Taking Aim Together

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SEEING THE WHOLE PERSON

“If you ask people with schizophrenia what they want, they’d say they want more money so they can live in a better place, buy a decent car and Christmas presents, or they want a girlfriend,” says Dr. Diamond.

Physicians’ heavy-handed attempts to dispel all their patients’ “delusions” or silence their voices can be counterproductive.

“Look at all those researchers at the university who work all their lives thinking they’ll win a Nobel Prize. They know, on some level, they’re not going to win the Nobel. But if they didn’t have the delusion that they could, they might lose the initiative to do their work.”

And he believes that a lack of initiative, for those with schizophrenia, is often more debilitating than hearing voices.” People can hear voices and still be fully functional.”

The important thing for doctors, he said, is to understand how their patients feel about the voices.

“For the most part, people don’t like hearing voices. They’re intrusive. One patient described her voices like this: ‘Imagine your teenage daughter had control of a radio in your head, and she controlled the volume and the station.’ ”

On the other hand, there are patients who like the voices they hear. “Some voices are upbeat, they give advice and they make the person feel less isolated. Either the voices are a problem, or they’re not. We have to listen, and find out what’s going on.”

Doctors also have to listen to consumers’ feelings about the social fallout that can result from prescription medicines. What’s an acceptable amount of weight gain? How do they feel about decreased sexual function? And what about the effort that goes into consuming large quantities of pills?

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“For some people, taking a pill is a symbol of what they’re fighting for. For others, it’s a remembrance of what they’ve lost. Some are reminded by a pill that what’s happened to them is not their fault. And some see it as a condemnation.

“Because more doctors are working in community settings, they are starting to see their patient as a whole person, a person whose goals change over time,” Dr. Diamond said. “This survey is one more piece in what is becoming a larger dialogue about what ‘getting better’ really means.”

© 2005 Schizophrenia Digest. Reprinted with permission.

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