RE: Return response/ Recovering Psych. Patients

Bob Green (
Wed, 2 Jul 1997 08:54:42 +1000


I am going to give a more detailed response later as I believe your post is
worth further consideration, but for now make a few quick comments.

>Issues of denial and insight are interesting. Do clients deny suffering or do
>they deny the label of schizophrenia because of the images and associations it

Interestingly I believe a person can deny the diagnosis of schizophrenia/
being 'unwell' though have 'insight' that they are different or be aware
they having certain experiences. I don't believe these terms are therefore
mutually exclusive.

Denial can also be understood in grief/loss terms, not simply as
Denial=non-compliance. I always find it useful to ask people who say
someone has NO social skills, insight or are dangerous what they mean by the
terms. Just the other day I was interviewing a relative who spoke of a
client's violence, they were referring to verbal aggressiveness.
Elaboration of professionals constructions is a source of great interest to
me and I believe vital to providing reasoned services.

>>I would also like to know more about Chris Stevens' work.
>Chris is a colleague of mine who will be at the Seattle conference. His work
>is not about schizophrenia but rather the idea of "insight" in general. I find
>his work interesting in mental health because of the term mentioned above- the
>client "without insight". He is on line somewhere so I will let him describe
>his own work.

I would like to hear from Chris. A concept related to insight, particularly
for those working with offenders, is remorse. It is would be interesting to
see how this concept would be considered in Chris' framework.

>Currently I am trying to understand a man who used to work at the steel works.
>He has an elaborate "delusional system" who nobody I think has ever really
>listened to. Some may consider him thought disordered- he certainly doesn't
>meet the neater requirements of the cog behavioural ABC approach to delusions.
>Interestingly though he does use terms consistently- he has meanings for terms
>such as "pardon", "perfection", "one", "first born creature of the universe",
>"clear thoughts". These all relate in some way. "Perfection" is related to a
>steel process. He had difficulties towards the end of his apprenticeship. He
>talks of the steel works being at war, not receiving a pardon, and the
>psychiatric patients getting side effects because of what the steel works did.
>I am sure there is meaning in there, and it can't just be meaningless
>epiphenomena of a damaged biology. Currently we have a big white board and are
>trying to clarify meanings of these terms- as I mentioned they seem to be used
>consistently but sometimes bear little resemblance to common usage.

In formal psychiatric terms it would seem this person has very well
systematised beliefs. Sometimes you have to be careful not to get
incorporated into these beliefs. I don't mean incorportaed in the sense
of playing a role in the person's life but in the sense of becoming an
element in the system of views. Sometimes just understanding isn't enough,
it can get problematic when a person wants you to take sides e.g., against
the steel works. If you don't it is a sign you are in collusion with them.

Anyway, I will give more thought to your post, particularly the question:

>I wonder sometimes though whether the voices are the construing or the