|Journal of Humanistic Psychology, vol. 26 No. 1, Winter 1986 61-71
© 1986 Association for Humanistic Psychology
PREVENTING MENTAL ILLNESS:
Some Personal Discoveries
Twelve years ago I was hospitalized for paranoid schizophrenia. I was tranquilized with thorazine, electroshocked, and my progress was followed by a psychiatrist. I improved enough so that I was released, but afterward I still had depression and mental illness. All this didnt have to happen. Most of the knowledge I needed to deal with my illness was already known, but was not communicated to me. Through years of struggling with and studying my mental illness, I learned how to deal with it. It was then that I found, to my shock, that methods similar to the one I had developed for myself had already been developed. The most similar methods, cognitive and rational-emotive therapy, were developed recently and independently of each other, yet are very much alike.
The knowledge I have gained through studying my condition and reading has enabled me to conquer my condition as well as to lead a happier and more dignified life. I think this knowledge could help others deal with everyday problems, and I think it could help prevent people from becoming mentally ill. If I had known as a child what I know now, I dont think I would have become mentally ill.
THE SELF-FEEDING NATURE OF EMOTIONAL PROBLEMS
The easiest and perhaps the best way to describe the mental illness that I experienced is as a network of interconnected, self-feeding, vicious cycles. I have drawn my understanding of them in Figures 1 through 7.
In Cycle 7 (Figure 7) I list factors from ones state of mental health that influence ones moral behavior. Paranoia toward others makes it easier to justify to oneself actions that hurt others. Low self-concept means that self-respect is less likely to guide ones actions and makes one more likely to defend ones self-
Figure 1: Cycle 1
Concept by blaming others. A pessimistic attitude discourages one from making the effort to do good things or prevent bad things. In general, one is more likely to feel goodwill toward others when one is in a good mood than when one is not.
Cycle 7 can be misinterpreted to mean that mental illness is a product of moral choice or that bad moral choice is a product of emotional problems. My intention is just to show that one feeds the other and not that one requires the other or that one inevitably leads to the other. For example, during my mental illness I developed immoral impulses. I resisted them, so they did not lead to immoral behavior.
The fact that mental illness and immoral behavior promote each others development suggests that reasoning or actions that promote mental illness, such as self-deception, low self-concept, or the belief others are bad, as well as unnecessary actions that lead to mental exhaustion, promote immoral behavior, and are therefore immoral. On the other hand, I think it is immoral not to feel low self-concept when one has done something one should be ashamed of, even if that low self-concept has adverse consequences, since that feeling can lead one to make reparations for what one has done. I think negative feelings can serve a very important purpose, but only when they are called for.
I have illustrated in the figures how false negative perceptions become self-fulfilling. I show how my negative image of my environment and the negative image others had of me began to cause me to become like that negative image, and how my false negative perceptions and the false negative perceptions of others became reality. I show how paranoia created hostility from others, how low self-concept led to failure, and how contempt from others led to behavior that evokes contempt. This was very
important for me to understand, because it gave me the hope that if I corrected my perceptions, my future would improve.
In Cycle 2 I show depression feeding low self-concept. I believe that I associated the pain of mental illness with guilt, since as a child I had learned to associate pain with guilt. Thus, depression fed feelings of guilt, which fed low self-concept. These diagrams show the self-feeding nature of mental illness. There are two implications of this that I will discuss. The first is that formidable and seemingly unchangeable problems can be attacked by attacking the problems that feed them. The second is that ones chance of success is much higher if one attacks the problems before the escalation progresses too far. Such an attack would consist of educating healthy people about the mechanisms and treatment of mental illness before they develop it. Preventa-
tive counseling programs already exist and are important, because once the escalation of mental illness progresses, there is so much momentum feeding the problems that they become very difficult to stop. Also, barriers are created to solving the problems. When I was mentally ill, my paranoia made me suspicious of anyone who tried to help me and thus acted as a barrier to them. My low self-concept made me afraid to talk about my problems because I was ashamed of them. My break with reality and my paranoia led me to believe that my depressions were caused by hostile alien beings. This incorrect perception of the cause of my problems acted as a barrier to solving them.
As my mental illness progressed, my false perceptions became convictions, since they had arisen partly as a self-defense mechanism for my self-concept. As my self-concept deteriorated, I clung more desperately to these defenses. The belief that I was a hero being attacked by aliens was a boost to my self-concept, believing that I was a weak victim of emotional problems was not. Also, it did not make sense to me that emotional problems could
cause the amount of suffering that I was going through. When people challenged my beliefs, I felt they were belittling me and didnt realize what a hero I was. My negative beliefs were also reinforced by my negative emotional state. When one feels overwhelming pessimism, pessimistic thoughts seem right. Another factor that reinforced my conviction in my incorrect picture of reality was that I interpreted all that happened to me so as to fit that picture, and this then became evidence supporting it.
In addition to internal barriers, external barriers to solving problems are created as mental illness escalates. The diagrams in Figures 1-7 show some of the ways in which the environment of a mentally ill person can become hostile and defeating. Once one faces such an environment, it is much harder to be optimistic or to feel loved. The constructive idea that helped me cope with my environment was that it would change for the better as I improved, and that change would help me improve still further, and so on.
When I was a child I was rejected by my peers. I became a target of constant ridicule and aggression. The effect of this was to create paranoia and low self-concept that grew until I had to be hospitalized. During a depression after I was released from the
hospital, I perceived that the negative thoughts I was having were exaggerated and I tried to reverse them by thinking the opposite. I thought "They love me" instead of "They hate me." To my astonishment and joy, I was lifted out of my depression. I tried thinking that every time depression started to set in, but it stopped working and I kept getting depressed. I found that I had to first diagnose the negative self-talk of my mind at the time I felt depressed and reverse that particular thought. The two negative thoughts I had to reverse most often were the belief that others did not respect me and low self-esteem. Reversing negative self-talk often led to another vicious cycle. If I was still depressed after trying to reverse negative self-talk, it would hurt my self-concept and create pessimism, because it made me feel I couldnt do anything to stop my illness. My increased efforts to
fight depression would lead to stress, which led to further depression. Once I lowered my expectations of reversal and realized that it is really a preventative measure in that it prevents negative self-talk from feeding depression, I was able to use reversal more effectively.
I mentioned in Cycle 7 how cycles similar to those of mental illness can develop in and among groups. I see the same type of reasoning errors I made in my mental illness among other "normal" people; and I believe these errors contribute to the poor mental health of society as a whole and that it would help society if people were taught to recognize these reasoning errors.
Over the years I kept a journal in which I would write down the things that were bothering me as well as the approaches I used to deal with them. When I reviewed my journal, I found that certain problems repeated themselves. These problems were low selfconcept, paranoia, and pessimism. I have used this knowledge in my self-therapy. If reversal didnt prevent depression, I set aside time in which Id go through the following three steps.
(2) Diagnosis of internal problems.
(3) Development of correct attitudes to replace false negative ones.
By external problems, I mean problems that are not emotional. For example, a car breakdown is an external problem. Planning a coherent approach to external problems, besides helping me deal with them, helps alleviate the worry and other internal problems they lead to.
The first step I use in self-diagnosis is simply to write down all the things I am aware of that are bothering me. To aid in my self-diagnosis I go through a list of core problems to see if they bring to mind any of the things that are troubling me. Often I become aware of problems that I was not aware of before by asking myself, "Do I have any problem that reflects one of the items on the list?" I have listed the core problems below:
(1) Low self-concept
(4) Hostility and lack of respect for others
In addition to this list, being aware of errors in logic made under the influence of a negative emotional state is helpful. I learned about these cognitive errors by reading about cognitive therapy. Magnifying problems out of proportion or overgeneralizing are two such errors. For example, generalizing that one is a failure because of a mistake is such an error.
After self-diagnosis I try to develop correct attitudes not influenced by these core problems. The adjective "correct" is very important. Trying to believe incorrect positive thoughts is very difficult if one knows they are untrue; it is dangerous because they are self-destructive. False positive thoughts are self-destructive because an incorrect view of a problem, positive or negative, prevents its solution.
Ones work is an important part of happiness. Work used to be a major source of problems for me. My mental llness made it difficult to concentrate and to remember and so led to failure. My supervisors pushed me so that I tried to force myself to perform well and to rush my work, which led to stress. This stress led to mental exhaustion and more failure. Through self-diagnosis I found that negative self-talk during work was contributing to making it a problem. Before I performed a task, negative thoughts would go through my head, such as "Im a failure because I havent been performing well enough," "I better force myself to perform at my peak or Ill fail," and "The task I have to do is boring and routine." I reacted to failure with the belief that I would always fail, and the pessimism and depression that resulted led to more failure. Now that I have become aware of this negative self-talk, I can reverse it by telling myself before performing a task that I am good at my work and by self-praise when I have done well. When I feel stress from tedious tasks, I try to think of the overall usefulness of the tasks, so that they become more exciting. To prevent myself from creating stress for myself, I try to set standards of achievement that are reasonable, break my long-term goals into smaller, achievable goals, and put the need of achieving those goals in perspective. By reducing stress, I achieve more in spite of the fact that I have reduced my immediate standards of achievement.
In Cycle 5 I show how overly high standards for myself promoted mental illness. When life didnt meet my standards, I would feel a sense of loss, despair, and sadness, which promoted mental illness. The philosophy of rejoicing in what has been instead of mourning for what was, and being grateful for what I have instead of despairing for what I dont have, has been very helpful to my mental health.
A major factor feeding my madness was loneliness. My negative feelings and depressed outlook as well as low self-respect and undignified behavior made it difficult to make friends. As I improved myself it became easier to make friends and that helped me improve still further. The main lessons I learned about socializing are not to try to feel or act a certain way in order to get approval but, rather, to be oneself and to prevent oneself from blocking love and friendship from developing. In Cycle 3 I listed some ways in which my mental illness led me to prevent friendship from developing. I think that a good preventative measure for mental illness would be efforts to create community for lonely people. I think a good way to help people who already are mentally ill would be for people to volunteer time to be a friend to a mentally ill person. Finally, I think schools and parents should take rejection of children by their peers very seriously and do whatever they can to stop it. A school friend I had who also was rejected is now in a mental hospital and resists my efforts to reason with him. I obviously am not an isolated case of rejection leading to mental illness.
One very disturbing aspect of my friends situation is that he resists taking medication, even though he desperately needs it. His doctors cant force him to take it, since in the state in which he is hospitalized they dont have the legal right to do so. I think the laws preventing them from doing so are an example of the insanity of society.
Although self-therapy cured me of my condition, I dont think I would have reached the point of developing it if I hadnt initially been hospitalized and treated with electroshock and thorazine. Once I was mentally ill, I resisted attempts of others to reason with me and so needed thorazine and electroshock to correct the neurochemical imbalances created by my condition and to ease the negative emotional state that was reinforcing my false convictions. Life would have been made much easier if a cognitive therapist had educated me about self-help and helped me uncover the causes of my illness. On the other hand, if I had known about self-help to begin with, I probably would not have developed mental illness and would not have needed drugs, electroshock, hospitalization, and so on.
It is well known that physiological problems can lead to mental illness; in fact, that was why the condition was called an illness in the first place. In addition, emotional stress can lead to physiological problems. For that reason medical diagnosis is very important. However, even in this case knowledge of self-help should be useful, since, as I have illustrated in my cycle drawings, escalation of emotional problems can occur which can take on a life of its own.
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