Read Aloud the Text Content

This audio was created by Woord's Text to Speech service by content creators from all around the world.

Text Content or SSML code:

OCT3ECM – Assessment 4. By Daniel Moffatt. In this presentation, I will be discussing the book Recovered, Not Cured A Journey Through Schizophrenia, written by Richard McLean. This memoir details McLeans personal journey with mental illness, following a chronological timeline from his late teens through early adulthood, while the final chapter contains reflections on his journey 20 years later. The narrative details the gradual onset of schizophrenia, starting with distrust and suspicion of others, then progressing to auditory hallucinations and disordered thinking with reference and persecutory delusions, which occurred more frequently over time. As a creative individual, McLean was able to capture many of these beliefs in drawing, allowing the reader great insight into his then current state of mind. Despite a strong support system of family and friends, McLean initially believes he is not unwell and refuses to seek a doctors opinion. Eventually, in a moment of clarity he was able to be convinced to see a doctor, resulting in a prescription for antipsychotic medication. Slowly, McLean developed trust in the doctor and the medication regime, finding that his negative symptoms were slowly dissipating, allowing him to live a normal life. At the conclusion of the book, McLean reflects that while he has recovered from his episode of psychosis and is able to live a normal life, he is still a person with Schizophrenia who experiences occasional residual delusions, which he must continue to manage through therapeutic outlets and medication, therefore demonstrating that often mental illness is very different than physical illness, and should be treated as in terms of management, not cure. The first identified theme is the gradual decline from prodrome into significant psychosis. McLean initially experiences feelings of suspicion, stating Sometimes food tasted funny, leading me to believe it had been tampered with in some way. He found that meaningful coincides seemed to happen all the time, such as thinking of a song and having it play next on the radio. He often had strange visual perceptions, including seeing faces emerge from patterns in concrete. This evolved into more detailed delusions, reporting Sometimes I perceived what seemed to be magical messages meant only for me. Soon after he started experiencing auditory hallucinations, recalling I walked through crowds of people and heard voices saying where do you think youre going now and we know where you are. These auditory hallucinations became more aggressive over time, as McLean would hear voices over the loudspeaker at his job stating Well kill you motherfucker, rot in hell, and various other threats or encouragements towards suicide. The delusions also became more frequent, as McLean believed there was a largescale conspiracy that even his family members and friends were involved in, thinking The conspiracy are going to a lot of effort to give me messages transmitters, friends turning against me, family against me, remotecontrolled streetlights, messages from the radio, as he made note of these messages in a cryptic code as seen in the images to the right. This eventually drives him into a fullblown psychosis, as he states I just cant take this anymore, I have no one I can trust, and fuck this conspiracy. This narrative of gradual deterioration falls in line with the teachings on youth psychosis in OCT3ECM. Within the Royal Australian and New Zealand College of Psychiatrists clinical stages of schizophrenia, McLeans initial presentation places him at stage 1a , with mild or nonspecific symptoms of psychosis, however as the condition is not recognized he ends up in stage 2, first episode of a psychotic disorder with moderatetosevere symptoms, neurocognitive symptoms, and functional decline. The second identified theme is the stigma McLean felt around his sexuality, which he believes contributed to the development of psychiatric illness. McLean describes himself as bisexual, stating I knew I liked girls, I knew I liked guys. However, living in a house with 16 young men he felt unable to be open in this identity, reporting the youthful blokeyness of the joint challenged me as someone not out as bisexual. After accidentally outing his sexuality, McLean describes living in that house as turbulent, recalling I knew they looked upon me as a different type of guy. The societal stigma around bisexuality plagued his brain, as he frequently dreamt of sexual references, stemming from underlying guilt and irresolution. He describes the drawing of his inner self on the right as This person is constructed in layers, with the grey line showing the guts of the matter is underneath. Ultimately, McLean reports that this stigma contributed towards his mental decline, stating I think my bisexuality played a big part in causing stress at this stage in my life, and that it contributed to my psychotic episodes. This aligns with the information provided about LGBTQ health disparities in OCT3ECM. Individuals, such as McLean, who are LGBTQ face negative attitudes and prejudice from society, rejection and subsequent social isolation from family and friends, and are more likely to become a target for hate crimes, ultimately pushing the individual to hide their identity to avoid discrimination, which causes significant mental stress. The impact of this includes higher rates of mental ill health, increased maladaptive coping mechanisms, and an avoidance of seeking medical or mental health care due to fear of discrimination. The third identified theme is the social support McLean received throughout his life, which he credits as a major reason he was able to seek help. Despite his deteriorating mental health, McLean reports that he was still mixing quite sociably with my family and friends, and most of the time they seemed to be quite accepting, however bizarre my comments were from time to time. The image on the right depicts this idea, reflecting overlapping personal relationships among multitudes of people. While he struggled to trust anyone, including family and friends, he was occasionally able to reach out, remembering Mum knew I heard voices, and treated the situation as if it were completely normal. I was grateful for her accepting attitude. As his symptoms progressed, he recalled Mum said I should go see a doctor, it was a small indication of a great well of concern in the people around me. This theme continues throughout the narrative, as Mclean states that to this day They have continued to support me lovingly, they give me strength. At the time of writing this book, 20 years from his initial psychotic episode, McLean reflects that The great tragedy of psychosis is that it precludes awareness that something is going wrong which means its vital for others to show insight, showcasing how important the support of his family and friends were to his recovery. This ties in with the Family Work Model taught through OCT3ECM. This model suggests that the family play an important role in providing a supportive recovery environment for the affected individual during and following the mental illness, by allowing the person a space to recoup and gather strength to venture back out into the world. This model also includes providing psychoeducation to the family, allowing them to further understand the psychiatric disorder and better support both themselves and the unwell individual. The fourth identified theme is McLeans use of art as a creative outlet. Growing up, McLean showed a consistent interest in art, pursuing a fine arts degree as he was keen to explore the big questions in conversation and through various art forms. He recalls that Making images was often very therapeutic for me. I would feel exultant at completing even simple sketches. As his delusions about the conspiracy increased, he found that ability to express things in words was limited, stating drawing images crystallised ideas for me, brought them into the conscious arena. This quickly became McLeans primary coping strategy, whilst also offering an insight into his developing psychiatric disorder, as he recalls Whenever I had a pen handy, I would draw surreal little sketches, suggesting the chaos that would soon begin to envelop me. These sketches produced the image to the right, as well as the other images throughout this presentation. Furthermore, McLean produced many sketches during his recovery, reporting that Most of the images in this book were created in hindsight as a kind of art therapy, a process of defining and solidifying myself by manifesting hallucinations and letting them go. This demonstrates the therapeutic possibilities that art can provide. This correlates with the teachings from OCT3ECM that the best way to facilitate engagement, particularly with young people who are often distrusting, and those with psychosis who may have delusional thinking, is to utilize subjects that the individual is interested in, which in McLeans case is drawing and creating art. By offering a therapeutic service that integrates an occupation he enjoys, he is more likely to perform the activity and receive the associated therapeutic benefits. The fifth identified theme is McLeans experience within the medical model, with negative experiences and psychiatric delusions causing difficulties maintaining compliance. Initially, McLeans delusional thinking prevents him from seeking a medical opinion, reporting I was convinced that because I had read a book on schizophrenia, people were trying to make me think I had it. If I went to go and see a doctor, then it would mean the conspiracy had won. Eventually he was convinced to see a general practitioner doctor, who dismissed his concerns as a simple lack of sleep. McLean didnt know then that a lot of doctors were not well versed in psychiatry. After further decline in his mental state, McLean revisited this doctor and asked for a referral to a psychologist, advising him it was a matter of life and death. When he visited the psychologist, he informed her of his hallucinations and delusions, to which she responded his was a very common experience, but that he needed to see a psychiatrist for medication, something she could not prescribe. Mclean recalls this experience as another wasted effort people were taking me for a ride. When McLean went to see the psychiatrist, he reported being in two minds one harbored all the fierce energy, the guilt, sadness, hallucinations and delusions, and one wanted to tell this amalgam of the last few years where to fuck off. He states that It was a leap of faith to confide in him, I had in mind he was the enemy. However, he managed to open up about the symptoms he was experiencing, and was prescribed psychiatric medication. Despite initial distrust, Mclean recalls As the weeks passed, I started to trust that Dr X really was trying to help. Unfortunately as reported in OCT3ECM this narrative of medical mistrust, particularly in people living with disordered thinking, is incredibly common. Even in people who decide to seek help, a large portion of society to not understand the differences between different medical professionals, and where the best place to seek help is. In addition, general practitioners are often undereducated when it comes to mental health presentations. The sixth identified theme is McLeans recovery, and how he emphasizes that recovery is explicitly different than a cure. Mclean reflects that Psychosis is not like a physical illness, which is similar for everyone. The messages scattered through the book show very clearly that while there are some common denominators, there are many manifestations. While the symptoms of the illness themselves are highly variable, the other major difference is the notion of healing. McLean notes that To this day, although my illness is at a manageable level, I am residually delusional and sometimes read odd meanings into things. This highlights the ongoing effects of his mental health condition, despite being considered recovered from his episode of psychosis. He reports that he feels almost glad to have had such a powerful experience, even though I would never wish it on anyone, which signifies him finding the positives in a difficult situation. Finally, McLean states that Nowadays, I say that I am recovered, not cured. I have achieved a sense of normality and live with the knowledge that a couple of pills a day will keep me slightly lethargic yet sane at the same time. I can live with that. This demonstrates that while he is able to live a full, independent life, he must remain considerate of his lifelong condition and maintain its therapeutic treatments. This stance is supported by a myriad of mental health research presented in OCT3ECM, which states that mental illness must be differentiated from physical illness, and that recovery is nonlinear with high likelihood of relapses along the way. With the proper treatment, people with mental health conditions can still participate in all of lifes occupations whilst remaining taking care of their mental health. Thank you for listening.