Chronic Illness

Chronic ambivalence can affect the healing process.

Managing a chronic illness, either physical or emotional, requires resilience. Unfortunately, the nature of the illness can severely impair a person’s ability to apply the skills and the attitudes of resilience. For example, a severe emotional disorder, such as schizophrenia, makes communicating and connecting with others a difficult task. Distrust and paranoia often accompany the disorder. Instead of relationships being a source of support, they can be a source of fear and aversion.

Emotional control may be an extremely difficult chore for the patient, and feelings may fluctuate from one extreme to the other. Dr. Paul Meehl identified chronic ambivalence as one of the hallmarks of the disorder. These strong feelings may be extremely hard to manage. Even with antipsychotic medications, patients may still have difficulty thinking clearly and reasoning in a logical and rational fashion. Feeling confident in yourself and secure in a world that is distorted by a thought disorder is very challenging, to say the least.

But as I write this, I recall two of the patients that I worked with for many years who have been struggling with the disorder most of their lives. It has been an extremely rocky road for them, but both have learned to manage their illness in different ways. One has learned to do this by accepting the reality that the psychotropic medication can help in controlling his thought and should be taken as prescribed. He has also learned that he needs to have some basic trust and check reality out with a therapist on a regular basis. It has been a difficult process, but over the years he has gotten better at taking care of himself and feeling confident in his ability to manage his life.

My second patient, who is a very bright and creative woman, has learned to use her brightness and her thinking, although at times distorted, to better control her emotions. This has allowed her in the last few years to have less difficulty with the police and other authority figures in the community, to reconcile with her daughter and to live in a supportive relationship with her family. It is also worth noting that both patients have learned to use their sense of humor, admittedly somewhat bizarre at times by my perception, in dealing with the world.

In the next blog I will talk more about chronic illness; specifically, chronic physical illnesses and physical disabilities such as brain injury.

Dr. Ron Breazeale