Working with Mental Illness

I just did an intake with a gentlemen who really came to get help for his wifes, as he put it, Mental Illness.
What he described was "She is either in front of our computer buying self help books, CD's ect or she is reading or listening to them, yet she doesn't apply any of what she is supposed to be learning. This has gone on for over 25 years. This started back when she was in psychotherapy. She was there for over 60 sessions and seemed to be worse off post the sessions."

Husband tells me that he recently was forced to retire, thus doesn't have the money to pay for her self help habit.

He also said that she was diagnosed with "Mental Illness" by her psychiatrist 25 years ago and he feels that she leverages this label..

She is on many prescribed narcotics. "She doesn't cook, clean, go out, do laundry,, just hybrinated in the house, looking at her books. She gets prescriptions and than will not take them sometimes"

To me,, this lady is OCD,, I have yet to meet her,,

Just wondering if anyone has successfully worked with someone, successfully that has this type of back ground?

Scott Cooper
Clarkston, MI

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Permalink Reply by Scott Cooper on December 14, 2009 at 9:31am

I agree Sheila and am going to pass on this situation for several reasons

I havn't met the wife,, so I don't know if she is motivated to even work on her issues. I explained this to the husband that the keys to change lie in the will and motivation, just so he's understand why I didn't sign up to help her.

I always go with a Dr referral,, thanks for the reminder.

And I agree that she is working on being stuck,, as there likely was secondary gain from doing so,, perhaps it get's her out of doing anything,, yet, now, I'm just guessing,, yet,, the husband was most upset that he as he puts it "Does everything including paying bills, ect" so perhaps he's motivated to find the miracle cure to her issues.

Thanks Sheila,,, Hope all is well in Oakville today

Scott

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Permalink Reply by James Malone on December 14, 2009 at 1:34pm

Scott, the person you can help is the husband in dealing with his situational stress.

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Permalink Reply by Scott Cooper on December 14, 2009 at 6:55pm

Thanks for the replly James and Paul and earlier today Sheila,

Here is a good compromise,, I just received a call from the husband, he was impressed and wants to start working with me for his own stress and anxiety,, right on the mark James..

I'm going to, tommorow afternoon, meet with the husband and wife,, and see if there is an opportunity to help her,, makes sense to meet and see what we can do to help both of them..

Thanks for your help,

Have a great evening,

Scott

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Permalink Reply by Henxy on December 15, 2009 at 1:28am

Hi Scott,

Indeed, my take on this would be to help the husband increase his ability to cope through various strategies- and decrease the negative effect of his wife's behaviours on him.

I'm interested in why she in on 'narcotics', especially as the only diagnosis you've made us aware of is a rather bland blanket term which I can't see narcotics being of use for. Purely out of interest, I'd be asking about this, as it may inform you about these behaviours, and why they have had such an impact on the husband.

She doesn't sound too different from many of those after 'self help' or 'being slender'- just more exaggerated- than those who invest lots of money in self help, and the gym, but don't optimise their benefit from it. Perhaps being afraid of losing their identity or reason to feel sad for themselves.

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Permalink Reply by Hugh Cole on December 15, 2009 at 6:00am

Hi Henxy
Yes One can see a dump truck full of secondary gain here, but nothing that warrents narcotics. Perhaps the narcotics are part of the secondary gain. The potentially manipulitive relation between the two of them is perhaps an additional source of secondary gain. Scott's only real and ethical alternative is to start working with the husband on his stress issues.

Hugh Cole
The Pretty Goodest Hypnotist on the Planet

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Permalink Reply by Henxy on December 15, 2009 at 7:38am

Agreed, Mr C.

But what clinician would ever knowingly prescribe narcotics to feed secondary gain?

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Permalink Reply by Hugh Cole on December 15, 2009 at 8:02am

Key word ... Knowingly ....although here in the United States at least and I expect also in the UK... The drug companies are the biggest factor in medical "continuing education". It is quite common for medical professional s to assist in "running to the shelter of her Mothers little helper" based therapies. and .. just being sick and needing medication has its own set of (sometimes) powerful secondary gains.

Hugh Cole

Henxy said:

Agreed, Mr C.

But what clinician would ever knowingly prescribe narcotics to feed secondary gain?

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Permalink Reply by Henxy on December 15, 2009 at 9:37am

Nope!

Pharmaceutical contributions (financial or otherwise) are limited by ethics and government to ensure medicines are appropriately prescribed- and opiates only have a street value to dealers, and have a very small cost otherwise, as their patents have expired, so they are generics, not brand-specific .

The opposite of what you're suggesting is happening- the NHS is so scared that prescribers are going to be influenced by pharmaceutical marketing that freebies (post-its, pens etc) are banned in many hospitals.

Hugh Cole said:

Key word ... Knowingly ....although here in the United States at least and I expect also in the UK... The drug companies are the biggest factor in medical "continuing education". It is quite common for medical professional s to assist in "running to the shelter of her Mothers little helper" based therapies. and .. just being sick and needing medication has its own set of (sometimes) powerful secondary gains.

Hugh Cole

Henxy said:
Agreed, Mr C.

But what clinician would ever knowingly prescribe narcotics to feed secondary gain?

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Permalink Reply by Donna Carter on December 15, 2009 at 9:45am

With the understanding that you would need a medical referral...

Interesting, do you think(?), that you have labeled this lady OCD and have yet to meet her. Do you think, hypothetically, that if you were to meet her - your opinion of her would have been biased because of what the husband shared? Something to be aware of...whatever your answer.

Also, I want to point out, when you described her: "She is on many prescribed narcotics. "She doesn't cook, clean, go out, do laundry,, just hibernated in the house, looking at her books. She gets prescriptions and then will not take them sometimes"
Can I just say... you just described who I used to be. It could have been my husband who wrote in, if this was 10 years ago.
I went to the doctor for something, they would give me medicines (xanax mostly) in the past and ...I did not take them. (I had anxiety over taking meds) I might even buy them...and let them sit on the shelf. Just 'knowing' I had them...used to make me feel better. I know what my problem was... it was anxiety. Of which, hypnosis helped me make a drastic DRASTIC change in my life.
I am curious...how much she DOESN'T take them. If she doesn't, it would mean she is NOT actually on many prescribed narcotics.
Also, maybe she doesn't cook, clean, go out, do laundry...because her husband has been controlling in the relationship up to this point and she has had enough? Maybe, she is saying, "hey...I'm an individual and I don't have to take care of these things for you." Maybe she is fighting for her individuality and she sinks into what she knows.... her books and her 'labeled' illness - which saves her from her controlling husband.

I'm not saying this is how it is - I'm just saying...there are other perspectives.

I think it would be interesting to see how quickly the symptoms of her 'mental illness' would disappear if her husband embraced cooking, laundry, and general upkeep of himself - to allow not only a change in routine (well known to cause behavior shifts - reference book - Developing Ericksonian Therapy) it will also give her space and give him control of, the only one he should be controlling: himself.

cheers,
~D.

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Permalink Reply by Michael Ellner on December 15, 2009 at 10:02am

Hey Scott,

Back in the days when I was mentoring you - there was a young client with a shocker who had all sorts of problems and you were very, very busy trying to psychoanalyze the young man who was seeing you simply to improve his "game" You might remember I lovingly SMACKED you and told you to stop that crap and simply focus on helping the young man reach his goals -- Turned out to be a huge success story -- didn't it

I only say this -- cuz I love ya and I want to be the best hypno that you can be: STOP IT! You are not a freaking licensed diagnostician -- So please --stop wasting time and energy trying to diagnose your client's problems and focus on their goals -- Especially, when the person hasn't even indicated that they wanted help -- It is never wise to make up your mind about anything based on a husband or wife's opinion which may or may not be accurate...

Great advice James -- Way to go!

Great Question Henxy -- Mental illness is not a diagnosis and you are right on! The fact is that dispensing narcotics is heavily regulated and most doctors are very careful about writing scripts for them.

Hey Hugh,
If you are looking for secondary gain it is easy to find it by the truck load --

Yo, Donna,

It is always a pleasure to read your posts

Love and Hugs,

Michael E.

Hugh Cole said:

Key word ... Knowingly ....although here in the United States at least and I expect also in the UK... The drug companies are the biggest factor in medical "continuing education". It is quite common for medical professional s to assist in "running to the shelter of her Mothers little helper" based therapies. and .. just being sick and needing medication has its own set of (sometimes) powerful secondary gains.
Hugh Cole Henxy said:
Agreed, Mr C.

But what clinician would ever knowingly prescribe narcotics to feed secondary gain?