Realistic Issues in the Treatment of Schizophrenia
By Chess Brodnick, MA
The treatment of severe long-term
schizophrenia involves a unique approach to the treatment process. Dealing with
intra- psychic issues to the exclusion of more practical problems is one of the
main reasons most psychotherapeutic treatments fail. Insight will not stem the
tide of confusion, helplessness and alienation this population experiences. It
is only when looking at the person as a whole that constructive approaches to
treatment emerge.
The first and perhaps most essential element in the
treatment process is to establish a relationship with the client. It will be
necessary for the therapist to initially assume responsibility for developing
and maintaining this relationship.
The purpose of this relationship will be
to establish the therapist as a meaningful fixture in the client's life. The
client will then be able to build a new way of seeing him or herself based on
this relationship. The therapist will also be able to see the client as someone
who is able to make constructive changes. Productive communication will be
possible. The therapist will now have an entry into the client's inner
world.
The therapy or re- educative process can begin effective therapy
consists of assisting the client to recognize his or her condition, and then to
find ways to control it. Uncovering causal factors may not be very helpful to
someone who doesn't recognize reality. Dealing with childhood memories may only
serve to add confusion to an already disorganized life. If a solid relationship
has been established, the therapist can begin to point out how the client's
present thinking is standing in his or her way. An exploration of how stress
exacerbates the thought disorder can begin. It can be pointed out how a client's
fears will lead to feelings of alienation, and antisocial behavior consistent
with that feeling. Social patterns can be evaluated. This type of practical
information is highly valuable for effective therapeutic
intervention.
Clients can be educated about their thought processes to
the point that they recognize the difference between reality and unreality. The
therapist can point out how the person jumps from a "reality" viewpoint to a
psychotic one. Clients can then be taught to track this themselves. They will
have a chance to see first hand how stress is a major factor in the acceleration
of symptoms.
Therapy can then focus on behavioral changes. Clients can be
shown how their behavior influences the manner in which others treat them. They
can be assisted in implementing a healthier approach to life.
Therapy in
practical application can teach them how to have fun, solve problems and get
along with others. Progress in therapy can only occur when a healthy change of
life style takes place. This means adopting a new way of living or doing.
Insight, while a helpful component, is not enough to bring about a change of
life style. It is important for the therapist to focus on more productive ways
of living and to actually help the client explore new behavioral
patterns.
It is imperative to begin seeing the treatment of schizophrenia
from a more creative standpoint. Being mired in a stagnant system of treatment
with this population is certainly not the answer. Rebuilding lives is indeed
hard work, but it is work that is abundant with hope and life.
P.S. I am
proud to announce the Anne Sippi Clinic "Help the Homeless" program continues to
be a great success. At this time, residents have made and passed out
approximately 9,000 sandwiches to the homeless population.