A Review of "I am not sick, I don't need help!"

By Patricia Parker, stagiaire

In the book, I am not sick, I don't need help, Xavier Amador discusses the experience of the individual afflicted with a mental illness. These individuals do not see themselves as being sick or of needing any help. Many family members can probably relate to the experience of knowing that their loved one is ill, even though they may not realize it themselves. How do you get through to them? How can you get them to understand what is going on so they see what you see with respect to the illness? The author of this book explains the four crucial steps required to create a good tie between you and your loved one that will help promote treatment and a positive daily attitude towards life.

This first step emphasizes the importance of listening. Look for what your loved one feels, wants and believes. Listen to their opinions on taking medication, what they feel they can or cannot do, their hopes & expectations for the future. Understand the cognitive deficits that are brought on by the illness. Effective listening involves setting time aside to listen. Listen without judgement to what your loved one feels, wants and believes in. Time should be structured and designated to sharing. If a set time cannot be agreed upon in advance, then continue listening just the same. Doing so can build trust, and promote a stronger rapport, which will break their isolation and create a common ground from which to build future discussions.

Try to understand how your loved one sees themselves and explore with them their beliefs as to whether or not they feel they are ill. Remaining open to their views and feelings will help break the isolation they live in and create a more harmonious alliance between the two of you. It is important to learn about their aspirations and yearnings. Ask them what they would like to get from life. While your loved one is expressing themselves, it is important not to jump in with your opinion. Do not make a point of disagreeing with their belief, this may only serve to shut them down emotionally and prevent them from sharing with you in the future. It is vital to repeat what it is you've heard to see if you've understood them correctly. Be open to being corrected on their thoughts and feelings of a specific matter, in the event that you misunderstood them. In doing so, you offer your loved one the opportunity to hear your opinions or requests at a later point in time. Write down what you have agreed upon. This written testimony will act as the contract the two of you can refer to at a later point in time.

The second step is about being empathic. Empathize with your loved one's feelings, especially their frustrations, fears, discomforts and desires. Reflective listening can help convey empathy. To do so, ask your loved one questions about their feelings in order to understand them better. Doing this clarifies your stance as the listener, conveys your interest to your loved one and ensures that you are trying to better understand their experience and point of view. For example, supposing your loved one says something like: « I don't know why everyone wants me to stay on my medication. I feel just fine. » You can respond by saying: « It must be rather confusing for you to still be encouraged to take your medication when you feel fine. » Reflective listening is an active form of hearing your loved one and re-stating, in the form of a question, what it is you heard them say.

In the third step, it is important to validate you loved one's experience (ie. letting him/her know that you would probably feel the same way if you were in their shoes). Try to discuss only perceived problems and symptoms. Agree to review with them the perceived advantages and disadvantages of treatment, whether they be rational or not. Strive to correct misperceptions for your loved one (ie. that medication is not necessarily addictive) Reflect back what you've heard and highlight the perceived benefits of the topic at hand. And of course, agree to disagree. No two people can agree on everything.

The fourth and last step involves forming a partnership. This can be the most gratifying step; wherein both you and your loved one make a decision to work together as partners against the effects of the illness. Essentially, you are both collaborating on attaining important goals that you set together. It is important to understand that these four steps will not solve problems completely. Rather, they act as aids to help you and your loved one learn ways to get along and communicate better in dealing with the mental illness. This book is an easy read, with simple directives to follow. It includes interactions between patient and doctor, with many other realistic examples to make use of. I thoroughly enjoyed it and found it to be very informative. I highly recommend it to anyone who is struggling with the effects of mental illness. 

***Please note that this book is available in our library, which is open from 9am-4:30 pm Monday to Friday.