This is a video of a long but excellent talk by Xavier Amador on the whole topic of why people do not believe they are sick.


Date: Mar-2013Minutes: 1:37:36
Helping People w/ Mental Illness - Xavier Amador

Highly recommended!

I'm still watching it ... .I cannot overstress how awesome it is

Auspicious,

This was fantastic!  The way Dr. Amador described everything was complete common sense really.  Simply saying that if you went to work one day and everyone told you that you did not work there and you were not married to the person you believed you were married to etc, and the level of frustration and anger you would feel because you truly believe it, put it all in perspective from a borderline/mentally ill persons point of view.  I think everyone who cannot get over the behaviour of a borderline should watch this, regardless of how angry and upset you feel, this explanation could not fail to pull at your heart strings a little and really helps you understand how an illogical thinker relates to people pushing and shoving them to see that they are ill.


This is one of the best resources looking at mental illness i have seen in a while.

yes it helped me understand alot of what I hear from him and helps me let go a bit... just finished it this morning

I've watched half of this.

I still am waiting to hear about how to deal with what he talks about.

I've already resolved I cannot change my stbx, nor can I blame her, but I am still very angry about her actions and lies that do so much continual damage.

The hardest part is to get others to see whom they are, I don't think I really care anymore for her to have "Insight"

I think it's only human nature to feel angry when someone seems to be hell bent on hurting you or damaging your relationship, while you are reading, researching and trying to do everything you can to save it or help them.  The most important information i took from Dr Amador, was more or less, if you are going to be in any kind of relationship with a mentally ill person (and that includes the therapist treating them) then it is not ever going to be plain sailing and communicating as two logical adults is going to be like trying to find the holy grail.  Looking for them to realise they are ill is something you may have to work on too, they may never realise, they may never appreciate you pointing out all their faults/flaws... in fact they are more than likely going to resent you.  In a nutshell, if you know they are mentally ill and you want to stay with them, you have to accept... understand... and live with the idea that you may have to change your entire way of dealing with them.

Every time i feel upset about how my ex treated me, i just keep thinking of Dr Amador saying "if someone kept telling you that you were wrong about something you truly believed to be fact, how would that make you feel, angry, upset, frustrated"  So i keep in mind that the person i was in love with thought i was telling him he was mentally ill, telling him he was hurting me, telling him he was damaging me, telling him constantly how much he was wrong, telling him to get help, telling him every thought he had was only his thought and not actually happening.  This is a person who cannot deal with emotion at all and probably never could, yet i expected him to just change in a short time and relearn new behaviours as of "right now"

Anosognosia (Lack of Insight) Fact Sheet

When a person cannot appreciate that they have a serious psychiatric illness, a tremendous challenge to family members and caregivers follows. About one-half of people living with schizophrenia, and a smaller percentage who live with bipolar disorder, have this clinical feature. Individuals with Alzheimer's disease and dementia also often have this feature. The medical term for not seeing what ails you is anosognosia, or more commonly known as a lack of insight. Having a lack of awareness raises the risks of treatment and service nonadherence. From the person's point of view, if they feel they are not ill why should they go to appointments, take medication or engage in therapy?

Why can't a person see what is so apparent to those around them? The best thinking indicates this is a core feature of the neurobiology of the conditions. Frontal lobes organize information and help to interpret experiences. In conditions like schizophrenia and Alzheimer's disease, frontal lobe difficulty is central to the neurological processes that underlie the disorders. Psychological denial is not the reason for the lack of insight in these illnesses.

Efforts to get people to see that they are ill are frequently fraught with frustration and may be met with denial or anger. Approaching the person in a supportive way will be beneficial for your relationship. Finding out what goals a person has (for instance getting a job, forming relationships, living independently) can be a good place to start engaging in next steps. Check to see if the service system has outreach workers who work on engaging people who lack insight. Working with the person's goals does not mean you have to pretend he or she is well. For example, if the person applies for disability services, encourage the doctor to review the diagnosis; getting a person to agree to disagree can be a first step. You don't need to argue about diagnosis to have a person participate in-or respect-basic household chores and rules.

There are situations where a person's lack of insight can, at times, create dangerous situations. This combination of no insight and dangerous acts often requires intervention. In more than 40 states, there are laws for Assisted Outpatient Treatment (AOT), also known as outpatient commitment. AOT status requires a person to engage in treatment and gives the state authority to bring the person to a treatment center if they do not. All states that have these laws have protections and a process for assessing whether this intervention is appropriate. In most states, doctors are required to submit an affidavit of the person's state and the reasons for the requested AOT status and a judge decides.

NAMI has active support groups all across the nation and local NAMI members may have information on outreach services for service engagement or doctors who are interested in this issue. You do not need to worry alone with this difficult situation.

Resources



   NAMI: www.nami.org

   LEAP: I Am Not Sick I Do Not Need Help by Xavier Amador

   AOT: For a list of current state laws see www.treatmentadvocacycenter.org





I've often wondered how often (or if) this aspect affects those with BPD.