Microaggressions People with Schizophrenia Face on a Regular Basis

People unfamiliar with schizophrenia often make a number of misguided assumptions about this mental illness. These misconceptions can lead to hurtful microaggressions that people with schizophrenia encounter all too often.


Lisa Guardiola has been living with schizophrenia for 17 years. In a recent blog post for WebMD, she described how in her interactions, she “found that most people aren’t only surprised that I am living with schizophrenia, but that they don’t know what to say to me. As well-intended as they may be, some have asked questions or made statements to me that have been more harmful than good.”


The awkwardness of such encounters is typically based on a pervasive lack of knowledge about schizophrenia. In 2012, psychologist Patricia Owen looked at portrayals of schizophrenia in entertainment media and found that “one of the more prevalent stereotypes found in movies is the depiction of a character with a serious mental illness as dangerous and violent.” She wrote that “media analysts have criticized movies for associating schizophrenia with unpredictable and often violent behaviors.”  


In his book, The Environment of Schizophrenia, Colorado Recovery founder Richard Warner listed a number of widespread stigmatizing misconceptions about schizophrenia including


  • Nobody recovers from schizophrenia
  • Schizophrenia is untreatable
  • People with schizophrenia are usually violent or dangerous
  • Everything people with schizophrenia say is nonsense
  • People with schizophrenia are unable to make decisions about their lives
  • People with schizophrenia are unpredictable
  • People with schizophrenia are unable to work


The items on this list are very familiar to Guardiola. Among the microaggressions, she has encountered is the question “Do the voices you hear tell you to hurt people?” Such a query is very stigmatizing and offensive. “Unfortunately, there’s a misconception that people who live with schizophrenia are violent and that the voices they hear are all negative and homicidal,” she wrote. “In fact, not all people who have auditory hallucinations will hear the same thing. For some, their voices may tell jokes or make sounds that aren’t violent and can be quite comforting to the person experiencing the auditory hallucination. So to assume that every person who lives with schizophrenia hears negative voices is so wrong.”


Another stigmatizing but unfortunately common question to be avoided is “How many personalities do you have?” This very problematic “because many don’t understand that schizophrenia and dissociative identity disorder (formerly known as split personality) are two different disorders,” explained Guardiola in her article.  While someone with schizophrenia may have a hard time distinguishing what is real and what is not, people with dissociative identity disorder have multiple, distinct personalities. 


Instead of asking pseudo-psychiatric questions or telling people “it’s all in your head!” it’s much more appropriate to treat people with a mental illness with courtesy and respect—just like other people. They are usually neither homicidal maniacs nor people with “special abilities.”  


As Guardiola wrote, many “people often have this romanticized perception that all those living with schizophrenia are creative. While some who live with this disorder are creative, this perception really feeds into the stereotype and detracts from their natural artistic qualities. For those living with schizophrenia who aren’t creative, it can make them feel as though they are lacking in their abilities. Creativity is not dependent on the fact that a person lives with this disorder.”


It also doesn’t make you someone who is “really awesome in bed,” another awful stereotype. “There’s the assumption that people, especially women, who live with schizophrenia are wild in a sexual way. People who have this diagnosis can and do have healthy and satisfying relationships, but that doesn’t mean that they are wild or overtly sexual just because they live with schizophrenia,” wrote Guardiola.  

 

The Warner treatment model at Colorado Recovery is based on the idea that people with schizophrenia can and do live very purposeful and fulfilling lives. Our treatment professionals empower their patients by giving them roads to be productive, to help them perceive a positive meaning in life and a sense of belonging that can significantly improve treatment outcomes. We offer a variety of vocational services to help clients with their short-term and long-term career goals, including job-seeking skills, career exploration, and resume creation.


The recovery model counteracts feelings of disempowerment and worthlessness, partially driven by stigmatizing prejudice prevalent in our society. “A central tenet of the recovery model is that empowerment of the user is important in achieving a good outcome in serious mental illness,” wrote Dr. Warner in 2010. “To understand why this may be so, it is important to appreciate that people with mental illness may feel disempowered, not only as a result of involuntary confinement or paternalistic treatment but also by their own acceptance of the stereotype of a person with mental illness. People who accept that they have mental illness may feel driven to conform to an image of incapacity and worthlessness, becoming more socially withdrawn and adopting a disabled role. As a result, their symptoms may persist and they may become dependent on treatment providers and others.” 


At Colorado Recovery it is our mission to help adults with serious mental health issues stabilize their illness, minimize symptoms, improve functioning and enhance each person’s social inclusion, quality of life, and sense of meaning in life.


If you have questions about our recovery model or our services to treat schizophrenia, bipolar disorder, and similar mental illnesses, call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

The Healing Power of Horses

In September, Colorado Recovery teamed up with the Colorado Therapeutic Riding Center (CTRC) in Longmont—the oldest therapeutic riding center in the Centennial State which has been operating since 1980.

Equine-assisted therapy incorporates horses into the therapeutic process, offering a valuable additional service to Colorado Recovery clients. People engage in activities such as riding, grooming, feeding, and leading a horse while being supervised by a mental health professional.

Carrie Wells has been organizing the equine therapy group for Colorado Recovery since the group started in late summer. Wells holds an MS in applied counseling psychology and has a broad range of experience including 12 years of working with community mental health specifically focused on working with adults in a transitional residence who struggled with persistent mental illness. Wells is also a trained equine therapist which makes her the perfect liaison with CTRC.

Excursions to the riding center usually take three hours out of the day and although Wells does not conduct the sessions herself, observing clients with the horses yields valuable feedback for her.

If the horse reacted in a certain way, she can ask the client how that made them feel. “Putting the halter on, is that something that resonate with you in your life,” she may inquire. “It’s the kind of thing that I may key into, based on my own training as an equine therapist.”

It’s a valuable experience for clients to be a little bit out of their comfort zone and out in nature. “Horses are mirrors to people and you can observe a whole lot of stuff when you are working with those animals,” explains Wells.

On their first series of visits to CTRC in Longmont, Colorado Recovery clients got to watch the
herd and observe how the horses interact. Wells prompts her clients to decode the animals’ behavior: “Why do you think they are doing that?” she would ask them. “That’s always very interesting for the clients, to learn about the behavior of the horses. By the third visit, clients got to halter the horses, then learned how to groom a horse.”

Some clients are quickly at ease with all of these activities while others may take a little longer to get comfortable. “There’s a whole range of responses,” says Wells. “On later visits they got to lead the horses—we even created an obstacle course and led the horses through it.”

So far, there have only been a few occasions where people actually got to sit on a horse. Equine-assisted psychotherapy does not necessarily involve riding because the aim is to help clients learn about themselves and others, while processing or discussing feelings and behaviors. The goal is to help clients in social, emotional, cognitive, or behavioral ways.
Equine therapy has been a very successful addition to Colorado Recovery’s already broad offer. Our treatment program aims to empower adults with mental illness, and those who support them, with an unrelenting optimism for recovery, purposeful involvement in the community, and an enhanced sense of meaning in life.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.

Why Keeping a Regular Schedule is Important for People With Bipolar Disorder

Keeping to a regular schedule is good for anybody’s health and well-being but it is especially important for people with bipolar disorder. BD is characterized by periods of depression and periods of abnormally elevated mood that can last from days to weeks each. If the elevated mood is severe or associated with psychosis, it is called mania. Sticking to a consistent routine can help decrease the risk of experiencing these periods of mania and depression. 

People with bipolar disorder are more vulnerable to disruptions in their circadian rhythms, which are biological processes that operate on a roughly 24-hour cycle and serve a crucial role in maintaining health. Circadian rhythms include the cycle of sleeping and waking and the cycle of regulating body temperature. 

The circadian system is governed by a region of the brain known as the suprachiasmatic nucleus, with assistance from peripherals located in body tissues. These internal clocks synchronize biological circadian rhythms with external cues in the environment, such as light, meal times, and daily routines.

Such external cues are also referred to as “social zeitgeber,” explained Alexandra Gold Ph.D. in Psychology Today. “According to the social zeitgeber theory, developed by Dr. Ehlers, Frank, and Kupfer, life events that disrupt social zeitgebers can lead to irregularity in circadian rhythms, which can in turn contribute to ongoing, broader desynchronization between circadian rhythms and social zeitgebers, ultimately leading to a mood episode.”

The social zeitgeber theory suggests that “life events disturb social zeitgebers (“time givers”), which, in turn, disturb biological rhythms, resulting in affective symptomatology in vulnerable individuals,” wrote Boland, Stange, et al. in their 2016 study “Affective Disruption from Social Rhythm and Behavioral Approach System (BAS) Sensitivities.” 

“The occurrence of life events, or the stress associated with their occurrence, disrupts daily social rhythms (such as bedtimes, mealtimes, and the beginning and ending of work), which are theorized to entrain internal circadian rhythms,” wrote the authors “In turn, the disruption of the circadian rhythms is thought to lead to depressive or manic episodes.”

Keeping a regular schedule works to minimize those disruptions. So, what should a healthy schedule look like? “Ideally, this looks like having regular times for some of the major events that create the framework for your day,” wrote Dr. Gold. “This would include regular times that you go to sleep and wake up, regular times that you eat your meals, and regular times that you go to work.”

She recommended three steps for putting schedule regularity into practice: 

  1. Aim for consistency in daily activities. Try to keep the same sleeping and waking times, meal times, and work times on a daily basis. 
  2. Use a calendar to help you keep track of times for consistent daily events outlined in step 1. A calendar can also be a helpful tool for scheduling new events that might not fall into your regular routines.
  3. Notice how your schedule is impacting your mood.

Recovery from serious mental illness requires that people experiencing disorders such as BD retain a sense of empowerment—a belief in their ability to take charge of their lives and manage the complex demands and consequences of the illness. This includes understanding and adopting a healthy regular schedule. 

Colorado Recovery opened as an independent treatment center in Boulder in 2006 to create a non-hospital treatment center for people with serious mental illness that employed the most effective diagnostic and treatment methods and focused on respectful, compassionate, and optimistic care.

Our treatment facility provides the services needed to address schizophrenia, bipolar disorder, and other serious mental illnesses which are specific to each individual. About half of our clients are under 35 years of age and we expect good outcomes regardless of the duration of the disorder. Clients of any age will feel comfortable in our program. Call us at 720-218-4068 to discuss treatment options for you or the person you would like to help.