Columns

Becoming symptomatic due to unfulfilled gratification systems is a scenario out of many in which persons with mental illness can become unstable. There are numerous paths to becoming acutely ill, and what I am about to describe is only one of them. 

What I am calling, "gratification systems," are not unique to persons with mental illness. Many people gain gratification through money and power. Some gain it through sexual encounters. In some instances, looking forward to a particular goal, or perhaps wish, programs the mind to create gratification through something a person thinks she or he will obtain, or attain. 

Even practitioners of meditation are sometimes subject to this; this seems contradictory to their philosophy. Trying to meditate because you want to "become a Buddha," is a goal-directed gratification system, and seems contradictory to the essence of the philosophy. Not all meditation practitioners are subject to this, however. 

In one of his books, "Peace is Every Step," Thich Nhat Hanh warns against postponing happiness, and says we should allow ourselves to be happy right now--not in so many words. (I would give an exact quote, but I've misplaced my copy of the book.) 

The concept that "I'll be happy as soon as I get [or have, or attain] something, is a source of distress for people, and is a way for us to frantically run on a treadmill of our own making. 

Trouble arises if the gratification system is too strong, to the point of being obsessive. This is sometimes relevant to a cycle of periodic relapse of people with schizophrenia. While there are a lot of non-afflicted people who have overly strong desire systems, a person with a predisposition to schizophrenia can be triggered into a psychotic episode when it is clear that her or his wishes will not come about. 

If you look, for example, at Olympic athletes, you see people who have obsessively strong desire/gratification systems. Who can blame them? If you win a gold medal, you could be set, economically, for life. However, Olympic athletes have done the hard work needed to have a chance at obtaining their goals. 

If a person is in "pre-psychosis," their mind could be establishing unrealistic desires or obsessions. These might be things we are set on, and yet we may not be functioning close to a level necessary to get what we want. 

Wanting something and having the sense that we deserve it is not enough. We must also be capable of doing the things needed to make it happen. This brings into the picture the need for a realistic self-assessment. 

Being obsessive toward a goal is usually unhealthy, including when a person is within the bounds of realism. Many politicians have realistic chances of obtaining more and more powerful public offices. Yet, many have made power into an exclusive focus, one that excludes the well-being of those they have been elected to serve. 

Other obsessions, that perhaps are more common, might include purchasing too many lottery tickets, to the point where one can't make rent. This is the belief that oneself is somehow special, and has some perhaps supernatural ability to obtain the winning ticket. 

On the other hand, when the jackpot is several hundred million dollars, I have heard of multimillionaires purchasing huge numbers of tickets, possibly on the basis that the jackpot is so large that doing this makes mathematical sense. I am not clear about this. 

My last purchase of a lottery ticket was in 1985, or 1986. (Before 1985, there was no lottery in California.) After buying maybe five scratchers at the most and not winning anything, I quickly realized that it was money down the drain. It is on a par with the foolishness of spending money on cigarettes. 

But, when a "pre-psychotic" person becomes aware that she or he isn't getting the thing they have set up their mind to expect, it can lead to an abrupt worsening of the illness. 

If the individual survives this and is hospitalized, it is a chance to learn acceptance of an unhappy truth. And that is when things can begin to be better. 

The above isn't the only way that someone can "decompensate." Furthermore, if the brain had been functioning as it should, and if the predisposition to psychosis had been absent, the individual, at the point of realizing they're not going to get what is wanted, could have some kind of epiphany, rather than their mind going down into the pit of psychosis. 

There is a border between mere lack of realism, versus being outright delusional. A mental health practitioner advised me to attend a day program because he believed I had unrealistic ideas about what my writing would do for me. 

When I went to the program [because I was open-minded about the practitioner's idea], a senior citizen tried to assault me. When I asked for help from staff, they didn't do anything. So, rather than having an altercation with someone who probably couldn't defend himself against me, I walked out. And that was the last time that I went to a day program of any mental health provider. 

As it turns out, the senior citizen who wanted to attack me suffered from a stroke or seizures that made him aggressive; this was further reason for me not to blame the would-be attacker for his actions. 

Schizophrenia is a disease, and so are alcoholism, drug addiction, gambling addiction, and many other behavioral problems. The thing about schizophrenia, however, is that the basic mechanism for finding reality becomes compromised. And because of this, schizophrenia is sometimes very hard to deal with and treat. 

Schizophrenia is not a character problem and it is not a sign of weakness. Someone might say, "Oh, he/she didn't get what he/she wanted, couldn't handle it and went psycho..." 

However, that is an oversimplification. You can insult mentally ill people all you want, you can label us losers, and you could call us freaks or weaklings. However, the truth is, we are human beings, we have dignity, and we've suffered from a brain disease. 

Unrealistic desires aren't the cause of schizophrenia. A brain defect is. In this week's column, I am pointing out a scenario that is not universal, and that happens only to some people who have schizophrenia or other psychosis. Other people can get reactive psychosis, due to a traumatic event. Still others can get sick with no particular cause that we can point to. 

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Yet, who is to be the judge of what is or isn't realism? Certainly, people in positions of treating mentally ill people are usually quick to judge that the ambitions of someone with mental illness are not realistic. If I'd bought that judgment, this column and my other published writing wouldn't exist. 

I've had numerous desires earlier in my life that, at the time, were not realistic, but which, later in life, were in the realm of possibility. There is no rule that says if you are mentally ill you shouldn't try to do great things. Numerous mentally ill people have achieved great things. 

And there are plenty of so-called "normal" people whose ambitions aren't realistic. Entire industries are built on people's foolishness. For example, there is "Invent-Help," a company that takes your money and your idea. If your idea is any good, they'll steal it. If not, they've got your money anyway. 

If you are mentally ill, it does not mean that you can't do anything. If you aren't mentally ill, it does not necessarily mean that you are not a fool.