Family Psychoeducation Can Change Lives

While writing this article about my mother's mental illness, someone asked me, "Isn't it difficult to dredge it all back up? " My immediate response was, "No, no at all. " I feel compelled to disclose our remarkable experience in the hope that others will learn the value of single-family consultation, psychoeducational workshops, and psychosocial rehabilitation. In my home State of New Jersey this treatment is known as the Clubhouse movement. At the Club the staff focuses on family involvement. The New Jersey Division of Health and Hospitals is very receptive to this process, as it closes institutions. In 1989, my mother's caseworker asked our family to participate in a new intensive family treatment. We were going to learn how to create a support system, one that might actually keep Mom out of the hospital. Mom was receptive to the treatment, and her family was eager to help her. Her clinicians, Linda Karimi of the University of Medicine and Dentistry of NJ (University Behavioral Healthcare) and Rusty Foster and Sheree Neese-Todd of the Club, with loving support, all went beyond their job descriptions to ensure this treatment's success. Our miraculous family experience required commitment and hard work from Mom, our family, and the mental health community. Perhaps, this treatment may sound like a panacea, but for me it was the one prescription that I had been waiting for. Will it work for others? I think so. At its worst, it could never cause the suffering that long-term hospitalization causes. My mother, who is now 65, has been mentally ill most of her life. Since the 1950s, she has been hospitalized approximately 13 times. Over the years, Mom's diagnosis has changed from paranoid schizophrenia to bipolar disorder and most recently to schizoaffective disorder. Some symptoms of her illness include incoherence, rage, paranoia, and manic insomnia. Severe depressions can cause her to withdraw for weeks, months, or even years. In 1954, Mom, a 23-year-old part-time student, married her first husband and had my older sister. Mom was an outgoing, vivacious woman with a keen sense of humor. Then in 1955, she was hospitalized for the first time. Against her will, Mom received electroconvulsive therapy without anesthesia, as well as insulin coma therapy, an experience that still haunts her. Her marriage ended during that hospitalization. In 1957, Mom met her second husband, my father. They fell in love. She was doing well—she had a job as a social worker and took care of her baby. My father was aware of Mom's mental illness when he married her in 1958. Within two years they had three more children (a set of twins and a baby girl), completing the family. The house where we lived in 1962 appears well-kept and homey in old family photos. In one snapshot, my twin brother and I sleep on the grass with our arms around each other. In another, my 1-year-old sister squints and smiles as my older sister dances across the back porch. Mom smiles as she corrals us for a group shot. Pictures capture my parents hugging and kissing. When did it all change? I don't remember those days, when she was well. I was too young. My father switched jobs in 1965, and we moved to a small college town, away from my mother's parents. In this unfamiliar world, Mom began to withdraw. My grandparents and my father always made sure that Mom had the best treatment that money could buy. Although she participated in some groundbreaking therapies of the time, nothing helped. When she was at home, Mom refused medication. In 1968, when I was 10, we attended a single session of family therapy. When we did not continue, I was convinced that we were stuck in a truly hopeless situation. Mom was then hospitalized for a few months and sent to live with friends. I don't remember her leaving. I don't remember any visits, or the day she returned home. She was away for a year. In 1970, my father began thinking of leaving the family. Mom's psychiatrist told Dad that if he left, Mom would probably wind up institutionalized for life. I'm sure