Translating Mental Illness

I’ve worked as a life coach for a little over two years, while having previously had a few years of experience working in a psychiatric hospital. Maybe it’s my own demons that allow me to have a sort of insight into mental illness, or perhaps everybody has a gift and mine is understanding the misunderstood. Whatever the case is, mental illnesses usually follow a pattern to one another. While this isn’t quite the revelation that many professionals hope to uncover, there’s quite a bit to build off of as far as the effectiveness of communicating with those who suffering from illnesses like bipolar or schizophrenia.

The hospital had many different disordered residents, ranging from the majorly depressed to the drug induced psychosis brought on by two decades of crack cocaine. My first few days were shocking, as many residents were wearing helmets because they were fall risks from either years of abusing their bodies with drugs, or from years of ineffective treatments that had left them as little more than zombies. There was a common theme that I noticed within those first few days which was that everything that they said was important for them, and that the reason they said it was because they were craving a connection.

Taking these two factors into consideration made interacting with the residents much easier. By learning how to translate mental illness, you’re able to then learn how to redirect and sooth that same mental illness. It’s much like a computer program that stops working, the frame is frozen, the sound shuts off, and void restarting your computer, there’s few options left to have it run successfully. You could abandon the program altogether, or you could try troubleshooting and turning the other programs off to help it run more efficiently. With mental illnesses like schizophrenia, I learned early on that dismissing the attempts at connection was more harmful than trying to speak “schizophrenic.” If a patient rushed up to tell me that people could read their minds, I would say something to the effect of, “well, if that’s so, why not think something nice or fun for the person listening?” Or even, “that might be true, but does it really matter? What’re they going to do with your thoughts?” It might seem silly, or seem unprofessional, but everything was documented, everything was considered as either a lapse in treatment or successful, and I wasn’t the judge, luckily.

I’m not a therapist, nor am I licensed to practice medicine. I kept notes on every resident and discussed their behaviors in bi-weekly team meetings with the psychiatrist and the social worker, but there was a sense of connection that I managed to create with the residents simply because I wouldn’t dismiss them as crazy. Though a great deal of patience was required, I allowed them to express whatever it was that they wished to express, and did my best to include myself into their narrative. By doing so, at the very least they began to feel included and understood. When there’s a monster under your bed, it’s terrifying to think that at any moment your legs could be grabbed from under you and you could disappear into the darkness without anybody knowing. If you happen to have a friend who sees the monster with you, then there’s something slightly less terrifying about the ordeal. Sure, the danger, even though it might be imagined is still there, but you aren’t alone, and that at least takes one giant variable out of the equation.

My job was to de-escalate anxieties in the residents. Later in life I worked with a man who was certain that the police were following him. Though I could calm him for a few minutes, very little of what I did or said mattered, as the narrative would replay for him. It wasn’t until we began going out and having fun that the delusions decreased in frequency. Sometimes, people aren’t looking for a connection, they’re looking for an escape. While there are unhealthy escapes like drugs and alcohol, there are healthy and even beneficial escapes like fun and leisure. This man had given absolutely zero of his time to allowing himself to let his guard down and find enjoyment, and so his delusions of the police after him simply mirrored his anxieties of his mind being a prison. Coupled with feeling understood and no longer alone, he began gradually to build a more fulfilling life for himself by getting a job and attending concerts on the weekend.

Though these connections are completely of my own observation, I believe that connection is an important factor in working in any capacity with the mentally ill. The monsters aren’t nearly as scary when somebody else can see them as they are when you’re alone and they’re there. Not everybody with a mental illness will act as dramatically as some, nor does one person’s symptoms look identical to another’s. The common variable with anybody with mental illness is the same as anyone without a mental illness. We as humans crave connection, we crave closeness, and we crave acceptance. Whether suffering from a mental health disorder, mentally sound, or being chased by monsters, all of us are doing the best we can to be understood.

Jay Pignatiello is a 28 year old life coach and a writer who lives in Los Angeles, CA. He currently works with Crownview Co-Occurring Institute, a mental health facility in San Diego. He enjoys playing music, attending concerts, and reading in his free time.

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