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Pointers for recovering from a neurobiological disorder

The following from the Georgia AMI was written by Dr. Frese, a psychologist in Ohio.

In the early 1970's he was in a seclusion room with barred windows in a state hospital. He demanded all people call him "Uncle" & communications be in Chinese or Japanese. He has been hospitalized many times. "Although we are like other people in the community, we are not exactly the same, & we must accept that," Dr. Frese said.

He has some specific ideas on how to make it easier to live with "Chronically Normal People" (CNPs).

1. Study your own illness, identify your particular "blind spots," & figure out ways to compensate. You can't learn this from therapists no matter how well motivated. CNPs cannot visualize what MI is like the way they can for being bind or deaf or at the loss of a leg.

2. You can't learn what you need to know from books, only from "direct, real-world experience." Since everyone's disability is different, your plan will be unique.

3. CNPs are not comfortable with those having a record of MI. As a general rule, don't talk about your disability with others. In a sense, you must "wear a mask" when around other people. Be careful when & where you remove it.

4. Don't talk with your voices where CNPs can see or hear you. It makes them very uncomfortable.

5. Don't "rehearse" conversations which you are preparing for future situations. It is important that you do this, but not where CNPs can see or hear. They'll say, "He's talking with himself again!"

6. Learn to follow the "core subject" & the flow of conversation when in a group of other people. Otherwise you are apt to make comments which CNPs will see as "way off the subject." Be very careful in conversations.

7. Don't expect to remember the names of new people-this is much too difficult. It is very hard for CNPs too. Don't embarrass yourself by fumbling for a name. You can learn to greet people without trying to recall their names.

8. Find your way to deal with stress. People who have MI have a low threshold for stress. Learn what places, things & people cause stress to escalate. Avoid them!

9. Devise a way to handle situations with people which you know from past experience cause great stress-situations you know you can not always avoid. Dr. Frese has cards printed which say in effect, "I have a disability which in some situations causes me great discomfort when addressed in a confrontational way. Please state your views in a more conciliatory way." It works for him.

10. Realize that your disability is "episodic." There are times when your symptoms will get worse. Learn the advance signals & take a brief vacation. The sooner you do this, the briefer the episode will be.

11. Recognize that the making of choices may be unusually difficult for you-even over such a simple matter as which route to take within an office building to the post office boxes. Suggestion: follow the lead of others. Ex. at a restaurant, rather than choosing, order what others order.

12. Come to terms with "delusional thinking." Accept this as a part of your disability. "Bounce off ideas-especially when you think you have a great new one-with your wife or trusted friend or therapist." If that person sees that you are getting delusional he/she can let you know in a nice way. At this point, if your doctor concurs, you may want to increase your medications. You will be able to tell when reality sets back in.

13. Recognize the need for work or a hobby. Find something that can be done which isn't stressful, something that you feel needs to be done everyday. Dr. Frese is very dubious of those in recovery who say they cannot accept any kind of work or hobby. Some say their calling is to be an "advocate" for changes "in the system". Well, says Dr. Frese, this may be needed, but it is bound to be a very stressful affair. Hardly therapeutic.