Experiencing and Overcoming Schizoaffective Disorder​  Memoir Excerpt From:  ​Chapter 7  Talk Therapy & Journaling

Medication was useful for stabilizing me  and limiting some of my symptoms, but talk therapy has been the most  important medicine for helping me cure my mental illness. I discovered  that the roots of my problems were negative and traumatic psychological  experiences, some of which had happened during my episodes, and others  that had happened earlier in my life, due to the difficulty of growing  up with a cognitive impairment. Talking about issues enabled me to find  relief from ailments lodged in my subconscious which were affecting me  constantly.

When I began talk therapy I was having difficulty  speaking even the shortest of sentences. I made enough progress to gain  employment in telephone customer service. Eventually I became  comfortable speaking to anyone, and I currently enjoy a vibrant social  life. The first thing my talk therapist did was develop rapport. I was  in talk therapy because I had many deeply traumatizing experiences that I  needed to disclose and analyze in detail. It was already difficult  enough to face the issues that frightened and traumatized me the most,  without having to relate them to someone who seemed to be judging me for  having them. My episodes and the years I’d lived through left me with  negative emotions such as anxiety and fear, and an important part of  therapy was determining the thoughts causing these emotions.  

I  had many delusions acquired from years of cognitive impairment as well  as delusions developed during my episodes, all of which contributed to  my stress and neurosis. I had always found it difficult to talk about my  deepest feelings, even to people I had known my whole life, never mind  to a complete stranger. That is why my current doctor's friendliness was  helpful in encouraging me to talk. His kindness assured he was on my  side. I have had therapists who have been austere, who I didn't make  progress with, and therapists who have been friendly, to whom I am  forever grateful, because they helped me progress beyond horizons I  previously could not have imagined.

My austere psychiatrists  exuded judgement, while my current psychiatrist is a guide who allows me  to think and listens to my thoughts and gives occasional advice when  necessary. The judgmental therapists were difficult to work with because  I made mistakes during episodes, did many strange things, and had many  issues I needed to share which, outside of therapy, would be completely  taboo socially. When I felt I was going to be judged I was far more  careful about disclosing information. However, with my current  therapist, who from the start has been someone who is there to help and  is always on my side, I felt it was safe to disclose my deepest and most  hidden thoughts. He created a positive and friendly environment which  encouraged me to talk and helped me to face difficult issues. My  therapist kept the conversations positive, which gave me a positive  attitude and a hopeful outlook. He made it seem possible to overcome my  mental illness, which created an inclination for progress. The attitude  which works best for me is to understand that we are talking about  ailments in order to solve problems, not to lament. Because of the mind  set he helped to foster, I have never felt as though I am complaining  during our sessions together. 

Even with this new therapist, I  withheld some problems from experiences in my first episode which I had  been thinking about for years. It took two years of therapy for me to  finally trust him enough to disclose the problems. After disclosing this  information, I came to realize my problems were common for someone with  schizoaffective disorder and I didn't have anything to be afraid of. I  think it's important to have the courage to divulge your secrets to your  therapist because doing so is immensely beneficial. There are also many  issues people think are particular to themselves but are actually  common for people with their particular mental illness. 

After overcoming these issues, I began progressing a great deal.

It's  important to understand that you can divulge your secrets to whoever  you want, but you can also withhold them from anyone too. Identifying  and talking about your problems with one person doesn't mean anyone else  will ever know anything about your conversation. 

In therapy, I  do most of the talking and my therapist guides me towards answers I have  trouble finding. There are occasions when he flat out disagrees with  me, but I am willing to listen when this happens, because he also  listens to me. There is a give and take in the conversation, which makes  me feel as though I am contributing and my thoughts are important. This  also allows him to disagree with me when he needs to say something  crucial for my well-being. When I have been preached to or lectured at  in talk therapy, I felt my thoughts were far less valuable and  contributed less to the conversation. 

There were times when I  developed a dependence on my psychotherapists, but later on I realized  that I myself am the person who needs to do most of the work of healing.  Psychiatrists are helpful and can help with major issues, but there are  too many problems in life for me to be completely dependent upon  another person to solve them. I need to think through issues on my own. I  know that the more I have solved problems on my own the better I have  become at it. This is useful because I can only meet with a  psychotherapist for one hour per week while I am on my own for the rest  of the week. Even if I did want to ask my therapist for help on every  problem in my life there simply wouldn't be enough time.

I have  been my own best asset in therapy because I have a record of all my  experiences in my mind and I am the one experiencing the feelings of the  trauma. I am the one who had the information which needed to be worked  with to alleviate my troubles, and the disclosure of this information  only began once I was encouraged to talk. I have also known when the  right "medicinal words" have been hit upon, because I have felt the  alleviation from those words as soon as I have understood them. Talking  with the therapist and being proactive in therapy is important because  there have been many times I have been able to resolve issues without  visiting my therapist. There have been other times where I wasn't able  to resolve them but did gather information regarding them. Once I shared  this information with my therapist we were able to find resolutions for  the problems I was facing. My talk therapist forced me to think through  and answer the questions I had about my issues and created a positive  environment which enabled me to develop the right attitude towards  psychology. He asked me the questions I needed to ask myself. My being  able to answer these questions made me realize I have agency, I can help  myself, and I can make my life the way I want it to be. This  realization was important because it motivated me to make changes in my  life. Developing problem-solving skills took time, but as my skills  evolved, the power I held over my life also increased.

Anyone  can develop problem solving-skills. I think it’s essential for  psychotherapists to help their patients to become their own best  resource. I developed such a liking for getting results through therapy  that I eventually started journaling. I psychoanalyze myself in my  journal and work through issues; this has helped me to progress much  faster than I could if I just waited for one hour of therapy per week.

Schizoaffective  disorder can be a difficult illness to combat because there are life  experiences prior to the illness that may have caused trauma but there  is also a network of thoughts, delusions, implied thoughts and implied  delusions that are created from the patient’s experiences during  episodes, which cause stress, anxiety, and paranoia after the episodes. A  “clear” delusion and/or thought is a sentence that has actually been  verbalized in the mind and is clearly identified as something that may  be bothering someone or is something they are afraid of. An implied  delusion or thought is when there are a series of events and there is  trauma resulting from those events and someone has subconsciously drawn a  conclusion as a result of their experience but hasn't actually  verbalized or consciously identified it. In talk therapy and journaling I  work to root out these thoughts and pacify them.

Stress was one  of the key elements that triggered my psychotic symptoms and diminished  the quality of my life, so my main goal in talk therapy has been  eliminating as much stress as possible. This is done by talking about  issues from any time in my life, finding and eliminating delusions, and  creating plans to improve my social life or any other facet of my life I  have felt is insufficient. The alleviation of stress from any and all  sources has been the main reason for the alleviation of my psychotic  symptoms such as referential thinking, auditory hallucinations, and  paranoia. Referential thinking and paranoia were a direct result of  having poor self-esteem and having traumatic experiences during  episodes; talk therapy helped changed my self-perception. With my  doctor’s help, I also transformed the meaning surrounding the traumatic  experiences, which alleviated their burden. My auditory hallucinations  always occurred after or during my most stressful days, but once I was  able to eliminate stress from trauma and delusions I did not experience  auditory hallucinations as often. At present I have them no more than  once every several months.

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