ON MENTAL ILLNESS: Living with the Cognitive and Social Deficits of Some People with Schizophrenia, And Trying to Reintegrate

Jack Bragen
Friday November 17, 2017 - 02:46:00 PM

Most people who have a psychiatric condition would rather not be defined by it. It is an unhappy thing to view oneself as "someone with mental illness" rather than as "an individual"-- who defines oneself by her or his career, ethnicity, family, and socioeconomic status.

The fact of being a mental health consumer, possibly one who does not have a job, children, a house, already puts us at a social disadvantage. When there is a conversation in a social context, the first thing that comes up is "What do you do?" How is an unemployed person with a psychiatric disability supposed to answer that question?

Additionally, those with schizophrenia could be socially impaired for other reasons, not excluding causes related to brain structure.

Both inability to socialize, and having social anxiety can cause a lot of awkwardness--which some people could misinterpret as obnoxiousness. This is where something like Facebook can potentially help. Social anxiety may not come up as much when one is in the comfort of one's home, rather than seeing people face to face. 

A cognitive deficiency may not be easy to understand. The person with schizophrenia could be perfectly good at solving a math problem, at reading and following an instruction manual for a gadget, or at understanding the written word. Yet, those sorts of things make up only a small fraction of people's functioning. 

It can be difficult to understand that people with schizophrenia could be doing their best at coexisting with people, but may be tripped-up by their condition. We may not always know how not to commit a faux pas; some of us do so constantly. This constitutes a major impairment in life. 

A social impairment interferes with work attempts. It interferes with being in public places. It interferes with making and keeping friends. 

If we have spent our adult life segregated into the outpatient mental health treatment system, it is a huge challenge if we would like to integrate into mainstream society. Persons with psychiatric disabilities often feel left out--and this perception could be accurate.  

Having a healthy social identity, one that is genuine, not a facade that masks fear and awkwardness, or that masks predatory behavior, could increase quality of life. But how do you get that if you don't have it? 

A sound social identity seems to arise from a history of being treated well by people. However, the big secret is that most people are concerned mainly about themselves. 

Making an effort to "reintegrate" could start with small talk. It also may help to take an interest in other people, in how they are doing today. Or, it could be something like having meaningless and brief conversations with people. If you don't work, you could avoid that subject. You should probably avoid politics, if you are talking with someone you don't know. 

Many people lack social skills, not just mentally ill people. It could help to realize that some of the people with whom you are dealing may themselves have some amount of social awkwardness.  

If your attempts to reintegrate socially don't always work, do not blame yourself. If you've been segregated into the outpatient mental health treatment system for years, you should expect that it will be difficult to fit in with non-afflicted people. 

People should realize that those with a psychiatric illness do not always come across well, yet we may still have good intentions masked by symptoms. I said this last week, and I'll say it again: Mentally ill people may be the most misunderstood category of people.