olson, Illuminating Schizophrenia: Insights into the Uncommon Mind, is currently available on the Amazon.com website. A version of the following article was published on the website: Brainblogger.com
The improvement of the condition of schizophrenia is strongly linked to family involvement in the life of the schizophrenic. Family members can ease the difficulties of this serious mental illness in ways that people outside the family system cannot.
Due to the fact that family members may be in close contact with their schizophrenic father, mother, sister or brother or child, they are better able to monitor the behavior of the schizophrenic. They know this family member, and they may be able to ascertain the causes of the schizophrenic’s negative behavior. This closer understanding may allow them to intervene proactively and before negative symptomatic behaviors emerge.
The psychotic fragmentation of the schizophrenic may occur at any time, particularly in response to aspects of the environment and the material world that can be monitored and controlled. Family members are more likely to recognize the deterioration of their schizophrenic family member if they are living with them. Being able to monitor medication compliance, for example, is a positive aspect of effectively managing the mental illness of the schizophrenic, and this monitoring becomes more possible if the family lives in close proximity to the schizophrenic person. It should be noted that the schizophrenic may have just as much to gain by living independently, even though the close relationships with his family members may be compromised as a result.
Even when family members do not live with the affected person, however, regularly seeing the schizophrenic offers many benefits. More than any other people in the schizophrenic’s perhaps sparse constellation of relationships, her family members may be able to understand the continuity of the schizophrenic’s life before and after the emergence of her mental illness. Even though it may be jarring to witness such behavioral changes, family members can be of immense service to the schizophrenic. This is due to the fact that, in spite of the realities of aberrant behavior on the part of the schizophrenic individual, the family members might stigmatize the schizophrenic to a lesser degree.
Another way that families can help their schizophrenic relative is by helping that person to access consistent and reliable psychiatric services. Also, families can aid crisis intervention. Relatives are likely to know when their schizophrenic member is a danger to herself, to others, or is gravely disabled. They serve a valuable function in this regard.
In addition, schizophrenics may suffer from extremes of alienation and subjectively punitive self-involvement. Families can help minimize the damage to self of the schizophrenic that this entails. Most importantly, families can make the schizophrenic feel loved, accepted and valued.
Essentially due to stigma, schizophrenics feel extremely alienated from the world of other people. Moreover, the traumatic effects of stigma regarding mental illness can be more or less eliminated by the family’s acceptance of that individual, although this may not be an easy task. The metamorphosis of the mentally ill individual, from someone who may seem psychologically healthy to a person labeled as a schizophrenic, can mean that individual transforms into someone unrecognizable. The struggle to accept oneself and be acceptable to others in terms of serious mental illness may be terrifying to the schizophrenic. The rage and grief associated with the onset of serious and chronic mental illness, for both the schizophrenic and her family, may be extreme.
Family members may be able to bypass some of what seems to be a tragedy for the troubled individual and themselves by educating themselves about mental illness and the diagnosis of schizophrenia. The difficulties of the schizophrenic and the subsequent difficulties of the family in dealing with this diagnosis may seem like a life sentence in terms of its chronic nature. In addition, the problems of the schizophrenic are cyclic: biochemistry causes auditory hallucinations, the appearance of hearing voices that no one else hears leads to stigma, and stigma causes the schizophrenic to retreat physically and psychologically from others, leading to greater isolation and greater self-involvement within the mind of the schizophrenic.
The schizophrenic may act out, and the family may respond by not understanding her behavior, which further alienates the schizophrenic in a way that makes her terrified that she can no longer be understood by anyone, even herself. For that reason, the person labeled as unrecognizable may act out in unacceptable ways. This means that the family may be compelled to re-evaluate and realign their values in terms of their efforts to accept their family member.
Overwhelmingly, the mentally ill family member wants to feel loved. The fear and terror that any family deals with as a consequence of such a diagnosis is intense. No one thinks that they are going to be a schizophrenic when they grow up. The tragedy of this diagnosed condition is enormous and devastating. Family involvement and acceptance, in particular, may ameliorate much of this tragedy. In fact, these qualities might even make the circumstances of the diagnosis of schizophrenia tolerable, for both the schizophrenic and her family.
Nevertheless, the emotional fury and grief felt by the family and the schizophrenic herself may be extremely poignant, inspiring intense anxiety and a sense of devastation. Connecting the family member and her family with the past is one component of crisis intervention. It may ameliorate the foreign quality of the emergence with schizophrenia in the family.
A female schizophrenic client of mine once shared a story with me which amounted to an intervention on the part of her family members. She spoke of how her siblings came to speak with her and talked about her with a psychiatric social worker at a hospital where this client was staying after a severe and life-threatening breakdown. They simply came – all of her siblings – and this was enough to make the schizophrenic feel that her life was valued. She felt loved based upon her families concern for her. She had never experienced this kind of validation.
