I am Not Sick I Don't Need Help!

Rating:
Summary: A helpful book for friends and family members
Review: (I have just read through this again, and I apologize for it being so long. If you don't want to read the whole thing, the summary is this: this book helps family and friends, particularly those who are new to mental issues, figure out what they can actually do to help in what appear to be hopeless situations, and it helps you a little bit to quit blaming yourself.)

I read this book about the time that a close friend of mine fell completely to pieces -- again.

He's creative, brilliant (a true "high genius"), has studied biology, is unusually knowledgeable about mental illness -- and is violently offended by any suggestion that he might have the same disease that institutionalized his mother for years and which appears to affect about a third of his close relatives (to varying degrees).

There is apparently a book called the DSM that lists the exact requirements for psychological diagnoses. My friend can recite, word for word, all of the sections of this book that apply to his family's class of diseases.

But he can't see that these items have anything to do with his own life.

For example, he may tell you that he has all of the major signs of clinical depression, and that his mother was bipolar, and that there is a category of bipolar disease whose sole diagnostic requirements are (a) that the patient is clinically depressed and (b) that the patient has a close relative who is bipolar, and that FOR ANYONE ELSE, this definition means that they have a sub-class of bipolar disease, BUT NOT HIM.

Like many people with his disease, he has done hallucenogenic drugs because he thought that being freaked out on LSD (or dead) might be better than being depressed. He has also become addicted to caffeine, tobacco, and any number of other legal or semi-legal substances.

Like some people with his disease, he claims to have spoken with and fought with demons and other spirits, and he believes that certain specific geological features are as alive as any animal, but "in my case, this is just part of my spirituality, although in most people it would be a sign of mental illness."

While he has finished college and held a couple of jobs, he has never once left a job on good terms with the employer, or, in fact, any individual on the staff -- they've all "suddenly changed, and turned against me." (Several of them "have tried to kill me.")

He has been engaged to be married several times, but they've all "suddenly changed, and turned against me." He can point out the exact hour that each one "suddenly changed, and turned against me." That this moment corresponds to the sudden onset of clinical depression "is irrelevant."

With a few exceptions, he is on poor terms with his family -- while they probably used to love him, he says, at some point, they've all "suddenly changed, and turned against me." (According to my friend, only one of them has tried to kill him.)

He suffers from sudden, terrible depressions, which he never thinks of as an imbalance in his brain, but as a natural result of the whole world "suddenly changing, and turning against me." (You'd be depressed, too, if the whole world turned against you.)

(He did once agree to "conduct an experiment" with a relatively mild antidepressant, and reported that it worked: it cleared up his depression. But then he quit taking it because he didn't need it: he never had any mental problems to begin with.)

When he's on an "up" swing, he thinks that everyone is for him (and every woman in love with him), and on a "down" swing, they've all "suddenly changed, and turned against me."

He honestly believes that he is the only steady, stable person in the world. He honestly believes that everyone else "suddenly changes, and turns against me."

And it was in this context, with the police officer telling me that I really ought to file for a restraining order because of his latest telephoned threats, that I heard about this book on the radio.

What I learned from this book is this: my friend is probably not ever going to really believe that he has a significant brain chemistry problem. And since it's not going to happen, I don't really need to invest my energy in that issue.

I learned that his internal feeling of what happens is NOT that he cycles into angry depression or mania, which is what it looks like to the rest of the world; his internal feeling is that he stayed the same, and everyone else suddenly changed.

(And what good could it do for YOU take drugs, go to therapy, or do anything else, if the real problem is that the entire rest of the world has "suddenly changed, and turned against me"?)

I learned that battles need to be selected with care: so many people fight to get the patient to "believe" that he has a disease, and this is much less important than trying to get them to take medication (if anything is appropriate and seems to work for them), to show up for therapy, and to take care of themselves.

I realized that I was trying to get him to say the words "I have a disease," when what is necessary is "You need to eat every day. You need to sleep every day. You need to take a shower. You need to save that money so you can pay your rent. You need to talk to your therapist."

This is hard, especially now that I, too, am on the long list of people who have "suddenly changed and turned against me," but I am glad to have a task before me that has some hope for success, and to know that his continued belief that he's the only sane person in the world is not any fault of mine.

Rating:
Summary: Essential for those with a loved one with mental illness
Review: Allow me to preface this by making it known that I have met Dr. Amador and had the honor of writing a blurb about his book, which is in it. So I am, admittedly, somewhat partisan.

In light of that, I will let my actions speak for me rather than make any attempt at flowing prose. I am an advocate for people with severe mental illness and their families. Many times each week I field a call from someone with a loved one overcome by mental illness but who refuses treatment because the symptoms of the sickness.

Without exception, I recommend Dr. Amador's book to anyone I talk to who has a loved one in this confounding state.

More particularly, this is the first book that should be read by someone unfamiliar with mental illness, but who has a family member going through that painful (for everyone) first "break."

More generally, this book should be read by anyone who lives with or loves a person who is not fully recovered from the symptoms of mental illness.

For family members, this is the most valuable book to be published in this field in many years. It has important information for consumers (like me) as well.

Rating:
Summary: Not the Stuff That Stars Are Made of
Review: Having heard nothing but accolades for this book, I scoured it for "new" information on helping consumers gain insight into their illness and thus accept treatment to hasten their recovery. I learned a new term for a particular type of "poor insight"--"anosognosia"--a neurological syndrome similar to the lack of self-awareness found in people with serious mental illness. Dr. Amador's message tells us that such consumers are not so much in denial or using defensiveness to dispute their illness but, rather, have neurocognitive deficits that prevent them from understanding they are ill. My criticisms are threefold. "Treatment" is equated with taking medications and assumes a competent & caring clinical framework. Overly simplistic advice for interactions with consumers merely encompasses what any informed family member and especially what any trained clinician should already know--employ active, empathetic, and reflective listening using a checklist of optimum conditions for productive dialogue, such as setting a time, agreeing on an agenda, listening to the consumer's beliefs without interjecting reactions or creating chaos, and echoing and writing down what you have heard. Dr. Amador suggests his prescription may open windows of opportunity for mutual goal setting and patient partnering in treatment planning and adherence.

The book's heralded reception as eye-opening shows just how desperate caregivers are for probable "fixes" and how seriously deficient are the outreach and education programs of professional and advocacy organizations who deal with serious mental illness.

Rating:
Summary: Very Little Information Actually Offered
Review: This is really a poor book and I'm sorry I wasted the money on it, for this main reason: there is really very little information to be gleaned from it. I believe the amount of real information and guidance offered would be more suitable for a pamphlet, not an entire book. The little bit of information there is, is strewn throughout, and the remainder of the book is puffed up with anecdotes of different patients and reiterations of patients and their symptoms already met with in the book. It is also written in a discursive, teasing manner, attempting to encourage the reader to keep on reading ("Some readers may be tempted to skip this section...however, I strongly urge you to go back... and read the three chapters" p. 1). Many times the book is annoying for its inability to get to the point succinctly. Once again, I believe this stems from the fact that there are so few points to be made, and if these points were set out at once, there would not be enough to fill an entire book.

For instance, in Chapter 6, Dr. Amador tells the story of Samantha, "a patient who had been admitted to the hospital four times in the past year" (p. 60), so that most of the hospital staff have a poor prognosis for her future. However, Dr. Amador "is optimistic about stopping the revolving door Samantha was stuck inside," because, he says, "I had been doing a lot of listening and what I had learned gave me a foothold with Samantha and good reason to have hope." He then immediately ventures off into what it means to listen, and offers his important seven guidelines for good listening. In the next 20 pages, he further explores these seven guidelines and puts them into scenarios with 2 other patients, Matt and Vicky. But as far as I can see, he never mentions Samantha again, or how this listening has helped her prognosis (or her revolving door).

Dr. Amador suggests that if you give the patient goals - such as staying out of the hospital, or finding a job - this will help the patient want to stay on medication. However, these are positive goals (and obviously not very exciting goals for most schizophrenic patients). But Dr. Amador never really addresses how listening and forming goals will help patients who suffer from negative symptoms - patients who are really somewhat apathetic and may not even have or want goals.

What the book is good at is helping the reader understand that a patient's lack of insight into his/her illness is actually part of the disease (brought on, many doctors believe, by the same impaired functioning of the frontal lobes as the disease itself) - that a lack of insight is not merely stubbornness or an unwillingness to face the disease. This is important information to be learned and may help families better empathize with the patient - however, is this small piece of information worth the price of the book?

Notice that the subtitle holds out the promise of "Helping the seriously mentally ill Accept Treatment," but I do not believe it in any way offers this help. When it comes down to it, the suggestions he offers are vague and elusive. He has not really done studies that empathetic listening or setting goals will really help the patient stay on medication - what it will do is help relationships. What the book does accomplish is offering tips to help empathize with the patient and giving those 7 guidelines to effective listening, which will help improve relations between the patient and family members.

This is really a self-published book (if you go to the Vida Press website, you will see they only offer two books, both by Xavier Amador) - and being self-published, it obviously lacked the critical input of an editorial staff that could have guided the book to be more focused and cohesive. Furthermore, there are many typographical errors. It would be better to purchase E. Fuller Torrey's Surviving Schizophrenia and use Chapter 12 - "How Can Consumers and Families Survive Schizophrenia?" as a starting point.

Rating:
Summary: We are not sick, we DO need help!
Review: We are a family of readers and of all the books on mental illness that we have read and purchased, this is the first one I have taken time to rate because it is the best. I have purchased two copies. It has been the most helpful in dealing with our mentally ill relative. It has given us insight into his feelings and impressions. The only thing we have control of is our own feelings and responses. Xavier Amador has written to us and for us. We recommend "I am Not Sick I Don't Need Help!

Rating:
Summary: A must read for families of the mentally ill
Review: Xavier Amador has performed a tremendous service for families and therapists by translating the research on insight into mental illness into a highly readable and very practical book. Family members and therapists who read this will find their frustration with a "non-compliant" consumer melting away to be replaced with empathy and compassion, qualities that will enable them to begin laying the groundwork for a cooperative relationship with their loved one/client. Step-by-step methods for developing that relationship are clearly laid out, making this one of the most helpful, hopeful books to come along in a long time for those who treat or live with a mentally ill person.

I Am Not Sick...adds to the number of excellent books written for families of the mentally ill, and, in my opinion, tops the list. I just wish it had been available 20 years ago when my sister became ill. I am convinced that she would be much better off today if we had had access to this information.