I write about alcoholism from time to time in this blog because I feel it has much common ground with schizophrenia. There is the condition itself, which I consider a spiritual conflict, but there is also the framework of Alcoholics Anonymous, involving a program, similar in some ways to the day program that our family was involved with for schizophrenia. AA is run by its members, not by medical professionals. In this regard, it is not like our day program.

No program is above criticism, and there is an interesting piece today from the Huffington Post that raises the question, how come, after seventy-five years of AA there aren’t more success stories?

Given that AA started in 1935, that it is still not proven to be successful is beginning to be a bit worrisome. Do drinking and drug problems, alcoholism and addiction, seem to be improving in the United States? (Hint: according to the National Survey on Drug Use and Health, 25 percent of 21-year-old Americans have a diagnosable drug or alcohol problem — far and away most often an alcohol problem.) Don’t you think we might be doing a little better in this area after 75 years?

Robert Whitaker asks these kinds of questions and more in his new book Anatomy of an Epidemic. These kinds of questions kick-started my interest in alternative therapies. Surely, I thought, there should be better outcomes after all these years for schizophrenia than the bleak picture that is usually presented. There are better outcomes, but you’ve got to do a little digging to find out where they are.

These questions need to be explored, not just for AA but for current approaches to schizophrenia and other mental health conditions. Most people will not recover in a program – they will recover when they get to the bottom of whatever it is that is troubling them and when they begin to accept personal responsibility. That is why, as the article points out, a wide variety of treatment options should be available. There is no one size fits all when it comes to mental health.

I just don’t have much motivation these days. It’s way too hot. I drag myself into work early and leave early as the office isn’t air conditioned. When I get home Chris and I drive down to the lake and jump in. We paddle around for a while before driving home and preparing a light meal.

Progress report on Chris: We are in a holding pattern. Chris does lots of volunteer work, such as working at the soup kitchen once a month on Saturday morning. He likes to cook and the food looks good on a plate. He is precise, punctual, thorough, and you can be sure if you ask him to do something, he will do the job well. Last Sunday he filled in for me as an usher at church. His once a week voice lessons are over for the summer and will resume again in Sept. He’s reading lots of intellectually challenging books. He also reads the Bible everyday. He is very slowly reducing one of his two meds. But, to speak with him and to observe him from a distance, there is a lag. If you ask him a question, there is a long pause before he answers, if he chooses to answer at all. If you watch him from a distance, you can see that he is hesitant. I used to think this was due the drugs, but I can’t blame the drugs for this one. I consider it the physical manifestation of his internal doubts.

Chris has been seeing an occupational therapist for a year now since he left the psych hospital after his relapse. I am trying to be patient with the fact that he seems to be dragging in the area of getting some kind of training, something that will regularly occupy his days. Ian and I have given up on the idea that he will be heading back to university, at least we don’t see this happening, if it happens at all, until he is 28 or even 30. We have decided to be philosophical about this because we are determined to be low Expressed Emotion, to give him time to knit together who he is, to come up with his own blueprint. He is being helped in this regard with the sessions with the sound therapist that he undergoes on a regular basis. It takes a long time to go from zero to cruising speed when it comes to personality development.

Still, it would be nice if he got going and had something to occupy his days. He has been talking about a three month computer technician course at a local trades school. I notice that despite professing enthusiasm for this, he manages not to make enrolment a top priority, therefore I am not sure if he will be starting in August or not. Ian and I will be away and it will be up to Chris whether he makes this happen. I feel something in him is holding him back.

Dr. Stern has introduced a new possible and surprising direction for Chris based on the last Constellation that Ian and I undertook where she had been groping to find the right words for his non-earthbound personality characteristics. She feels, in her words, it is “being like a good host for a group of people which might correspond, on a concrete level, to a professional activity in the hotel or tourism business.” She recalls his interest in “cooking for the family, for being useful for people, e.g. being helpful for members in the church community, for being a senior student at his college who welcomed first year students, his appeal for high standard places like Grand Hotels, his appeal for being very well dressed, and his interest in learning foreign languages.”

On a spiritual calling level Dr. Stern’s use of the word “host” is very interesting. Recall that Jung felt that addiction to alcohol (spirits) is a spiritual quest. According to the Catholic Encyclopedia:

The function of the angelic host is expressed by the word “assistance” (Job 1:6; 2:1), and our Lord refers to it as their perpetual occupation (Matthew 18:10). More than once we are told of seven angels whose special function it is thus to “stand before God’s throne” (Tobit 12:15; Revelation 8:2-5). The same thought may be intended by “the angel of His presence” (Isaiah 63:9) an expression which also occurs in the pseudo-epigraphical “Testaments of the Twelve Patriarchs.

But these glimpses of life beyond the veil are only occasional. The angels of the Bible generally appear in the role of God’s messengers to mankind. They are His instruments by whom He communicates His will to men, and in Jacob’s vision they are depicted as ascending and descending the ladder which stretches from earth to heaven while the Eternal Father gazes upon the wanderer below.

When it comes to occupation, Ian and I are still getting used to this possible role for Chris. At first we felt that his always being with us, always wanting to help, never asking anything of himself, was a sign of dependency, but I can see now that there is another way of looking at this, in line with my growing understanding that “schizophrenia” is communication of the highest sort.

The New Yorker ran an article back in October 2007 entitled We are All Larry David. Larry David is the creator, along with Jerry Seinfeld, of the television mega hit Seinfeld. If you have ever seen his subsequent show, Curb Your Enthusiasm in which Larry David is front and center, Larry David makes Woody Allen look like a people person. He seems to have no redeeming qualities. He is neurotic, horribly inept in his personal relationships, and well, in my opinion, not at all funny. My son Alex loves Larry David, demonstrating once again that there is no accounting for taste, and I respect that.

The New Yorker article is about a second year psychology student who worked for a summer teaching social skills to a group of “schizophrenic patients” at a state hospital. He was having a difficult time trying to get his patients to role play everyday social situations until he hit on a brilliant idea. And do you know what this brilliant idea was? Watching television with his patients! Not just any TV show but Curb Your Enthusiasm, which really struck a chord with this group, no doubt due to the heavy doses of neuroleptics they were on (my opinion, not the article’s).

I won’t go into my opinion of this article, but just offer it up as further reading material. You can access the article here.

Gianna Kali has reposted a 2007 opinion piece today by Furious Seasons’ Phillip Dawdy where she takes eloquent issue with his opinion that accepting your diagnosis is mandatory on the road to recovery. This idea of accepting your diagnosis is widespread and the thinking is that you are delusional if you do not. Today, many people proudly proclaim that they are their diagnosis. Coincidentally, more and more people have that diagnosis. Wearing your diagnosis goes beyond what the Dawdy piece is saying, but it’s a slippery slope. Accepting can become defining.

In mental health, pardon my ignorance, but what exactly is the basis of the diagnosis? There is no test for schizophrenia, no gene, and no drug fixes the problem, so what is it exactly that is being medically diagnosed?

A mental health diagnosis is not a broken leg. A mental health diagnosis is a sliding opinion underpinned by dubious science.

After you’ve accepted this diagnosis, then what? Will you be open to accepting any label that someone else sticks on you? I could have spent years urging my son to accept his diagnosis, but that would have done more harm than good, in my opinion. In fact, at the beginning my husband and I did urge my son to accept his diagnosis, because this is what the doctors told us Chris must do. In another post I wrote that accepting your diagnosis when you are labeled schizophrenic is akin to a teacher telling you that you are stupid, but if you want to learn you’d better first accept the fact that you’re stupid. Any learning you manage to accomplish after that will be the result of an heroic struggle at the expense of your own stupidity.

Robert Whitaker’s book has pointed out the pitfalls of becoming your diagnosis: Lifelong patienthood.

If I had it to do all over again, I would never have told a soul that Chris had been given a diagnosis of schizophrenia. I don’t know how I would have fudged this the past six years when anyone could see he had a problem, but I was operating under the delusion that there is no stigma in being mentally ill and the first thing to do is to accept your diagnosis. I also felt that if I told people, I could learn things from them that would help. In fact, most people haven’t a clue, and I had to do all my own discovery.

It hit home again at lunch today. My friend wanted to know how Chris was doing as she had seen him on one occasion last year when he was on a day pass from the psych hospital. Ian and I had foolishly decided to take him to a special interest group lecture and he spent the time being rather unusual. (Word to the wise. If your relative is out of the psych hospital on a day pass, best stay home.) My friend expressed surprised that (a) Chris actually can read books and (b) that he was able to travel around freely by train. Like most people, she has no clue what a diagnosis of schizophrenia entails, but like most people, she thinks it’s lifelong and handicapping. My father went to his grave feeling sorry for the burden that he felt I was going to have to carry the rest of my life. He also had no experience with mental illness beyond what the doctors say about the awful label of schizophrenia. My trying to convince my father otherwise was an exercise in his humoring me. He felt I was putting the best possible polish on a bad situation with my talk of Chris eventually leading a productive, interesting life.

It would be far better to reject the idea of accepting your diagnosis, but be willing to admit, as the Dawdy article puts in a more secondary light, that what you really have is a “problem.” That’s a diagnosis you can overcome.

Readers may ask, so why is it then that you put schizophrenia front and center in your blog if you reject the label? The answer is so that other people can find their way after they’ve been handed this label.