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I Am Not Sick I Don't Need Help: How to Help Someone with Mental Illness Accept Treatment Paperback – May 10, 2007
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I strongly recommend this to families and therapists of seriously mentally ill patients. -- AARON T. BECK, M.D., Emeritus Professor of Psychiatry, University of Pennsylvania, Department of Psychiatry
The focus throughout is on building mutual understanding and trust, so involuntary treatment can be avoided,if possible. -- LAURIE FLYNN, Executive Director, National Alliance for the Mentally Ill
This book fills a tremendous void in the literature on schizophrenia and bipolar disorder. -- E. FULLER TORREY, M.D., Director of the Stanley Foundation Research Programs on Schizophrenia and Manic-Depression;Author of Surviving Schizophrenia. --This text refers to an out of print or unavailable edition of this title.
From the Inside Flap
Looking back, the strangest part was not the omnipresent government agents, the agonizing radiation weapons, or even my own super hero-like capabilities. What frightens me most is that my manic depression gave me an immovable certainty that it was the world around me that was convulsing but that my perception and judgment of it were unaltered. Thinking of this time leaves me frustrated and embarrassed as well as apprehensive that it might come again.
I read Dr. Amador's book and felt better. First, he concretely and understandably establishes that most denials of treatment are but manifestations of the illness and that it is the illness that is the enemy. Dr. Amador then presents a powerful game plan for penetrating, or at least circumventing, sickness induced lack of insight that will maximize the cooperation with treatment of those affected. When I first became ill, I wish this book had been in the hands of someone who cared about me.
JONATHAN STANLEY, JD Assistant Director, Treatment Advocacy Center and, a Consumer diagnosed with Bipolar Disorder
There are several publications that address best practices for clinicians treating persons with schizophrenia. These are written from the perspective of the practitioner. There are a few books written from the perspective of the consumer or of the family member, but these do not incorporate the values of clinical insights, particularly those reflecting recent research findings. The great value of "I am Not Sick, I Don't Need Help" is that it incorporates both the consumer's perspective and that of the clinician. It finds common ground, pointing out where the consumer and his/her clinician can work together in partnership. It is practical, easy to read, and hopeful. I highly recommend it to anyone interested in helping those who, like myself, live with the condition we call schizophrenia.
FREDERIC J. FRESE III, Ph.D. Summit County Recovery Project and, a Consumer diagnosed with Schizophrenia
At last we have a volume for those individuals most closely associated with the mentally ill. In a very readable fashion, Dr. Amador addresses the nature of patients' unawareness of their illness and their need for treatment. He also clearly outlines the relevant research and gives clear prescriptions to help families and therapists deal with patients' obliviousness to their condition. I strongly recommend this to families and therapists of individuals with serious mental illness.
AARON T. BECK, M.D. Emeritus Professor of Psychiatry, University of Pennsylvania, Department of Psychiatry
This is the first book to address the elephantine question running roughshod over families of individuals with schizophrenia and bipolar disorder: Why won't the sick person take his/her medicine? Amador, a psychologist who has a brother with schizophrenia, has pioneered research on poor insight into illness, a.k.a. anosognosia, for the past decade and is an acknowledged authority on it. He blends clinical vignettes skillfully with his erudition, and the resulting mix is both edible and edifying. Most important, Amador provides families and mental health professionals with a concrete, step-by-step plan to improve awareness of illness. This book fills a tremendous void in the literature on schizophrenia and bipolar disorder.
E. FULLER TORREY, M.D.
Author of Surviving "Schizophrenia."
Of the myriad of problems presented by serious mental illness Dr. Amador has focused on the single most critical factor. Breakthroughs in treatment will not be effective unless we deal with medication noncompliance and the related issue of poor insight into illness. Dr. Amador takes this issue on in "I am Not Sick I Don't Need Help" and deals with it head-on, providing vital information and practical advice for both families and therapists of patients with schizophrenia and bipolar disorder. This book will be immensely helpful to anyone dealing with the problems of medication noncompliance and poor insight.
MICHAEL FLAUM, M.D.
Director of Mental Health, State of Iowa
This is a wonderful book bringing together the personal experiences of a psychologist and a lay person who have relatives with serious mental illness. Dr. Amador's research and clinical experience makes this book a rich source of information and practical advice. It is one of the salutary characteristics of our culture that people who experience pain convert that pain into something productive. People who are victimized by, stressed by, and dismayed by serious mental illness will find this book enormously helpful. It contains information about new research and concrete advice that will be of enormous help to both the families of the seriously mentally ill and to the mental health professionals who care for them.
HERBERT PARDES, M.D.
President, New York-Presbyterian, The University Hospital of Columbia and Cornell and, past Director of the National Institute of Mental Health
For so many, it is very difficult to accept the notion that people like Ted Kaczynski or Anna-Lisa Johanson's mother have medical illnesses. It is easier to somehow cordon them off in our minds, just like they have been walled off from society through the centuries, as somehow less human than the rest of us. In this book, Dr. Amador breaks through these walls with personal courage and brilliant science.
Lack of insight in people with schizophrenia and bipolar disorder is the major cause of many of the worst aspects of their illness, and may be the most recalcitrant since it is difficult to treat someone who thinks that nothing is wrong. Dr. Amador has spent the better part of two decades conducting research on this topic and has been the world's most influential scientist in this important area of work. In this book, he prescribes detailed interventions to help families and therapists deal with lack of insight and the many difficulties it causes people with major mental illness. Yet Amador is not an academic preaching from an ivory tower. His poignant personal experiences with people with schizophrenia, including his brother and close friend, are laced throughout this thoughtful, moving, and indispensable book. "I am Not Sick, I Don't Need Help!" is an essential guide to anyone who knows, loves or treats someone with schizophrenia or bipolar disorder.
RICHARD KEEFE, PH.D. Professor of Psychology in Psychiatry, Duke University Medical Center and, author of "Understanding Schizophrenia." --This text refers to an out of print or unavailable edition of this title.
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Top customer reviews
My son is diagnosed with bipolar disorder and has been in and out of treatment for 4 years. He is now in the hospital again, after having gone off of his medications, again, (and self medicating with marijuana and such) and close to having to do another stint at that state hospital. He is only 17, going on 18. I hope he reaches into adulthood. If he were to kill himself as he sometimes says he will do, having read this book and having tried everything within my power to help him, I will come out the other side with some solace for my heart. I know I am powerless to such a disease. Damn mental illness! It's as worse a curse as cancer.
I would put down every book you might be reading right now, even from Fuller Torrey, and read this first. Underline and keep going back to the reasoning behind the authors suggestions. (Some of the ideas in the book are usable when dealing with troubled people and youth in general.) Best of luck. I have recommend this book to the therapist now working with my son. I will send one in the mail to his current psychiatrist who could use this for her practice. She is not connecting with my son and it's causing very slow movement in his progress.
I so appreciate the author updating the book as time goes on! Hugs to you and all.
Mental Illness Policy Org.
Anosognosia can cause myriad problems for loved ones, their families, and society as a whole. A lack of insight results in treatment refusal. How could it not? Anyone who thinks they are not sick would understandably refuse diagnosis and treatment for what they do not acknowledge. Treatment refusal leads to medications non-compliance, which in turn can lead to more florid delusions or hallucinations. Personal hygiene can deteriorate. Isolation can increase. Especially when someone with a severe mental lacks insight and also abuses street drugs or alcohol, there is a heightened potential for violence in a small percentage of cases.
How can family members cope with a loved one lacking insight? How can they get a loved one needed help if the loved one doesn't acknowledge the need for help? Many family members in the maelstrom know the frustration of getting an oppositional loved one to do what might be good for them, at least as the family members perceive. Those in the earlier stages of the psychodysseys may feel particularly stressed the apparent futility of talking a loved one out of his delusions or into a treatment for an illness he refuses to believe he has.
In his classic work, I'm Not Sick; I Don't Need Help!, clinical psychologist and Columbia University professor Xavier Amador proposes a simple technique. It is called LEAP, for Listen, Empathize, Agree, and Partner. "Listen" means listening without commenting, disagreeing, or arguing. It is based in reflective listening, in which the listener drops his or her own agenda and redoubles efforts to understand the loved one, whatever his psychological idiosyncrasies. Amador stresses the three A's of good listening: apologize, acknowledge, agree. "Empathize" means displaying genuine emotion even when relating to a loved one's delusions. "Agree" means agreeing as a neutral observer, acknowledging that the loved one has personal choice and responsibility for his decisions. "Partner" is an undertaking with the loved one to achieve shared goals.
The LEAP technique is an amalgam of three therapies. From Carl Rogers' client-centered therapy is drawn the concept of reflective listening without judgment or opinion. From Aaron Beck's Cognitive Therapy come the ideas of collaboration, agenda setting, and cost-benefit analysis. From William R. Miller and Stephen Rollnick's Motivational Interviewing derives the emphasis on the loved one keeping the locus of control for personal change.
Amador's approach is elegant in its simplicity. It is also authentically based in Amador's lived experience as younger brother to the late Henry Amador, a man with schizophrenia. (The evidently deep love that Amador felt for his brother is itself an inspiration for other family members with loved ones in similar circumstances.) I Am Not Sick; I Don't Help!, now in its 10th anniversary edition, is a classic text in the field of treatment of schizophrenia, an invaluable navigation tool for all families in the maelstrom of severe mental illness.