Helping Families Cope with Schizophrenia

The anguish and confusion of family members who learn that a loved one has been diagnosed with schizophrenia can be huge. Before their eyes, a son, daughter, or sibling who once was full of hope and plans for the future has disintegrated into a being that they may hardly recognize. The opportunities for blame are many – blaming each other for causing the disorder, blaming the afflicted family member for his or her symptoms, blaming mental health professionals for not being able to cure the disorder, and blaming themselves. On top of this, family are now being asked to bear the brunt of the care for their schizophrenic members, acting as psychotherapist, medication specialist, caretaker, rehabilitator, intermediary with the mental health system, and unconditional emotional support system. It is no wonder that burnout and despair are common among this family.
One advocate on behalf of these families is E. Fuller Torrey. A very personal and painful experience brought Torrey to psychiatry and the study of schizophrenia. While Torrey was an under graduate, his sister, the 17, was diagnosed with schizophrenia. Torrey accompanied his mother and sister to a treatment facility and was appalled at the explanation and treatments offered for her illness. As he pursued a career in medicine, Torrey dedicated himself to finding better explanation and treatments for schizophrenia than those that had been offered to his sister, as well as to improving the treatment of people with serious mental disorder.
One of Torrey book, surviving schizophrenia assist the families of people with schizophrenia in understanding the disorder and finding appropriate treatment for their afflicted family members. This book educates family members on what schizophrenia is and is not, and it includes many specific tips on how to live with the schizophrenic family members and cope with the disorder. The key surviving schizophrenia, according to Torrey, is having a safe attitude, sense of humor, acceptance of illness, family balance, and expectation that are realistic.

Sense of Humor

It may seem strange to think the family members can approach schizophrenia with a sense of humor, but Torrey argues that families was successful at managing schizophrenia have maintained a sense of humor and an appreciation for the absurd. Family members cannot laugh at the person with schizophrenia, but they can laugh with him or her. For example, one family in which the son typically relapsed in the autumn and required hospitalization had a standing family joke that the son always carved his pumpkins in the hospital.

Acceptance of the illness

Acceptance of the illness thus not mean giving up but, rather, accepting the reality that the disorder will not go away, is likely to place limitation on the family members, and will need active management by the family. Unfortunately, it is more common to families to be angry at themselves, at the afflicted family member, at God, and so on. This anger can be overtly expressed, or it can seethe the quietly until a trigger causes a family to explode. Educating family members about the illness and what they can reasonably expect is one of the most important jobs of mental health professionals, because it can be the foundation of acceptance.

Family Balance

Caring for schizophrenic family member can be overwhelming. Some families put the needs of their schizophrenic members before those of all the rest. Such families are prone to burnout, and neglected family members can become resentful and hostile. Families must achieve a balance of concern for their schizophrenic member and appreciation for the needs of the other family members. This may require caregivers to get away occasionally and to find resources, so that they are not providing round-the-clock care and ignoring their own needs.

Expectation that are Realistic

It can be especially difficult for families to have realistic expectation of their schizophrenic member if that person had a particularly promising future before the illness struck. Pressure can be put on the schizophrenic family member that helps to trigger new episode of acute symptoms. Lowering expectation to help family members appreciate the schizophrenic members for who he or she is now, rather than focusing on what they wish were true:

Several relatives mentioned that giving up hope had paradoxically been the turning point for them incoming to terms with their unhappiness. “Once you give up hope,’’ One mother said, you start to perk up. Once you realize he will never be cured you start to relax. These relatives had lowered their expectation and aspiration for the patient, and had found that doing this had been the first step in cutting the problem down to manageable size.

Clearly, family members should not abandon all expectations of the person with schizophrenia. What is important is having realistic expectation. Again, educating the family about the disease is critical to creating such expectation.
Some family members find that becoming politically active on behalf of people with schizophrenia helps they cope. The National Alliance for the Mentally III (NAMI) is the largest national organization focusing on serious mental disorder, including schizophrenia. NAMI was created and is run by consumers (people with disorder) and their families to advocate for more research, better health care and access to health care and, and public education. Many communities’ have local chapters of NAMI, which can usually be found in the phonebook.

SOURCE: Abnormal Psychology by Carson