This post is part of a series of six posts describing how I manage my schizophrenia symptoms. The first pillar of my management of schizophrenia is external help. This refers to the professionals that help in a counseling capacity. I will not include members of my support network or details about my psychiatrist since each of these have pillars of their own.
You can see an introduction to my five pillars here.
As I mentioned in my introduction, I have spent hundreds of hours with professional counselors including psychologists, other doctors, clinical social workers, nurse practitioners, counselors at call-in centers and emergency room staff. They have seen me at my best (all things considered) and at my worst.
The first time I ever met with a mental health professional was in Iraq. I went because I was at such a terrible low place that I just couldn’t seem to dig myself out. He screened for PTSD (I had not been in combat and wasn’t admitting me pre-military traumatic event), give me a bottle of pills and sent me back to my unit. I told my boss about it and he frowned disapprovingly. So I stopped taking the pills and continued feeling in the dumps for the remaining five months or so.
This experience of a single, unsatisfying appointment became a blockade for many years. Even though my symptoms seemed to grow worse (it was during this interim that I became suicidal which you can read about in my post about my dog), I didn’t go in for help. Things seemed to get better on their own after a few years.
Years later things got bad enough that I needed regular help. At first I drifted from appointment to appointment and bottle of pills to bottle of pills. No diagnosis was made other than generalized anxiety. Help wasn’t that helpful at this point. Until the day I had a full-on mental break.
Having a mental break and an episode of extreme paranoia and agitation in a mental health clinic is a sure way to get sent to an institution. It was during this stay at the hospital from Halloween until the day before Thanksgiving that my mental health care changed greatly.
I discovered during my stay what was wrong with my treatment up until this point: me. There were several secrets about me that I was trying to keep to myself. I nearly typed here what those secrets are but didn’t. Those may or may not be part of their own post someday. With an open and honest dialogue between the professionals and myself we were ready to move forward. I still hadn’t recognized that I had a schizophrenic voice, I thought what I was hearing was something normal.
I was introduced to and walked through a fast and intensive series of sessions on cognitive behavioral therapy (CBT). I’m not going to explain what CBT is other than to give a simple explanation as I understand it. CBT is taking a series of thoughts and, using logic and reason, viewing them differently. For example, if my one kid is crying I might think it’s because they hate me. Using tools of CBT I could logic out that they might be crying because their brother stole a toy and it has nothing to do with me.
The trouble I have with CBT though is that there is an angry schizophrenic entity living inside of me that is always drilling its rhetoric so deep into me that they have become firmly held beliefs. Yes, I just described my thoughts about myself as delusional. When it comes to me I can play as many CBT games as I want… I just don’t have the buy-in. I can’t work past these kinds of delusions hardly at all. CBT is almost useless to me because the irrational dragon is stronger than the rational me.
But there is a part of CBT (or maybe it is from another kind of therapy) that has been useful. Setting up little science experiments. Saying and writing (CBT) isn’t believing for me – but witnessing is something very different.
With the professional I work with currently (well, just stopped with since we are moving) I told him about this and we decided that for me it would be best to set up little experiments. For example, we talked about how I felt like I was incapable of functioning socially anymore. To test this theory, we decided that at a social event I was going to attend I would initiate conversation with five different people and see if we could have a conversation. I could carry a conversation in all five cases. This helped to dispel the idea that I couldn’t function socially.
This was powerful knowledge. With this little experiment (which I repeat often to remind myself), I understand that, while uncomfortable, I can function socially. Now, I can go into things knowing that I’m not socially inept and that I only have to work through a few uneasy feelings. The delusion that I can’t was dispelled and an understanding of how I could was gained.
When The Dragon is digging it’s delusional claws and teeth into me I can fight back with these. It seems so simple but it really isn’t. There are a lot of things that The Dragon attacks me over that can’t be tested. He likes to attack me by saying things like, “this is it, your wife can’t stand your nonsense anymore.” The only thing left in places like this is to lean on the faith I have in her. While my skills at overcoming The Dragon with logical experiments have grown, he seems to get better at attacking me in ways that they won’t work.
In these cases, I lean on talk therapy, I try not to go to my wife with problems if I can because I’m still trying to manage things as much as I can on my own. The last therapist I had was good at helping me through the tougher delusional beliefs. He should have been good working with me, I bet we had 40 appointments!
I am to the place though where I feel like I am about at the limit of how much a professional can help me. I’m being shown the same few tricks over and over. I’m being told I need to meditate over and over. But I’m going to continue to go because maybe they’ll come up with something new or can help me work through something difficult.
I’m very nervous at starting with a new therapist once we are back in Kansas. I’m hoping that we can work as well together as the one I’ve left. It is exciting to be able to pull the continuance of my military career out of the conversation. The trouble I have with working with professionals is that they understand me on a clinical level and only have the experiences of others. I will never believe that someone external to suffering with schizophrenia could ever truly understand the condition. I bring a lot of doubt to the table, but I do try to look past it.
My next step in external help is to add in a support group. Once in the Kansas City area I will be searching for a schizophrenia support group or, if that doesn’t exist, a mental health support group.
What kind of external supports do you use? Please let me know in the comments below.