How building on hope can keep you going
Staying focused and motivated can be difficult for anyone, especially with the myriad of distractions in this high-tech, ultra-busy world we live in.
But for those with schizophrenia, staying motivated and remaining focused on the end goal can be even more challenging.
Nonetheless, there are many resources and coping skills that can assist in a successful outcome.
“Motivation comes from hope,” says David Palmer, a Baltimore, Maryland, resident who has schizophrenia. “One has to make the effort to improve your situation. It is easy to give up hope and become apathetic and give up socially. But I’ve been in treatment long enough to know that I can overcome the obstacles.”
Palmer says that staying motivated means forgiving yourself for past mistakes and believing in the future. It is also important to have in place a number of coping strategies for times when things are difficult.
For those who are part of a support group for people with a mental illness— whether that be friends, co-workers, or family members—it is important to look beyond the illness.
“People should look beyond the symptoms,” says Chris Summerville, chief executive officer of the Schizophrenia Society of Canada. “Historically we have focused on weaknesses and deficits, but that approach is definitely changing. The new philosophy is one of recovery, at looking at what are the strengths a person has and the importance of setting personal goals.”
Identify your strengths
Elyn Saks, a University of Southern California–Los Angeles professor of law, a MacArthur fellow, author, and a woman who has schizophrenia herself, does not have a problem with staying motivated. But “schizophrenia is different from person to person,” she says. “There are many different ways of staying motivated.”
For example, those who are unable to hold down a full-time job but love animals might consider providing a dog-walking service or offering to tend to pets when their owners are on vacation. “If you are part of a support network, try to work with what someone tells you about their interests,” says Saks.
Similarly, Ken Duckworth, MD, medical director of the National Alliance on Mental Illness (NAMI), says people need to identify their own skills and use them to their advantage. “Peers can often help motivate a person when a professional or a family member cannot,” he says. “There are those individuals with schizophrenia who might have something they are really into, such as music. While they might not be able to hold down a full-time job, they might consider joining a band.”
“I’m not a consumer or a mental professional, but I am a family member,” says Kate Farinholt, executive director of NAMI Maryland. “What I hear most from consumers is that they need to get to a point where they are able to feel that they are in charge of their choices. Often that is a result of a support network that gives feedback and acts as a cheering section to keep the hope alive when things are rough, and a support group that helps them navigate the mental health system.”
Farinholt advises consumers and their supporters to take advantage of NAMI’s educational programs. “Oftentimes friends and family do not have enough education to understand how much recovery is possible,” she says. “There is a peer aspect of recovery, which I have seen as a key component of success.
“People need to be educated. Often crises and very difficult behavior have occurred, and family and friends may have no knowledge that there is treatment and hope. On the other hand, educated friends and family have a picture of what is possible.”
Not everyone with a mental illness has a ready-made support system available; nevertheless, there are strategies for developing a supportive network, such as becoming involved in NAMI and other programs in the community, for starters. And doing this can be a powerful tool in remaining focused and motivated on achieving an end goal, whether that is finding meaningful work, making independent living arrangements, or completing a college degree.
Going with the flow
Remember that motivation can change from one time to another. “When people really want something, such as an apartment of their own, they can become determined to do what it takes to straighten things out,” says Duckworth.
“To a large extent, one can develop a support group of peers with schizophrenia who have succeeded in their lives in any context, but especially when bridges have been burned and family members have given up,” says Farinholt. “Depending on where they are in their recovery, these peers often have more education to understand what is really necessary and what services are available to help.”
Palmer stresses the importance of community and building meaningful relationships with others. “If you know (a person) casually, try to strengthen that relationship,” he says. “That might be as simple as asking someone out for coffee.”
But, he advises, developing a relationship often takes work. “Don’t expect a relationship to grow on its own. For a friendship to flourish, one has to invest energy into making that happen.”
Palmer also advocates for setting goals. “I was in a bad child-support situation with my two children [and one of my goals was] interviewing attorneys by myself. I am setting goals for myself and charting my symptoms on paper with the goal of staying out of the hospital and staying motivated.”
And setting goals is, in fact, a powerful step in staying motivated and on point—as is thinking big. “When I had to withdraw from law school at Yale University, it was suggested that I should limit my expectations,” says Saks. “It was suggested that I might consider a job as a cashier for a couple of years.”
But Saks was reluctant. “How much more stressful would it be for me to face a line of people every day demanding their change?” she wonders, adding that those with mental illnesses are frequently steered toward doing volunteer work. “But I advise people to truly explore what it is that they want to do.”
The value of work
Saks credits her recovery to therapy, medications, support from family and friends, and—most importantly—an accommodating and intellectually stimulating work environment. She also urges family, friends and supporters to look harder to determine what strengths can be bolstered in a person with schizophrenia.
And, as Saks notes, it was Sigmund Freud who observed that what is most important to people is to love and to work. “Relationships are important,” she says. “And so is work. I’ve been occupationally successful, even with my illness.”
But there are others who are less successful in their careers, even though they are doing well with their interpersonal relationships. It bears noting that schizophrenia is not a one-size-fits-all illness. For Saks, strengthening her people skills was largely a result of her relationship with her therapist. “Apathy was a problem, but intensive therapy interrupted the negative symptoms,” she says. “I really connected with my therapist, and when I started seeing her, I began to be open to the possibility of making connections with other people and staying motivated.”
Nevertheless, for those who are struggling to stay motivated, Duckworth recommends troubleshooting for depression. “Depression is treatable, and people who are depressed have no motivation at all,” he says. “But usually this can be reversed.”
And, says Saks, disability payments may be counterproductive to achieving one’s goals.
“Frequently, when one is on disability, he or she may never get off,” she says. “Often there is not enough motivation to become independent and get a job. I also recommend a peer who can serve as a mentor.”
When looking to the future, the new model is empowerment, says Summerville. “Historically we have focused on a person’s weaknesses and deficits, but that model is definitely changing. The new philosophy is one of recovery. That is looking to the person’s strengths and how can one help them set personal goals.
“What may be simple for many individuals may not be so easy for those with schizophrenia. We are very much moving from living within the illness to living outside the illness.”
Furthermore, those coping with schizophrenia should take note of a powerful tool: their peers who have been successful in their recovery. “These people have gone through their own recovery and they can understand the challenges when it comes to staying motivated,” says Farinholt. “We are seeing more and more of an emphasis on this. Nevertheless, there is a big disconnect between theory and practice, and it is not just about understanding what recovery is, but integrating the tools for recovery and hope into everyday treatment.”
And, cautions Summerville, mental illness is not on a par with illnesses like diabetes or high blood pressure. “Other diseases, such as cancer, do not affect one’s self-identity, but mental illnesses are different,” he notes.
“There is a lot of prejudice and stigma, which are very difficult to overcome. “What we are trying to do is to help people move through this illness with a sense of meaning and purpose.”
Hope is the key
All in all, hope is the key when it comes to staying motivated and focused on your goal. “It is easy to give up hope, to give up socially and to become apathetic,” says Palmer, who adds that his recovery includes four distinct elements: hope, empowerment, self-responsibility, and a way of reintegrating himself into a community with meaningful relationships with other men and women. “I’ve been in treatment long enough to know that I can overcome apathy.
“One has to believe in the future and that you can improve the situation.”
That point of view is echoed by Saks. “Don’t lose hope,” she notes. “It may take a lot of hard work and love, but one can still have a really good life.”
“The peer aspect of recovery is so important,” adds Farinholt. “One who is trying to stay motivated needs to know that there are those who are further along in their recovery and who can help them with empowerment and by sustaining hope.”