What do you see when you think of someone living with schizophrenia? Probably a shadowy person hunched over themselves, hair unkempt, talking to invisible demons. How accurate is that stigmatized version of this peculiar illness? I would say, as someone living with schizophrenia and has lived closely with other folks living with schizophrenia, that this is not accurate at all. On the unit I lived on for nearly three years, folks wandered the halls, lied down in their hospital beds staring at the ceiling, and sometimes sat in the dining room, chatting to themselves, or sitting quietly as stone statue. I spent most of my time in bed, watching strange shapes and critters climbing my walls. Because I was on 1:1 supervision, I was always with someone. These people were MHWs (mental health workers), trained to take care of elderly psychiatric patients, many with physical ailments to boot. I was on the medical/psychiatric unit because I had a feeding tube for most of the time I was hospitalized. Most of the MHWs made conversation. Sometimes I liked it, and enjoyed the kind, sometimes interesting conversation. Other times I was too tired or too drugged or too psychotic to follow the arc of conversation, and I would just drift off. But overall, I appreciated them and their words more than I was able to articulate. But it wasn’t the words, it wasn’t the therapy. It was the relationship. It was the connection.

There is a very unfortunate notion about schizophrenia-spectrum illnesses that therapy is futile, a waste of time, even harmful. This could be because clinicians are looking at a very narrow definition of what constitutes as therapy. I agree to a certain extent. At my worst I didn’t really give a damn about Dialectical Behavioral Therapy with its Dear Mans and TIP skills. It just didn’t make sense, and I didn’t have the capacity to follow a train of thought from beginning to end, and I was convinced the DBT counselor at one of the hospitals I was at (for far too long) was trying to read my mind. not exactly a recipe for theraputic success.

Living with schizophrenia can feel like being stranded on an island, except that island is you. I think many people, clinicians included, are afraid to engage folks living with a schizophrenia diagnosis. We are not always polite, or reasonable, sometimes we hurt ourselves and others, sometimes we can’t even move we are so locked into ourselves and our illness. That doesn’t mean they should not try. I remember being hospitalized in a hospital in Anchorage, Alaska, where I had been receiving ECT treatments twice a week for months, as an outpatient. One day I went in for my usual procedure and was deemed a threat to myself. I was suicidal, hearing the voice of the devil himself. I was admitted to the inpatient psychiatric unit. I don’t remember much about the unit, except that I was in bed most of the time.