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The Key to Psychosis-Empathy

Psychosis

 

Location: Old Country Hill Psychiatric Center

Tuesday Morning:  7:45 am. 

Temperature: VERY COLD.

His name is Chuck.

A tall dark-skinned man about 50 years old sits alone in a dim-lit cafeteria looking more like a “patient” than ever. He is wearing three ill-fitted coats, a royal blue baseball cap with some kind of gold pin attached, brown fuzzy slippers with no socks and worn and torn blue denim jeans with a darker shade of blue patch on the left leg.

He eats the same breakfast every morning; in a small plastic bowl, he fills it with hot cereal and dresses it with a complete layer of brown sugar he brings from home. On the side, an orange, a small cup of light and sweet coffee and a can of coke.

He looks agitated today. I think he may grumbling something under his breath. All he does is sit all day and does not listen to a thing staff tells him to do. He just yeses everyone to death and carries on, talking to himself and watching game shows in that same cafeteria seat from 7:00 am to 3:00 pm, until his cab comes to pick him up and drive him home. I pass him by with a cup of coffee in one hand and a file in the other.

I approach the kitchen door and am faced with the challenge of unlocking it with no hands available. My colleagues pretend as if they didn’t see me, and quickly continue with their tasks and pressured walks to the fax room just down the hall. Struggling to maneuver the objects around in my hands, I attempt to place the paper coffee cup in my mouth to free my left hand to be able to unlock the kitchen door.

Just as I was in mid action of doing so, I hear a chair scrape across the floor as if someone was pulling away from a table followed by dragging feet coming my direction. And there he came, walking towards me,with an expressionless face and a zombie like posture. It was Chuck from the cafeteria. Trying to keep cool and maintain a positive attitude, I feel my heart beat through my chest and immediately I begin to think of self-defense moves and escape plans.

Although my colleagues were not too far, this man is psychotic and I’m not his therapist so I really don’t know him too well. I usually just see him eating and talking to himself with an angry look on his face most of the time. Never have I saw him act violently towards anyone, but I do know if certain patients miss even one dose of their medication, the voices get slightly louder and slightly more demanding.

Well there he was, towering over me like a bully in a school yard. And with a smile, I began:

 Me: “Can I help you with something?”

Chuck: “Yea, tell me why no one believes me that I have powers.” “I am God you know, and it’s frustrating that no one in mah life believes me; “not mah brotha, not mah lady friend, not mah cleaning lady at the house and not even mah own doctah.” “I hear what they all thinkin, ya know?”. “It’s a whole lot of thoughts I hear every day, I should get some credit, I am GOD ya know!” 

Me:  (Filled with guilt because of how scared I am, I’m quickly trying to think of what to say right at this very instant that will defuse the situation, make him go away, but still sound therapeutic and nice) I reply, “Well you have a very tough job if you are God”, I guess I shouldn’t ever complain about mine.”

Chuck: “Well it’s tough, ya know?” I don’t wanna hear what everybody be thinking about around here” “Boy, is everybody thinking lots of shit today ya know?”

Me: (shocked that he has actually said more than a few words to me) “Probably is distracting to hear those thoughts all day when all you wanna do is just enjoy the day and get things done right?”

Chuck: “Hell yea, I don’t wanna be hearing about nobody’s sex life, or what this one thinks of that one, it’s too much, ya know” “That’s why I like to watch those game shows and wear mah head phones, cuz then I don’t be hearing these damn people’s thoughts as much, ya know?”

Me: I don’t blame you”

Chuck: “Alright Ms. therapist lady, mah cereal is getting cold.”

Chuck turns around and walks away. I was so relieved things went smoothly and that I wasn’t attacked, yet I was so shocked I got more than three words out of him. BUT, I spoke too soon. Chuck turned around again and began to walk my way as I was just attempting to try to unlock that employee kitchen door again. There he was again, standing right before me.

Me: Forgot something?”

Chuck: Yea, the reason why I walked over to you in the first place”

Me:  (Now, my heart is pounding against my chest, I’m finding it hard to swallow, and I’m just about ready to flee)

Chuck: (Takes my cup of coffee out of one hand and my file out of the other) “Now go ahead and unlock that door”

I unlocked the kitchen door, said thank you to Chuck and closed the door behind me.

Out of all people in that building, he was the one to help me with that door. I will never forget that.

Lesson #1 Crazy people are more sane than normal people.

Lesson #2 Most patients/people experiencing a mental health condition or crisis just want to be listened to, to feel understood and be empathized with.

It’s tempting for mental health professionals or family members of someone with a mental illness to try to get the person to believe their experience is wrong, bad and/or unreal. It’s not going to work. Only causes more conflicts within the person and with others.

Trying to get a schizophrenic to admit that his beliefs are fake is like trying to get a republican or democrat to admit that their beliefs are wrong, bad and/or unreal. Not going to work. Only causes more conflict within the person and with others.

Good Will Hunting

Empathy is one of the most important characteristics that a therapist NEEDS to have in order to develop a good relationship with their patient. Watch the movie Good Will Hunting starring Robin Williams and Matt Damon to see a perfect example of a therapist who uses empathy as his main source of treatment with his patient.

(Names and Locations were changed to protect the privacy and rights of persons mentioned in this article)

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7 Responses to The Key to Psychosis-Empathy

  1. I think the so-called mentally ill are some the most misunderstood people in the world. We are too quick to judge someone as mentally ill, and put them on medication. There might be other things going on. Of course, I am not a professional, but I think some people are labeled mentally ill because we don’t know what else to do. It is very interesting that the mental patient was the only person who helped him out with unlocking the kitchen door. They notice things the rest of us are too smart to notice.

    • Charles Hice (Tenn Man) says:

      Russell,

      In Ohio, The Mental Health system is bankrupt and spends money foolishly. The majority of citizens do not understand –that thousands of mentally ill persons walk the streets of our towns daily.

      Many mental health people are not a threat. Some of the extreme residents are not permitted to walk around. Mental Health authorities do not know what to do with some of them, so they outsource them to other agencies. These people can end up in jail and/or prison.

      I do not understand why citizens do not become involved with the homeless and mental health residents. There, but for the grace of God, there go I. Not sure, if I said that correctly, but I believe in that statement. Why don’t people volunteer more in their communities? Short term –an hour a week?

      Our tax money is often being wasted.
      Charlie

  2. What a great post! I will re-read again. I worked in a homeless shelter for four years. Most of the men and women were mental health residents. Everyone on staff and higher ups thought that the people were “lazy.” And, I have to admit that some were.

    No one came to visit. Some of the staff “tried” to relate, but were uneducated. People were classified in some way and shuffled aside. I am worried about mental health people, who have been given apartments. Do they have enough to eat? Are they taking right medication? Who is taking care of their money? We have hundreds going through the jail and prison systems daily.

    There are some people – that they do not know what to do with. So, they end up in jail and/or commit crimes.

    Empathy is a great word. Perception is a very strong word, and when we say people are lazy, we are branding them. There are many mental health people who do work. And, I think that if they treated people (like MRDD) —then it would be so much better. MRRD people live in a community setting.

    Hello World!
    Tenn Man
    Charles

    Hope that you give us more glances.. . . .My blog won’t be published until I get a .com. Not computer literate.

  3. otuss says:

    Thank you. I hope for the same as well. I’m glad we are no longer chaining people to walls and throwing them in ice water baths to calm them down as we used to do 100’s of years ago, but we still have along way to go, as stereotypes and stigmas are quite prominent within this population.

  4. showard76 says:

    Awesome post, I was just thinking about empathy last night (when I was trying to get to sleep lol) but as well as your own demonstration of empathy do you not feel that Chuck’s actions demonstrated his ability to empathise too? Other people could see your struggle but being selfish and ignorant chose to ignore rather than help, while Chuck recognised that all you needed was someone to hold something for you briefly to enable you to open the door and empathising with your predicament chose to provide the help that was lacking from others. As my mother said to me yesterday when discussing my own mental health “the old saying there is a fine line between genius and insanity is very true, you were far too clever even at 12 months of age and getting older and cleverer has just pushed you over that line” I think it was meant as a compliment! lol

    • otuss says:

      What a great perspective! It amazed me to see such a “crazy” man express such a kind and simple act, yet actual “helpers” struggled to do so. I would definitely take what your mother said as a compliment 🙂

  5. judithatwood says:

    This post is both a striking and well-told story, and a lesson imperative to anyone who works with people whose mental processes do not run in expected channels, and who wants to reach the people in his/her care. Somewhere along the line, society as a whole has decided to treat people with mental illness as though they were less than people, not deserving of or worth the effort of common courtesy in all its forms — including simply listening to what they have to say. Thanks for lifting this situation into bright light. Perhaps some caregivers will read this post, and think before they react to the people with whom they work. A terrific post!

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