Note: Information in the following article came from namigc.org)

It’s difficult to understand what someone with a mental illness experiences, but you can get a better idea by trying this empathy exercise.

Have you ever:

• Gone for 24 hours without sleep? 48 hours?  Longer?  How did you feel about being awake this long?  How did you look?
• Dozed off for a second, awakened with a start and didn’t know where you were?  How did you feel? What would it be like to feel that way for a day, a week, several weeks?
• Lost your sunglasses or car keys and no matter what you did, you couldn’t find them?   Did you feel like screaming?
• Been driving down the road when suddenly your directions got mixed up?  Say, you confused or reversed north and south. How did you feel?
• Had a funny little tune going through your mind for a couple of hours or a whole day and, no matter what you did, you couldn’t get rid of it.  How would you feel if that same tune went through your mind for three days, a week or a month?

Now let’s put three or more of these items together.  Say you’d hadn’t slept for three days, you heard the same music going on and on in your head, and you couldn‘t find your keys.  How would you feel?  How would you look?

All these things are experiences from the inner world of people struggling with serious brain disorders.  By thinking deeply about these symptoms, we can feel more empathy and understanding toward those who experience them.

The fact is, even in remission and even when properly medicated, chronic mental illness leaves its sufferers in a devastating limbo.  Many people with mental illness are effectively cut off from the predictable, rewarding, self-fulfilling live involvements that make existence meaningful.  They suffer deeply from their inability to be competent and successful in their daily lives.

This life-constriction threatens our loved ones’ psychological integrity.  It sets up a process where the people with mental illnesses feel they must protect their “core self” at all cost.

Many behaviors that result – refusing medication, rejecting family support and community programs, and disrupting family life, for example – don’t make sense to us. These behaviors are directly related to their struggle to maintain some dignity and self-respect in the face of stigma, failure and shame. It would be kind of us to appreciate that many of our relatives’ behaviors are driven by the need to protect their own fragile senses of self-esteem. 

Psychological Traumas Associated with Any Serious Chronic Illness

Whenever a person has a serious chronic illness …. COPD, emphysema, chronic heart disease, or a mental illness … two things happen to their sense of self.

First, they lose their protective belief that they are exempt from harm. Much of our sense of safety and our willingness to take risks in life rests on a belief that serious harm or real trouble will never happen to us. This has been called “evolutionary delusion” because it’s responsible for a large chunk of human progress. Young people especially have this sense.

Second, they lose their sense of a predictable, dependable future. This results in the use of defensive coping strategies.  These are self-management techniques that are basically maladaptive.  They don’t help people get what they really want, but they do provide temporary psychological refuge when confidence and self-image are taking a nose-dive. Let’s look at some defensive coping strategies.

Defensive Coping Strategies

• Self-absorption
• Irritability
• Haughtiness
• Controlling behavior /Manipulation
• Anger
• Rejections of friends and family
• Blaming others
• Defensiveness
• Drug and alcohol abuse
• Doing nothing
• Resisting change
• Refusing help
• Denial
• Apathy
• Bargaining
• Withdrawal
• Suspicion
• Dependency
• Envy
• Running away
• Refusing medication
• Quitting a job
• Abusive criticism of others
• Sleeping excessively

From time to time in daily life, all of us will use one or more of these behaviors.  If we are criticized at work … snubbed by someone we thought was a friend … having a fight at home … we may use one of these behaviors if we feel momentarily crushed.  We complain or attack.  We “need a drink.” We get fed up and call in sick.

For us, these are temporary responses when we feel temporarily defeated.  We normally pull out of them quickly.  We turn to our social and personal life structure, finding comfort and reassurance.

Defensive Coping Strategies in Mental Illness

The situation for people with serious mental illness is drastically different.  Their social and personal life structure is vastly diminished. They are facing poverty, stigma, disability, joblessness, and social rejection. They are trapped on a runaway train going the wrong way.

The negative coping strategies become a familiar and reliable way to protect themselves from becoming even more diminished.

It’s impossible to conceive what mental illness is really like without recognizing the fundamental problem of psychological demoralization.

It takes enormous courage and determination to pull up out of these defensive postures of reacting to mental illness.  But it can happen.  Next time we’ll talk about how we can help.