Thursday, March 26, 2009

the fragments

There is so much misunderstanding and misinterpretation with mental illness. The ill keep their facade in motion by fragmenting their lives. Not one person in their world has the entire box of puzzle pieces. It takes years to intervene and make changes. In fact, sometimes intervention is not successful when the stories told by the ill carry on with a life of their own. Her husband knows some things. Her parents see odd behaviors and accounts of events that don't make sense. The siblings are drawn into drama. Co-workers observe behaviors. The children of the mentally ill are subjected to it all. They have the longest effects and most unstable existence when their parent is untreated and ill. All of these fractional parts of their lives are used in a manipulation as fuel. If the husband hears terrible things about the inlaws and the neighbors hear terrible things about the husband and the kids hear terrible things about their father and the co-workers hear stories about the kids... then over time, alienation and defensiveness keep everyone from effectively tackling the illness itself. Everyone is so distracted with the offenses and slights and attacks that they have lost focus on the common denominator that ties them all together-- the manipulation of the ill to keep the focus off the illness. The loudest voice should be a rational voice, but it's not.

We wonder why the mentally ill are resistent to treatment. If there truly were a doctor who could see the whole picture, diagnosis would be much easier. It wouldn't be easy, but it certainly wouldn't waste so much time. Those who struggle with mental illness are not reliable sources. Why would a psychiatrist ask questions and expect accurate answers from someone unaware of what day it is? Why would a psychiatrist put more faith in a fragmented and confused mind than in the people around who can "testify" as to the effects of illness? In order to deal with a problem, there should be a detective phase... a gathering of accounts and stories and events. Use multiple sources. Gather information from people who live with it. Grant an open forum to those who suffer along side the ill. There will be agendas. There will be anger and resentment, but a good psychiatrist can discern and sift and find insight.

Every time I have been involved in the treatment or care of someone with mental illness, there has not been a forum for my opinion or my observances. Even when the child lives with me. Even when I observe behaviors that no one else sees. Even when I have seen "crazy" up close, there is not credence given to my account. Psychiatrists need to change their method of diagnosis. They need to consider the firsthand accounts of those who live with fractured minds. They can dismiss or find fault with our accounts, but they should, at a minimum, attempt to determine it's legitimacy. The only thing more desperate than living with someone with an untreated fragmented mind is knowing that there could be help for that person if a professional would just listen. Living with the mentally ill day-to-day is enormously stressful and futile, but giving up hope is worse.

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