BETTER FAMILIES
by
Jomo Phillips MSSW-MFT (Clinical Fellow AAMFT)
Couple & Family Therapist/Clinical Social Worker
Since I have been a clinician, I have had individuals on various occasions call me often in a panic about a family member who has started to exhibit bizarre behaviour. Nothing is scarier than experiencing a family member who appears to hear voices or see things that do not exist or have developed odd and false beliefs, or are encountering bizarre and disturbing thoughts. Many of these symptoms are often associated with experiencing a psychotic episode.
Generally in this community, psychosis and psychotic disorders are misunderstood and highly stigmatised. While the rates of people who develop psychotic disorders are low – usually below five per cent of the general population, persons with psychotic disorders like schizophrenia, however, account for higher rates of hospitalisation, more extended hospitalisations, higher rates of suicide and more disability.
Many persons who develop psychotic disorders first begin to experience behavioural changes in late adolescence and early adulthood. Some of these behavioural changes can include deterioration of performance at school or work. Persons might also have difficulty organising their thoughts, and they might be suspicious, paranoid, or apprehensive socially. Other behavioural changes can consist of social withdrawal and isolation; decline in personal care and hygiene; difficulty differentiating reality from
fantasy; disorganised speech; and difficulty communicating with others.
There appears to be an association between marijuana use and the development of psychosis. This is particularly salient in the Caribbean where many young people are exposed to and consume marijuana. Of course, the relationship between marijuana and psychosis is complex. It appears that factors like the drug’s potency, frequency of its use, the age the person first consumed the drug, and genetic vulnerability might all play a part in why some young people who consume marijuana might be at higher risk of psychotic disorders.
Families are a vital alert system in recognising and securing help for a family member whose behaviour might appear odd. The research on psychosis treatment indicates that early treatment of individuals with psychosis is vital and improves prognosis. Many families experiencing a family member exhibiting the earlier mentioned behavioural changes that precede a psychotic episode or experiencing a full-blown psychotic episode often experience grief. This grief usually consists of a range of emotional responses. On multiple occasions, I have, for example, experienced family members who are in shock and denial about the severity of the illness their family member is experiencing.
Family members might also experience a range of fears. Parents might, for example, be fearful that they did something that caused their child’s illness. Family members might also be afraid that their relative’s condition will worsen as they access psychiatric care. From my own experiences, I know the fear of accessing psychiatric care is particularly intense in Barbados where many individuals have mostly learned stereotypes about institutional psychiatric care. Other emotional experiences include grief and acceptance.
Because of the nature of psychotic disorders, someone experiencing psychosis might not be able to access help because of the deterioration of their functioning. Family members will therefore need to be much more active in securing psychiatric care for their relative. Securing this help will require family members to be supportive, calm, and firm to ensure their loved one gets help. In the case of emergencies when a relative might be actively suicidal, have made a suicidal gesture, injured themselves, damaged property, or threatened or been violent to others, family members can call the police or the Psychiatric Hospital for advice on emergency assistance.
Psychotic symptoms are scary for family members, but the earlier a family member experiencing psychosis secures help, the better their outcomes. Getting help will involve family members working through their feelings about psychosis, educating themselves, and being active in obtaining assistance.
Jomo Phillips, MSSW-MFT (Clinical Fellow AAMFT) is a Couples & Family Therapist and Clinical Social Worker ([email protected])
NOTHING IS SCARIER THAN EXPERIENCING A FAMILY MEMBER WHO APPEARS TO HEAR VOICES OR SEE THINGS THAT DO NOT EXIST OR HAVE DEVELOPED ODD AND FALSE BELIEFS
