Experiencing and Overcoming Schizoaffective Disorder

Memoir Excerpt From:

Chapter 7  Talk Therapy & Journaling

Medication was useful for stabilizing me and limiting some of my symptoms, but talk therapy has been the most important medicine for helping me cure my mental illness. I discovered that the roots of my problems were negative and traumatic psychological experiences, some of which had happened during my episodes, and others that had happened earlier in my life, due to the difficulty of growing up with a cognitive impairment. Talking about issues enabled me to find relief from ailments lodged in my subconscious which were affecting me constantly.

When I began talk therapy I was having difficulty speaking even the shortest of sentences. I made enough progress to gain employment in telephone customer service. Eventually I became comfortable speaking to anyone, and I currently enjoy a vibrant social life. The first thing my talk therapist did was develop rapport. I was in talk therapy because I had many deeply traumatizing experiences that I needed to disclose and analyze in detail. It was already difficult enough to face the issues that frightened and traumatized me the most, without having to relate them to someone who seemed to be judging me for having them. My episodes and the years I’d lived through left me with negative emotions such as anxiety and fear, and an important part of therapy was determining the thoughts causing these emotions.  

I had many delusions acquired from years of cognitive impairment as well as delusions developed during my episodes, all of which contributed to my stress and neurosis. I had always found it difficult to talk about my deepest feelings, even to people I had known my whole life, never mind to a complete stranger. That is why my current doctor's friendliness was helpful in encouraging me to talk. His kindness assured he was on my side. I have had therapists who have been austere, who I didn't make progress with, and therapists who have been friendly, to whom I am forever grateful, because they helped me progress beyond horizons I previously could not have imagined.

My austere psychiatrists exuded judgement, while my current psychiatrist is a guide who allows me to think and listens to my thoughts and gives occasional advice when necessary. The judgmental therapists were difficult to work with because I made mistakes during episodes, did many strange things, and had many issues I needed to share which, outside of therapy, would be completely taboo socially. When I felt I was going to be judged I was far more careful about disclosing information. However, with my current therapist, who from the start has been someone who is there to help and is always on my side, I felt it was safe to disclose my deepest and most hidden thoughts. He created a positive and friendly environment which encouraged me to talk and helped me to face difficult issues. My therapist kept the conversations positive, which gave me a positive attitude and a hopeful outlook. He made it seem possible to overcome my mental illness, which created an inclination for progress. The attitude which works best for me is to understand that we are talking about ailments in order to solve problems, not to lament. Because of the mind set he helped to foster, I have never felt as though I am complaining during our sessions together. 

Even with this new therapist, I withheld some problems from experiences in my first episode which I had been thinking about for years. It took two years of therapy for me to finally trust him enough to disclose the problems. After disclosing this information, I came to realize my problems were common for someone with schizoaffective disorder and I didn't have anything to be afraid of. I think it's important to have the courage to divulge your secrets to your therapist because doing so is immensely beneficial. There are also many issues people think are particular to themselves but are actually common for people with their particular mental illness. 

After overcoming these issues, I began progressing a great deal.

It's important to understand that you can divulge your secrets to whoever you want, but you can also withhold them from anyone too. Identifying and talking about your problems with one person doesn't mean anyone else will ever know anything about your conversation. 

In therapy, I do most of the talking and my therapist guides me towards answers I have trouble finding. There are occasions when he flat out disagrees with me, but I am willing to listen when this happens, because he also listens to me. There is a give and take in the conversation, which makes me feel as though I am contributing and my thoughts are important. This also allows him to disagree with me when he needs to say something crucial for my well-being. When I have been preached to or lectured at in talk therapy, I felt my thoughts were far less valuable and contributed less to the conversation. 

There were times when I developed a dependence on my psychotherapists, but later on I realized that I myself am the person who needs to do most of the work of healing. Psychiatrists are helpful and can help with major issues, but there are too many problems in life for me to be completely dependent upon another person to solve them. I need to think through issues on my own. I know that the more I have solved problems on my own the better I have become at it. This is useful because I can only meet with a psychotherapist for one hour per week while I am on my own for the rest of the week. Even if I did want to ask my therapist for help on every problem in my life there simply wouldn't be enough time.

I have been my own best asset in therapy because I have a record of all my experiences in my mind and I am the one experiencing the feelings of the trauma. I am the one who had the information which needed to be worked with to alleviate my troubles, and the disclosure of this information only began once I was encouraged to talk. I have also known when the right "medicinal words" have been hit upon, because I have felt the alleviation from those words as soon as I have understood them. Talking with the therapist and being proactive in therapy is important because there have been many times I have been able to resolve issues without visiting my therapist. There have been other times where I wasn't able to resolve them but did gather information regarding them. Once I shared this information with my therapist we were able to find resolutions for the problems I was facing. My talk therapist forced me to think through and answer the questions I had about my issues and created a positive environment which enabled me to develop the right attitude towards psychology. He asked me the questions I needed to ask myself. My being able to answer these questions made me realize I have agency, I can help myself, and I can make my life the way I want it to be. This realization was important because it motivated me to make changes in my life. Developing problem-solving skills took time, but as my skills evolved, the power I held over my life also increased.

Anyone can develop problem solving-skills. I think it’s essential for psychotherapists to help their patients to become their own best resource. I developed such a liking for getting results through therapy that I eventually started journaling. I psychoanalyze myself in my journal and work through issues; this has helped me to progress much faster than I could if I just waited for one hour of therapy per week.

Schizoaffective disorder can be a difficult illness to combat because there are life experiences prior to the illness that may have caused trauma but there is also a network of thoughts, delusions, implied thoughts and implied delusions that are created from the patient’s experiences during episodes, which cause stress, anxiety, and paranoia after the episodes. A “clear” delusion and/or thought is a sentence that has actually been verbalized in the mind and is clearly identified as something that may be bothering someone or is something they are afraid of. An implied delusion or thought is when there are a series of events and there is trauma resulting from those events and someone has subconsciously drawn a conclusion as a result of their experience but hasn't actually verbalized or consciously identified it. In talk therapy and journaling I work to root out these thoughts and pacify them.

Stress was one of the key elements that triggered my psychotic symptoms and diminished the quality of my life, so my main goal in talk therapy has been eliminating as much stress as possible. This is done by talking about issues from any time in my life, finding and eliminating delusions, and creating plans to improve my social life or any other facet of my life I have felt is insufficient. The alleviation of stress from any and all sources has been the main reason for the alleviation of my psychotic symptoms such as referential thinking, auditory hallucinations, and paranoia. Referential thinking and paranoia were a direct result of having poor self-esteem and having traumatic experiences during episodes; talk therapy helped changed my self-perception. With my doctor’s help, I also transformed the meaning surrounding the traumatic experiences, which alleviated their burden. My auditory hallucinations always occurred after or during my most stressful days, but once I was able to eliminate stress from trauma and delusions I did not experience auditory hallucinations as often. At present I have them no more than once every several months.