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My Top Priorities of Skills and Attitudes for Mental
Health Workers
Presented to Aftercare by Pia Fugaccia
Preface
I will preface all these remarks by stating at the
outset that I have derived them from my Christian faith in the goodness of
God and of life, and the enormous worth of each individual one of us that
has been created to be each the most critical piece in the puzzle of life
that we are all engaged in solving, and ultimately the banquet that we are
all daily tasting, and capable of enjoying. When one of us suffers we all
suffer; When one of us gets better we all rejoice...we all feel the
effects of what each individual goes through, because somehow we are all
connected, and a diagnosis of mental
illness cannot minimise our importance to each other. The worth of our
life is nothing less than life itself, and that of our dignity and liberty
is even more. For we are a race of individuals, not one identical to
another. It is more productive to think of the mentally ill in terms of
their uniqueness rather than the medical model of illness or deviance from
a norm. These categories, however, do seem helpful to those who profess to
heal our disorders, but the thing that really heals us is to know that no
matter how we feel we will be treated with respect, and that while our
doctors and advisers are mapping out a course for us to be better in their
eyes, what we ourselves want will be seriously
considered. Communication is everything. And negotiation. Always consult
the consumer himself, even if it means playing a waiting game while he
slowly comes to understand that his doctor and advisers have his best
interest at heart, and the skill to greatly assist him.
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Give the consumer his full personal worth.
There are problems with special kinds of people. A
gifted artist may feel that his medications limit his talents. A doctor
must have a really serious justification for not trying another approach,
or even another drug, and there is no excuse for callously enforcing the
treatment without supporting the consumer with counselling help. However,
I have found that the creative spirit does not so easily die, and that
consumers may help each other find it again. We can get better. We can
recover ourselves and all we seemed to lose. Our battles are glorious, not
tragic, and the price that has bought us has told us our worth. The penny
eventually drops, and even though the illness itself rarely disappears, we
know that our human dignity is intact, our life has not been wasted, and
our simple daily chores become precious as perfect gold. The disaster of
even one of us being lost, and the joy of even one of us recovering is so
great that it is worth all we suffer even if we die. The problem is that
most people just don't think our victories are worth it, or that we
ourselves are worth their care. They just have to get to know a few of us
to give them pause in that opinion.
That is my first priority. Give the consumer his full personal worth.
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My next priority is to be compassionate,
without patronising the consumer.
It is most important that people dealing with consumers should understand
the enormity of what they typically suffer. The loss of self esteem, of
opportunities of employment and marriage and friendships.... the loss of
income and status, and often the alienation from family and the rest of
society. In the wake of all this comes years of inertia and depression.
This gives the consumer a feeling of his tragedy being larger than life,
and the medications are seen as diminishing him. The health worker must
treat this situation most skilfully. Be compassionate, and keep on
reaffirming that the consumer will become and will be what he wants to be
better if he complies with the treatment. Keep on negotiating. Keep on
trying. We do learn, though slowly. Do not assassinate the
consumer in the name of healing him. I do not envy you what you must do,
except that, as a recovered consumer, I stand in great awe of the skill
which has imprinted on my chaotic life the portrait of who I am today and
may continue to be. May this be multiplied. May this be given to many. At
this moment, I am smiling at all my former truculence and rebellions...the
times I threw away my tablets and insulted those who were my greatest
allies. What an adventure it has been!
Be compassionate, but be firm, and always communicate what you are doing
to the consumer, and insist that he will have cause to be thankful before
the end.
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My next priority is a Good working Knowledge of
Mental Events and Processes
Not only does the mental health worker require a systematic knowledge of
mental illness and all its categories, he needs to know the picture of
mental health as well, and so that the end result will not be too
disappointing to the self-perception of the consumer. Modern treatments
are MUCH BETTER than the older ones at preserving our creativity whilst
cutting out any florid stuff. We must understand that sometimes psychotic
behaviour is learned and not naturally arising, and that drug treatment is
not the only nor necessarily the best option available. A good health
worker will understand, too, that there is a difference between a
psychosis and mere eccentricity, and always watch out for the odd artists,
poets and other mystics. These people cause real problems to
psychiatrists, though I have found that the entire profession beats a path
to your door if you tell them you have a Catholic background.
All these opposites will be reconciled if only they will all work for the
same good purpose, and if they will continually keep on informing and
reassuring the consumer that his own wishes are being respected. Encourage
him to be patient as they dither around. Rome was not built in a day, you
know.
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My next priority is a Good Knowledge of the
Treatments
I stress again communication and negotiation. If the consumer comes to
feel that the treatment he is taking is not doing him any good, he is
perfectly entitled to ask for some sort of change. But I do think that too
much is made of side effects compared with the benefits of the treatments.
My first psychiatrist told me he loved, just loved talking to artists and
poets, and once he had a mediocre artist as his patient, and this man
would not take his medications because he was afraid they would cramp
style as an artist. With great skill the doctor persuaded him, and the
result of taking his medications was that instead of being a mediocre
artist he became a super one! This is the sort of knowledge that I
mean...we should try to forecast the unforeseeable like that! We should
remember the old virtues of faith, hope and charity, and expect life to
surprise us like this.
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My next priority is a Good Attitude to Medical
Authorities
How do we know that something is true? We can either find out for
ourselves, or take the advice of a proven authority. The consumer often
tries the first option many times before tentatively trusting the second.
This is only human nature, and there is more fault with the doctor if
tempers run high
and vital treatments are compromised. Communication. Negotiation. Give the
consumer a say in his own recovery. Take account of his wishes and
expectations. Treat him with compassion and with dignity, but be firm for
his interests, and just wait, because everything is resolving with time.
Finally, do not be afraid of compromise, which is the strategy of an
adult, whereas confrontation is the MO of an infant. The natural process
of maturation is everybody's best friend. It all goes into the mix. It all
goes round and round, and sometimes we land on our feet, and sometimes
it's down the
tubes again. God knows how it will end, but I bet we are in for many
surprises, especially if we are certain of our own opinions of the
outcome. A doctor's medical qualifications give him an authority that it
is wisdom to heed, but I like to choose my own doctor, and also when to
move on.
While all human beings are equal, and the consumer is equal to his doctor,
the doctor is a proven medical authority which it is sensible to respect.
In any case, sooner or later, the consumer will hopefully get better with
the passage of time, and better adjusted to his life with its limitations.
His attitude to the medical authorities reflects his attitude to other
authorities. Like the police, psychiatrists are basically friendly. The
little child who asks the policeman for the way home is actually a very
good model for us all.
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My next priority is a Good Sense of what is Real
and what is Unreal
The best guide to something real or unreal is actually common sense. The
more unreal a thing is the larger it tends to loom over the rest of one's
life. They tend to be either too threatening or too good to be true, and
we know that we are dreaming, or fantasising, or at least exaggerating
them. There are treatments, but the best thing is to stay calm and
focussed, and meet every suggestion with sheer sang froid. We must be
determined that our good life is not going to be derailed by our
nightmares. Our good life is characterised by a certain gentleness and
peacefulness, and sometimes we have to fight for it by these means.
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My next priority is the Ability to Do
Nothing
When you know that something you feel is just a side effect either of the
illness or the medications, and has no organic basis, you must develop the
skill of ignoring it and doing nothing. Fiddle while Rome burns. There is
nothing bigger than Ben Hur. Nothing at all. This ability is the beginning
of
overcoming the illusory, and is most precious to humankind. It is to the
consumers that humanity is looking to exorcise its demons and shrink its
hobgoblins to teeny fairy size. Do nothing, and get all your friends to
help you. If you just do nothing, you will not be accused of psychotic
behaviour. We
have to just take our tablets and go to bed.
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My final priority is COMMUNICATION, and it is
really the first and last one of all.
Communication can be verbal or written, formal or informal, or now by
computer. I really would like to see more of us become computer literate
for the heck of it. Acquiring this skill is really fun to do at Tafe or
other centres. And it opens doors.
For we must speak out. We must step forward and declare ourselves that the
game is worth the candle...the consumer can recover, and make his own
unique contribution to the human race. His dignity is no less than others.
Modern psychiatry takes a lot of bad publicity, but it has its successes
as well as its inadequacies. In the last analysis, it is up to us to live
right, to let live right, and to wipe all our tears away.
Pia Fugaccia
Consumer and poet
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Sr. Giles (C) 2007
Edited
05/12/2008
Br Andrew EFO |
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