No shortcuts to recovery


	Alan Bodnar, Ph.D. is the Co-Director of Psychology Training at Westborough State Hospital, Mass. and a consultant in the field of leadership development.

By Alan Bodnar, Ph.D.

For weeks, the newcomer to the group sat in silence. Slouching in his chair with his backward baseball cap and heavy-lidded eyes, he gave the impression of being asleep. His muscular frame and impassive expression kept us from testing the sleep hypothesis with the kind of question we would have asked a more approachable member. Then, one day, after weeks of silence, the fellow exploded - not with the rage that we probably feared - but in a heartfelt plea to be understood for the person he is beyond his psychiatric diagnosis.

Remember "The Merchant of Venice" and Shylock's demand to be recognized and respected for his essential humanity rather than scorned out of fear and prejudice against his station in life? Remember that bit of Shakespeare and you will have a fair picture of what took place in the group therapy room - with one important exception. Shylock's mistreatment had fueled his hunger for revenge and he declared in no uncertain terms that he intended to take it. Our young man was just as clearly renouncing violence and asking for our help to keep his resolution.

As this man told the story of his life and the way his challenging circumstances were complicated further by the emergence of a mental illness in his teens, he balanced the failures so well chronicled in his medical record with reminders of his equally impressive successes. He took offense when he heard another patient's behavior labeled as "strange" by hospital staff and asked how anything marked with the dignity due to the human person could be so callously noted and dismissed. He told us about a child in his neighborhood with a severe developmental disorder that in his estimation would make him and his fellow patients appear to be exemplars of mental health. When he described his neighbor, he gave us a picture of a little boy, so radically different from what most of us consider normal but no less a complex person with likes and dislikes and the capacity to respond to the attention of others.

The young man knew these things about the boy because he clearly took the time to look beyond the obvious to the hidden strengths that people so often missed. The young man in our group told us nothing about acknowledging the strengths of our patients that we hadn't already encountered scores of times in formal lectures, the scientific literature and in our daily experience as therapists. Maybe it wasn't so much the message that impressed us as it was the messenger, the timing and the manner of its delivery.

Sometimes it is not the therapist but the patient who has to be reminded and convinced of her strengths. A young woman who has been hospitalized a few times is now learning to integrate various aspects of herself into an image that is positive, hopeful and realistic. She understands she has a mental illness but also knows how to identify its symptoms and take action to minimize the chances that they will interfere with the life she wants for herself. These days, her presentation is markedly different from that of the apprehensive person so puzzled and shamed by her illness that she would spend hour after hour describing every aspect of her being that once radiated health - her brighter smile, stronger voice, glowing complexion and easy manner that all seemed to fade when mental illness struck.

All of the assurance that we felt capable of providing seemed to do nothing to convey the message that she was a good and whole person with a new challenge that she could learn to manage. Yet until she could accept her basic dignity, she was unable to acknowledge and begin to address the problems that brought her to the hospital.

Elementary geometry teaches us that the shortest distance between two points is a straight line and, in our work as therapists, we are sometimes tempted to find and travel that line from problem to cure. Eventually, we learn the limitations of the geometrical paradigm and look for another way of understanding what we do. In this quest, we may do well to emulate that new breed of philosophers, architects and urban specialists who style themselves "psychogeographers" in their attempt to reclaim the neglected spaces between traditional points of departure and arrival.

If I were a psychogeographer traveling from my home in a Boston suburb to visit a friend in London, I would walk to and from both airports and let myself be drawn in by the landscape and architecture of the neighborhoods I crossed. My journey would be shaped by a sense of drift as well as purpose and I would arrive with a better understanding of myself, my friend and the world that we both share.

This is hardly a practical way to travel, but it does provide the traveler with a thorough knowledge of the terrain. This is the terrain that our patients invite us to notice, the journey that they ask us to share. In their shoes, wouldn't we do the same?

No shortcuts to recovery (November 2008 Issue)

By Alan Bodnar, Ph.D.

No shortcuts to recovery
(November 2008 Issue)