Recently, at a virtual NAMIFaithNet Luncheon, a faith leader of a nearby parish, asked, “What can you do when the person you love has mental illness and refuses treatment?”
Edmund Ibarra, a FaithNet staff person and member of St. Martin of Tours Parish recommended the anguished parent read, I’m Not Sick. I Don’t Need Help! The author Xavier Amador, PhD, is a Clinical Psychologist at Columbia University and professor and speaker of the LEAP Institute. Moreover, Dr. Amador’s brother Henry, brilliant, creative, fun-loving, and a life-giving member of Dr. Amador’s family of nine close siblings, was diagnosed with schizophrenia in his twenties. This familial experience of mental illness and its effect on those with the diagnosis and on those who love the one with the diagnosis, shaped Dr. Amador’s clinical research. Dr. Amador particularly focused on those diagnosed with serious mental illness such as bipolar disorder, schizophrenia, and schizoaffective disorder.
Dr. Amador keyed in on a mostly missed aspect of living with these serious mental health conditions: Anosognosia. This is a million-dollar word to describe a debilitating, baffling, and often provoking, lack of awareness of one’s brain dysfunction. The one who is ill is not denying his or her mental illness out of spite or lack of intelligence or cultural influence. The one who is ill is simply not aware due to executive (frontal brain) dysfunction. As Dr. Amador writes, ‘In most patients with schizophrenia and related psychotic disorder deficits in insight and resulting non-adherence to treatment stem from a broken brain rather than stubbornness or denial.” Dr. Amador notes that three hallmarks distinguish anosognosia from denial:
- The lack of insight is severe and persistent (it lasts for months or years)
- The beliefs (“I’m not sick,” “I don’t have any symptoms” etc.) are fixed and do not change even after the person is confronted with overwhelming evidence, they are wrong.
- Illogical explanations or confabulations that attempt to explain the away the evidence of illness are common. (p. 49)
Dr. Amador continues that the most important question is not about denial. Instead, it is, “How can I help the person accept treatment?” As Dr. Amador stresses, “The cause of the severe and persistent denial is, in fact, a symptom of the illness….First, when faced with the frustration of trying to convince him or her to get help, remember the enemy is brain dysfunction, not the person. The shift in your thinking will lower your frustration and increase your effectiveness in building a collaborative relationship with the person you are trying to help. Second, this knowledge can rekindle hope that you will be able to help your loved one accept the help that’s being offered.” (p. 50)
Dr. Amador developed a communication tool called LEAP to help you and your loved one with severe mental illness to partner on goals you BOTH agree can be worked on together. Next week, I will write more about LEAP. In the meantime:
- Purchase a copy of I’m Not Sick. I Don’t Need Help by Xavier Amador, PhD; VIDA Press; available through Amazon;
- Check out the family and peer support groups available online through our local NAMI at www.namisantaclara.org;
- Pass this article onto family members and friends dealing with serious mental illness;
- Read and Pray through Hope & Healing, the California Bishops Pastoral Letter on Mental Illness. You will find it HERE
Author: Barbara F. Zahner, BCC; 3GEN+ Mental Health Ministry; Email: barbarazahner1@mac.com
