recovery/voices

Bob Green (bgreen@dyson.brisnet.org.au)
Fri, 4 Jul 1997 06:21:11 +1000


A quick response to the latest posts, my comments to earlier posts follow
below the dotted line.

Some of the differences in views seem to me to occur because of our
differences in who we have contact with (the 'sample population'). Barabara
seems to be working with people who recognise their experiences and have/are
working toward ways of living with them or are willing to participate in a
research project. In contrast, I mostly see people whose behaviour has
resulted in them being arrested , at times for very serious crimes. Many of
these people have had no previous contact with mental health services,
though families will report inexplicale changes over a period of months or
years. In such circumstances the same level of self understanding
described by Barabara is far less likely. In the case of a person who
previously killed while having disturbed thoughts, the question of their
insight may have relevance to their eventual release. It may also have
importance for their own well being if they can detect similar
thoughts/beliefs/experiences occuring again.

I would see insight as one dimension, but not necessarily the only or most
important one. I regularly see a guy down at the shops who burnt his
parents house down. You couldn't say he has great insight but he has been
able to develop working relationships with health workers, despite disputing
schizophrenia/need for treatement and just about anything else. When I see
him we have agree not to talk about certain matters as these raise his
"persistance" (see below).

I look forward to the latest.

..........................................................................
Lindsay wrote:

>Asking what they mean is a great idea. In terms of denial not equating simply
>ot non compliance I agree. I think the issue of "resistance" is another term
>somewhere in this discussion. Fransella suggested we replace resistance with
>persitence. That is the person persists, tries to maintain their construct
>system to avoid threat.I think the grief denial may be in the persistence
>domain.

Persistence is an interesting concept. If I felt I was developing bizarre
ideas persistence might be a way to maintain my preferred identity.
Persistence however has relevance to your suggestion that:

>It strikes me that "delusions" with whatever adjective "fixed", "unshakeable"
>or whatever may then be the opposite of insightfulness- they may be the non
>testing out that is required for insightfulness.

Further, not only is ther non testing but there may be persistence in the
face of what appears massive invalidation. This may result from poor
judgment or a lack of insightfulness.

>Returning to delusions- the distinction between utility and validity is of
>use. For example, it may be useful for the grieving person to be in denial (to
>the point where they may be labelled as "deluded". The belief is however not
>viewed as valid. Hopefully those informed more about neo-pragmatism and
>viability as criteria for assessing knowledge claims can help with this one.
>That is, are we missing the point when we say a belief is not valid and label
>it as a delusion?

Is it because they are in 'denial' that they are labelled as deluded or
because of the beliefs they have, which othwers don't share or find
strange/frightening?

Esteban wrote:

>I guess we can start from something like: Voices are real to schizophrenics
>-the question is: can we understand why do they need them?

I have never asked someone who hears voices/has "strange" ideas this
question, the answers could be interesting. However, does this suggest
people who have these experiences choose to do so?

>What kind of denial are we talking about: the client's denial to himself or
>to others? The verbal-explicit or nonverbal-implicit one?

By "nonverbal-implicit one", do you mean denial by action?

>I'd rather say: we can _create_ a meaning for a delusional system.
>Delusions are very threatening in our cultures -we have no way of
>construing them except as _sickness_.

I wouldn't see all delusions as threatening, certain societies will accept
certain "different" behaviours more readily than others, while I'm told some
cultures don't even make a distinction/have terms for "mental" problems.

On a day to day level delusions and related phenomena are construed in all
manner of ways by all manner of people and agencies. Sickness is one
construction, in albeit in hospitals it is a more likely distinction. I
would add some delusions are threatening because of their content or the
actions which ensue from them.

Regards,

Bob

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