Tag Archives: Schizophrenia

“Schizophrenic and Successful”? What are the factors in success?

This recent New York Times Opinion Page essay is written by Law Professor, Elyn Saks. She tells a bit about her diagnosis of Schizophrenia years ago and her fight against those who thought that she would not amount to much. While we shouldn’t assume that everyone who struggles with delusions and hallucinations will rise to Dr. Saks level of accomplishments, we should take note where we give in to hopelessness when someone we love receives such a similar diagnosis. Such hopelessness will surely hamper our loved one’s prognosis for recovery.

There are two important factors that predict both recovery from mental illness and future recurrence of symptoms.

  1. Acceptance of diagnosis and treatment compliance
  2. Absence of family and social stressors

These factors are found in nearly all forms of mental illness, but especially pertinent for depression, mania, and psychotic disorders. When a person accepts the existence of a problem and commits to a treatment strategy, they are likely to be more cognizant of the signs and symptoms re-appearing and therefore willing to seek additional help. When medications create irritating side effects, the committed person will either find ways to tolerate these irritations or work with their doctor to find alternative treatments.

The absence or minimization of family stress requires the family or community to not behave in ways that exacerbate the problem. The family must also accept the limitations and not act in ways that place unrealistic expectations on the patient. This of course requires a great deal of sacrifice–on top of existing grief and loss over relationships that will not be what they could be (e.g., caretaking a spouse with mania, supporting an adult child who needs a sheltered environment). This means releasing the demand for the patient to reciprocate empathy or have insight about their impact on the family. Still further, when we loved ones maintain a hopeful perspective–identifying a patient’s value, capacity, and possibility for a future–we offer that person the greatest chance for success.

For some, success may mean being able to hold down a steady cashier job. For others, success may mean staying out of the hospital. Still others may rise to Dr. Saks level of success in academia. If you have a family member who suffers with mental illness, work hard to see them beyond their illness and evaluate their current capacities (rather than by their best or worst day). Oh, and be sure to find someone to talk to. Your family member isn’t the only one who needs help coping with a difficult world!

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Filed under counseling, counseling science, Psychology

Science Monday: Easing the suffering in schizophrenia

While few outpatient, private practice therapists deal much with those diagnosed with schizophrenia, there are things therapists can do to ease the suffering of both client and family. Kim Mueser, a professor at Dartmouth Medical School has published a number of helpful research and popular writings designed to increase social and cognitive functioning and decrease family distress in people with schizophrenia. Click here for an Amazon.com list of his writings. His Complete Family Guide (#1 on the list) is probably the best though several other texts may be just as useful depending on the reader’s focus. And while medications are important in the treatment of schizophrenia, it is quite clear that when families and client learn to minimize family distress and conflict, they also reduce active psychotic episodes


There are a number of interesting research angles on the pathways of Schizophrenia. One such hypothesis is that the croticostriatal loops do not work correctly in such patients. In lay terms this means that information doesn’t flow normally from the frontal lobe of the brain to some of the mid-brain structures and then back again. This seems to be part of the cause of apathy and lack of volition and/or planning. One wonders whether the longer time it takes for information to flow properly in order to make a decision or interpretation increases the likelihood of making random assumptions about the world. I know that when my children get stuck in a math problem, they are more likely to begin wild guessing to complete the task.  


Filed under conflicts, counseling science, counseling skills, Psychiatric Medications, Psychology