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The Joy of Recovery

[Remarks to a conference by a Philippines family member]

...I stand before you as an advocate and torchbearer for mental health and the role of psychosocial rehabilitation with the family at the core of the intervention. That, in fact, patients who suffer from chronic depression, emotional dysfunction can be well even after a long wait of more than two decades. In my case, a sister, a professional who suffered the pain of psychosis and not unlike Rip Van Winkle woke up to our world after sleeping and not remembering what happened and why.

This happened in 1972 while in a special training on drug addiction rehabilitation. My sister had a nervous breakdown which caused her to cut short her stay in England. Her companion psychiatrist suggested she return home without any treatment, viewing the psychotic break as primarily culture shock.

Her swift return became a nightmare to the family. No one had an explanation on the whys and wherefores of her mental aberration. Her behaviour was such that she could no longer effectively discharge her duties and functions as head of a child welfare institution. A priest psychologist described her bizarre behaviour as "climbing the walls". For example, she would eat morsels of food found on the floor. She prayed a lot, read the Bible and gave away her food, clothes and took little care of how she looked. Most of all, she lost her capacity to communicate verbally. She would just nod or shake her head or just smile. She shunned eating with the family, and more so attending social functions. It cost her her job.

My mother tried to get her cured or healed through various indescribable means. She blamed us for not caring. She was quite right for we were uncomfortable with the situation and did not quite know what to do. She was just there, a sick or unwell sibling. None of us knew how to deal with the problem until now.

In understanding the pain from inside, we have to realize that the person in pain does not see the rules and regulations of this world applying to her except as to their ability to interfere with her internal world. The exterior world, that regular individuals deal with day to day, holds little or no interest to her. Punishment and pain are less likely if she does what the family decides she should do. So she does these while dealing with the world that is more critical to her at the time. Without medicine this is usually the inner world. Skills don't necessarily have to be retaught like to a child who has never learned them. But the inner world must be made peaceful enough for the patient to deal with the less critical outer world.

The next thing that must be understood is that the inner world of the patient has the upper hand. This means that no matter how much the family may want her to deal with the outside world, unless the patient is good and ready, this will not happen.

The third thing that must be understood is that the inner world is as real if not more to the patient as the world most people deal with. There are terrible physical pains, there are screaming, threatening people. And it is all exacerbated by a real world that adds to these pains with drugs that make you feel awful, leave you helpless and in psychic pain and stress fight or flight? And one often enough gets fight. "Leave Me Alone" "There is nothing wrong with me".

The fourth thing that must be understood is that the patient, when she is doing "nothing", is just sitting trying to deal with this inner world, without guidance or help.

The fifth thing is that patients need evidence as much as regular people. Will her behaviour be evidence that she is good or not? When she gets approval and affirmation from family, it means being good. To do otherwise is to be perceived as evil.

The sixth thing that must be understood is that the world of psychosis is very complicated. She must learn to recognize that she is powerless against them and does what needs to be done to reduce the pain inside through medicine, rest, distraction, biofeedback, etc.

A close friend of my sister volunteered to accompany her to Dr. Lourdes Ignacio to try once more, having failed with two previous psychiatrists. She was distracted by weekly special trips with a sibling every Wednesday, where bonding must have taken place, going to church, eating out, going to the movies and visiting with family and friends. Weekends were for me to drive her to places like church, cemetery and shopping malls and connect her to places and people she had lost in her inner world.

She took her medicines assiduously supervised by a string of caregivers other than family members. She saw the psychiatrist weekly, later less and less.

She was sick at 39 and got well at 60. She has since travelled abroad to Asia and the US and parts of the Philippines. She works, is active in church and community organizations. She does ballroom dancing and enjoys going to the theater and attending parties.

Up to now no one could explain why she got sick. But we can explain why she got well. It is because we understood her pain and she was ready to face the rigors of recovery. The family knew that unless we were part of the solution we would continue to be part of the problem.

It continues to offer moments of blessing; moments of celebration as I witness the joy of my sister's recovery.

I have come up front to speak before you as a testimony that there is hope, and when you have hope you have everything, for without hope there can be no faith and no charity. Sometimes it takes a long time. Ours took 21 years.