I am Not Sick, I Don’t Need Help!

I Am Not Sick I Don’t Need Help!: How To Help Someone With Mental Illness Accept Treatment
In this updated edition of Dr. Amador’s best selling book, you will learn why so many people with serious mental illness are in “denial” and refuse treatment. Whether you are a family member, friend, or therapist, you will learn, using a step-by-step plan, how to convince someone with mental illness to accept treatment.

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Book Excerpts

TABLE OF CONTENTS

Part I. The Truth about Denial of Illness
1. A Common Problem
2. Staying in the Game
3. The Root of the Problem: Anosognosia

Part II. How to Help
4. The Right and Wrong Approach
5. Learning to LEAP
6. Listen
7. Empathize
8. Agree
9. Partner

Part III. What Should Happen Next
10. Treatment
11. When to Force Treatment
12. How to Do it
13. Dealing with the Betrayal
14. The Surprise

PREFACE BY PETE EARLEY

“How would you feel Dad, if someone you loved killed himself?”

I was rushing my college age son, Mike, to an emergency room when he asked me that question. He was seeing secret messages in bumper stickers and experiencing rapid mood swings. When we reached the hospital, I felt a tremendous sense of relief. The doctors there would know what to do!

Four hours later, a doctor finally appeared and after briefly questioning Mike, declared there was nothing he could do to help him. Mike was convinced that he wasn’t sick and he refused to take anti-psychotic medication. Because the doctor did not believe Mike was an “imminent danger” either to himself or others, my son was turned away even though he was clearly delusional.

During the next forty-eight hours, Mike decompensated. Only another parent can really understand how agonizing it is to stand by and watch your child slip further and further into a mental abyss. I tried, of course, to intervene. I told Mike that his anti-psychotic medicine would help him think more clearly. But he told me there wasn’t anything wrong with the way he was thinking. I tried to show him that he was having delusions, but he disagreed. Finally, I begged him to take his pills. “Please, please, just do it for me!” But he wouldn’t. “I’m not sick,” he kept repeating. After hours-and-hours of exhausting conversations, I demanded that he take his medication or leave the house. That threat only made the situation worse. Afraid of what might happen to him on the street, I backed down. The next morning, when Mike caught me spiking his breakfast cereal with his medicine, he became enraged.

Forty-eight hours later, Mike was in police custody. He had slipped outside one morning and broken into a house to take a bubble bath because he felt dirty. Luckily, the homeowners were out-of-town. It took six officers to subdue him. Mike was charged with two felony crimes.

Uncertain what to do, I contacted the National Alliance on Mental Illness (NAMI), the nation’s largest, grassroots mental health organization, and a volunteer there urged me to read Dr. Xavier Amador’s book, I Am Not Sick, I Don’t Need Help!

When I did, I was amazed. Just about everything that I had done to help Mike had been wrong. Rather than calming the situation, my actions had driven a wedge between Mike and me. I had not Listened to him, not Empathized with him, certainly not Agreed with him and finally had not formed a Partnership with him. Those are the four guiding principles behind LEAP, an acronym that Dr. Amador has coined to help teach parents and others how to better communicate with their mentally ill loved ones. When I was arguing with Mike, I had felt frustrated and overwhelmed. In Dr. Amador’s book, I found a simple to understand blueprint for parents, siblings, children, and friends to follow. While I was reading Dr. Amador’s book, I also realized I was not alone. Others had faced the very same situation that I had encountered with Mike.

I discovered that Dr. Amador’s advice came from years of experience as a clinical psychologist. His academic and professional credentials were impressive. He had served as a professor of psychiatry at Columbia University, as director of Research at NAMI, and director of psychology at the New York State Psychiatric Institute. He had worked as an NBC News consultant, appeared on countless television news shows, been quoted regularly in the media, and had been called on by the National Institute of Mental Health, Veteran’s Administration, and U.S. Justice Department for advice. Dr. Amador also had served as an expert witness in high-profile cases, including the Theodore Kaczynski “Unabomber,” trial, the Elizabeth Smart kidnapping, and the Zacarias Moussaoui “Twentieth Hijacker” case.

But it was another tidbit from Dr. Amador’s background that really caught my eye. His brother, Enrique, has schizophrenia. This was important to me, because it meant Dr. Amador not only had professional experience, but also a personal stake in his research. One of the reasons why he had developed LEAP was to help him find ways to better understand his own brother.

Eventually, my son was sentenced to two years of probation and during that period, Mike followed the rules. He attended therapy, participated in group sessions and took his medication. But several months after Mike’s court imposed sanctions ended, signs of his illness began to resurface. I was stunned when I discovered that Mike had stopped taking his medication. Despite everything that we had gone through, he had, once again, quit taking his pills. My first impulse was to confront him. How could you do this again? Haven’t you learned anything? But my wife reminded me of Dr. Amador’s book. Using LEAP, she was able to work out an agreement that soon had him back on his medication and into treatment.

In this new edition, Dr. Amador updates his groundbreaking book. He explains how “unawareness” of a mental illness is a symptom brought on by the disease. It is not a choice that an ill person makes. He gives practical advice about how families and doctors can bridge the gap created by the federal Health Insurance Portability and Accountability Act (HIPAA) that frequently prevents loved ones from being informed and involved in treatment. He summarizes state commitment laws, using simple to understand terms to explain the legal complexities. Since releasing his first book, Dr. Amador has delivered more than more than 300 lectures and conducted hundreds of LEAP workshops. He has taken information from those sessions and added it to this edition. These include model scripts that suggest specific phrases to use and NOT to use. Being able to refer to these passages is much like having Dr. Amador in your hip pocket.

The needs of every individual who has a mental illness are unique. But regardless of that person’s specific problems, the basics that Dr. Amador teaches help readers improve their communication skills, help develop trust, and help turn combative situations into cooperative ones.

One night while Dr. Amador was autographing books, a man approached him empty handed. He had left his dog-eared copy at home, he explained, but had stood in line anyway because he wanted to shake the hand of the doctor who had, as he put it, “given me my son back.”

I feel the same way.

Pete Earley is the author of Crazy. A Father’s Search through America’s Mental Health Madness. He is a former investigative journalist for the Washington Post and the author of several New York Times best-selling books.

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