I present a narrative of my journey through schizophrenia towards recovery. Primarily, this revisits the traditional roles of psychiatrists and patients, via an empowerment framework for mental-health intervention. I call this ‘Feminist Self-Advocacy’ (FSA). It evolved, over a period of five years, from my experiences as a consumer cum professional, when I was also taking medication. I was a bright child but underwent socio-cultural pressures at puberty, due to a troublesome aunt who was also a neighbour. This resulted in depression, I think, because my parents didn’t allow me to protect myself. However, I managed bravely and determinedly to pull myself out of my depression and finish high school with high academic credentials.
It was later that I again succumbed to mental illness (schizophrenia). This was precipitated by a series of very bitter experiences with the troublesome aunt. She had a tremendous influence over my parents and I suffered from patriarchal oppression which rendered me helpless. Due to this my academic work also suffered.
I was taken to a psychologist who had a private practice but who only seemed interested in controlling his clients and making money. Then I was taken to another psychologist who claimed to be practising transactional analysis. In my view, both psychologists advocated a rest cure. So, very much against my wishes, I was made to stay at home and kept from attending college for a year. This only made me brood, and I deteriorated and completely lost confidence. Then I was taken to a third psychologist. The medicines thoroughly slowed me down and destroyed my spontaneity and high level of creativity, and I lost touch with the subject I had been studying. My attempts to get hold of the basics and to understand everything again were not encouraged by the college. Consequently, I found I just couldn’t manage. I returned to the paramedical college after this year of being made to stay at home.
During that critical year when I was forcibly kept at home, relatives kept coming by the house and taunting me since they thought I had dropped out of college. And when I tried to explain what had happened to the therapist she called me paranoid. Then, since I hadn’t graduated, I couldn’t get a job either.
I became so thoroughly dysfunctional that I couldn’t hold a book and study for more than five minutes. I also developed severe writer’s cramp which rendered me incapable of taking notes in class. When I consulted the psychiatrist again, instead of offering me viable alternatives to overcome my problem, I was dubbed ‘a medical failure’. I felt terribly betrayed during that year. When I attributed my illness and problems to socio-cultural causes the psychiatrist said that the illness had nothing to do with my problems, but rather the problem was my “inability to take stress“, and “a genetic propensity for mental illness“. Later on she even refused to listen to the details of how my parents were ill-treating me.
Since the diagnosis of mental illness is based on a judgement of a person’s behaviour as ‘maladaptive’, there is always the risk of altogether invalidating them as a person.
When I returned to college, I took an entirely different academic course. I desperately desired to study but found it impossible. With neither a decent job nor a graduate degree nor a husband to support me, what would become of me after the death of my parents? Would I not be on the streets?
The crisis that I was going through awakened my social conscience and made me evolve Feminist Self-Advocacy (FSA). This is a user-support model that trains users to support themselves and be self-reliant. Today I have a PhD in Women’s Mental Health and a good job. I am very happily married and we are financially secure. I attribute my full recuperation to FSA.
What Is FSA?
It is a derivative of feminist therapy. The essential ingredients are:
1. Recognition of patriarchal oppression.
2. Empowerment. The essence of this is to encourage the user to see herself as having the personal resources and bargaining power to change her pathological environment (Finfgeld, 2001).
4. An egalitarian relationship between the therapist and the user.
As part of FSA, I abandoned traditional controls and constraints placed on my sexuality, and told the professionals to stop assessing me purely on the basis of criteria like ‘cognitive distortions’, ‘delusions of grandeur’, etc. Many professionals think users suffer from such cognitive distortions. However, research indicates that it is actually non-depressed persons who show the most cognitive distortions: they tend to have greater illusions of personal control, they show unrealistic expectations of future success, and they maintain and overestimate the amount of positive feedback that they receive (Alloy & Abramson, 1988).
So who are the real “distorters of reality“? If there really are cognitive distortions, cognitive techniques need to be implemented without the use of pathologising labels and user-blaming attributions.
In this manner, I told my psychiatrist and caregiver not to say or do anything that could hurt my self-esteem; not to judge me as ‘loose’ or ‘crazy’, nor jump to conclusions regarding my moral proclivities whenever I reported misbehaviour on the part of a member of the opposite sex. Neither should they indulge in gender stereotyping during therapy. They should help me take decisions for myself, instead of letting my relatives decide for me. As far as possible, they should refrain from over-sedating me when I talk about my problems, and instead they should offer me viable alternatives.
More than anything else, I empowered myself by means of an academic education that went a long way towards my rehabilitation. My psychiatrist had rudely suggested that if I recovered, then that, in itself, would be a big thing. Another psychiatrist tried treating me without my informed consent – but failed because I was too smart for him.
The question of why those diagnosed as ‘schizophrenic’ are so eager to ‘deny their illness’ is very threatening to psychiatrists: it undermines their medical authority and reflects the flaws in their profession.
The professionals also asked me why I had allowed myself to be so affected by what my mother had done to me.
We question whether such an approach really serves the long-term interests of patients. To date, it has certainly not encouraged therapeutic alternatives which are acceptable to service users. ‘Nothing about us, without us!’
It was in the context of user/survivor experiences with mental health systems that the UN Convention of the Rights of Persons with Disabilities (UNCRPD) evolved. FSA is a rights-based, user-support model.
In short, when I was in the first year of my Bachelors course, after the medical professional and the psychologist had declared me a medical failure, I stopped going to see them. This was because they simply indulged in exercises of professional negativity. But I did take the prescribed medication, in combination with FSA.
When I recovered and studied for a PhD in mental health, they asked me to share my FSA treatment approach with them. I told them it was I and not they who were eligible to use it since I was trained professionally and was an experiential expert, whilst they lacked first-hand experience.
What had begun as a psychiatric power-play ended up being a role-reversal designed to shock the medical community at large and to make them stop being so arrogant.
And that was the grit and determination with which FSA was evolved so as to facilitate true recovery. I spoke truth to power and can legitimately say with Robert Frost:
“Two roads diverged in a wood,
and I took the one less travelled by,
And that has made all the difference.”
Finally, as always, I thank my Lord and Saviour Jesus Christ for having rescued me and shown me the way out of the morbid reality which at one time engulfed my life. I also thank my mother, Mrs. Lalitha, whose extraordinary sacrifices, infused with love, and enabled me to reach where I am currently in my life. And, yes, my exceptionally brilliant husband, as well.
Dr. Lavanya Seshasayee formerly held a fellowship at the BAPU Trust (Pune, India) and is currently Director of the Indian Women’s Recovery Movement Trust.