Public Comment

ON MENTAL ILLNESS: The Internal Work of Managing Symptoms

Jack Bragen
Friday July 24, 2020 - 01:17:00 PM

Sometimes there is only a hair's breadth, metaphorically speaking, between my consciousness rejecting a delusion versus believing in it. It requires unrelenting effort to recognize and nullify delusions, and this process is far from foolproof. Psych medication is the precondition; it is far from being a complete solution.

In addition to being medicated, a person subject to severe psychosis should probably do a lot of "reality checking" where practicable and should find a reliable person with whom to discuss thoughts. We can practice at teaching the mind to pinpoint a delusion. Nullifying a delusion also entails not being emotionally attached to the erroneous belief. The ability to let go of a belief to which a person is emotionally attached is improved with practice.

Clinical depression is probably not without a psychotic element. If depressed, the patient's perception of life is exaggerated toward everything being bad and hopeless. If not depressed, the same circumstances would likely be interpreted as workable. But how does a person obtain this better attitude, this more positive perception? Normally it would be accomplished with medication and therapy. You wouldn't normally be able to create it on your own. This is not to rule out independently working on oneself. 

There is a fine line between accepting medication because it is the only thing that will do a good enough job of relieving your symptoms, versus trying to medicate away the normal difficulties, problems and pain that come with being a person. On the other hand, this fine line is not fine in the case of severe psychosis, the distinction is very clear: take your medicine in order to save your brain cells and your life, or play games with not taking the medication--and life fizzles out. I've learned this the hard way. However, in 1996, I made a lifelong commitment to compliance. As a result, I have gained a lot of ground, especially regarding cognition. 

The more years a person with schizophrenia can go without relapsing, the more opportunity there is to reinstate and improve faculties. 

A person with schizophrenia probably has a structural problem in a part of the brain. A psychiatrist I saw in the mid 1980's showed me a poster of a brain and pointed out the problem area. Filtering of stimuli is the problem. The problem area of the schizophrenic person's brain is not the same area as that responsible for intelligence. Yet, that one trouble area can ruin the ability to discern reality versus the unreal. It also sensitizes the patient, often making them unable to handle excessively stimulating and/or demanding environments. 

Trump, whether you like him or not (I don't) in one of his books said that he has three hours of alone time every day--and he may have recommended the same thing to others (That part I don't recall). This strikes me as the same coping mechanism that I need to clear my head every day, a need that exists due to the psychotic condition. 

I've benefited a lot from writing in a notebook, instructions given to myself on how to improve my internal processing. When all of the junk got out of my head into notebooks, I became able to write for publication. 

About twenty-five years ago, I was having problems finding my way back to reality following a psychotic episode--hopefully the last one that I will have. I adopted the practice of studying how my mind works and how parts of it could be fixed. This led to a return to clarity. 

Now, my life path has brought me more difficulties. Most are dealt with and done, and they occurred in my life over the last three to four years. Yet now I'm still trying to make things better. I've returned to the practice of journaling my thoughts and giving myself instructions on what meditative practices I will use and how to do this. This is a written meditation. I don't know if others have developed something similar. However, this practice has allowed me to improve my mental health. And this bears fruit: more skillful actions and speech, ultimately resulting in better life circumstances. 

A psychiatrist might say you should not get heavily into your thoughts because it will lead to getting worse. Yet people with mental illness may have the capacity to meditate. Probably, some of us can, and some can't. 

"Lion's Roar" a top-notch Buddhist magazine, in their submission guidelines, implies that mentally ill individuals do not have the capacity to be meditation practitioners and writers. This is the prevailing belief. This is unfortunate, because many mentally ill people could benefit by pursuing this. 

I would say, if you want to pursue meditation, begin by learning what others have done. Read some books about meditation and spend time with people who practice mindfulness. I did exactly that, beginning in 1983, following my first psychotic episode. I was seeking answers. And I credit the practices I learned for giving me a better outcome than the doctors prognosticated.