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Since I am in a more intensive level of treatment than I have been in a while, I have a chance to be in group therapy on a regular basis. Sometimes, not always, the subject matter is irrelevant to anything people must normally deal with in life.

The above isn't necessarily a shortcoming. It occurred to me the other day that the subject matter probably wasn't the object of the meeting.

While we interact in the group, we are being observed. The facilitator was probably observing people's levels of engagement, and numerous other things about how group members have interacted. And this is fine for clinical theory and practice.

My participation in a clinical program is temporary, and I plan to move on from it fairly soon. However, I have benefited from it. I've been able to use their services in order to deal with specific problems. Now, the problems are different.

But it is good to take a pause and let group therapy help me. I do not actually feel trapped by this, nor do I feel that I am in a dead end scenario. The program that I am attending is allowing me to refurbish parts of my insides that I have long neglected. 

I have prospects for the future. If I did not have this hope, I would not see a point in being "healed" by therapy. The program I am going to has done a lot to scale down my paranoia. It is a change in environment from that of trying to "tough it out," take care of my spouse, and try to succeed in life at the same time. 

Part of surviving exists on an emotional level. I turned down a job interview I had lined up because it seemed to me that the particular job wouldn't feed my spirit. While money is a need, loneliness and the absence of connections will kill you. 

The issue is not necessarily about having a job, but about what the job does for you other than just make extra money. If the environment is corporate, or if it is impersonal, and doesn't do anything for you other than bring home some bread, then you could be working in an emotional vacuum, and your needs are not met. 

I am in favor of supported housing for those who suffer from psychiatric disabilities. I am in favor of supported employment. My stance has changed from what it was ten, twenty, or thirty years ago, when I had the bravery, energy, and the foolhardiness of youth. 

Persons with psychiatric disabilities, especially those of us who are afflicted with ambition, have a very hard time making it in society, especially when we age. I see most mentally ill people fall apart at about my age, sometimes sooner. Mentally ill people often do not last into their hoped-for final quarter century or so, of life. 

I am fortunate that I have made it this far. If I can create better conditions for myself, I could do very well in later years. 

Some mental health practitioners seem to project on me that I am doomed. That isn't enough to make me give up. However, just as with the carrot analogy, I have a different approach. I am using the mental health system to my advantage. In the not so distant past, my strategy was to do things outside of the system and to distance myself from the system. 

One result of distancing myself from "the system" is that I have generated a lot of writing credits. However, I've ended up in a bad rut, and I was becoming increasingly delusional and paranoid. Now I am dealing with that, and I am accepting, even asking for, more help from the mental health treatment system. 

The State of California has services that have come about as a result of Prop 63 funds. This is a good thing. It means that there is a little bit more available on an outpatient basis. 

If mentally ill and aging, conditions can be very hard. One of the hardest challenges for some is that of having a reason to go on. Another challenge is that of having sufficient emotional and interpersonal support. And another challenge, almost universal, is of making one's income last the entire month. 

So, yes, my stance has changed. I am not quite as rebellious against the mental health treatment system, and instead I am being helped by it. The "carrot," in my analogy, represents dealing with the predicament of getting older while mentally ill. 

It is important that even if we are not as strong and brave as when younger, that we still can adapt to new challenges. And a lot of this is related to brain condition. And, concerning brain condition, it is subject matter for a future installment of this column.