I write posts for two blogs, our Special Needs Blog and our Special Needs Book Review site, and loved ones who care for individuals with an invisible special need always cry out how difficult it is for all concerned. Coping with mental illness in your family, be it a child, teen or adult, is especially overwhelming. In their Introduction, the authors of Defying Mental Illness: Finding Recovery with Community Resources and Family Support gain your trust because they show they are aware of the struggles caused by mental illness, “No one should minimize the challenges of mental illness. Like many other severe and chronic disorders, mental illness devastates people with symptoms, and blasts family, friends and co-workers too… The world as you have known it will never be the same. Mental illness means a struggle.”
We are so pleased that both authors, Paul Komarek and Andrea Schroer, agreed to take part in our interview. Read Andres’s interview here. This one is with Paul Komarek, a man I see who has worked in various fields because his LinkedIn profile tells us,” Paul Komarek: Author, Consultant, Teacher, and Activist.” The review of Defying Mental Illness is here.
Lorna: Welcome to our Author Interview Series and thank you for writing such a wonderful resource for families struggling with mental illness. I read that you are a graduate of American University’s School of International Service and Northern Kentucky University’s Chase College of Law and that your work involves multiple systems besides mental illness. Please tell us about your interesting career.
Paul Komarek >> I had my first exposure to the world of mental illness as an undergraduate. A student on my dorm floor had post-traumatic stress disorder, with sleep problems and flashbacks from experiences he had in the military. My undergraduate work focused on international relations, on how economic power plays out, and how bureaucracies work. I lived in the international student dorm, experiencing cultural diversity at close range.
My first job after college was with the Social Security Administration. I worked with people from every walk of life. I interviewed retirees, Holocaust survivors, refugees, and people seeking disability benefits or SSI, disability benefits based on need. The disability claims system is flawed but remarkably strength-based. We would look at a person’s education, work history and transferable job skills, and see what capacity they had to function at work despite the impact of their medical conditions.
Our office linked with Longview State Hospital, a state mental health facility which was in the midst of reducing its population. I interviewed dozens of former long-term hospital residents as they were being discharged to the community. Ohio was also shutting down its state-run developmental disability facilities, sending residents back to their home counties after years of institutionalization. I had an opportunity to investigate how representative payee issues played out for residents of newly-established group homes for this population. I was horrified by the conditions I encountered.
I attended night law school while working full-time for Social Security. Once I started practicing law in a small firm, the pace of my life increased. I had a busy, stressful caseload of commercial litigation, criminal law, Social Security and bankruptcy work, plus a young family that included a son with a newly-diagnosed disability. It all proved too much. It triggered my own case of bipolar disorder. I ended up misdiagnosed, with medication that made my condition worse. I had the whole experience — deep depression to mania, mixed states to rapid cycling. This was very difficult to get through, and it was not compatible with the effective practice of law. Fortunately, I have had my recovery. Once my condition was properly identified and the right medication kicked in, and with my family’s support, I found a way to rebuild my career. I found employment with Catholic Social Services, where I helped start a network of support groups for caregivers of older adults and people with disabilities. Later I started my own consulting practice.
My consulting practice involves fostering innovative solutions to tough social problems. I help my clients meet regulatory requirements, communicate with their constituencies, and find funding. I’ve worked on several projects that connect mental health or substance abuse treatment with court diversion, corrections and re-entry. I developed a training program for court and jail personnel based on the earliest Crisis Intervention Team models, and taught the curriculum in jails across Ohio and Kentucky. I’ve also worked on guardianship issues, housing issues, education issues, mediation, and restorative justice.
Lorna: Thank you for sharing your inspiring story. You were fortunate that your condition was identified and that you found the support you needed to get back on track. Why did you feel Defying Mental Illness: Finding Recovery with Community Resources and Family Support needed to be written? Had writing a book always been in the back of your mind?
Paul Komarek >> This book started out as a project for NAMI Ohio in 2004, a how-to guide for people with mental illness and family members. Unfortunately, even though people found it useful, the group could not keep it in print. After another group sponsored a revision in 2009, but could not support its completion, I took on the project as my own. I recruited Andrea Schroer as a co-author, and over the course of six months in 2011 we re-wrote the whole thing. Andrea helped me discover the key strength of this project – that our work was delivering hope, and a way forward through the struggle to recovery.
The most important thing for any parent is to love and support your child, no matter what, and never lose faith that your child will find their own success and lead a meaningful life. Some practical things do help. The more you can keep to a routine at home, and make your home life seem ordinary and supportive, the better.
Lorna: Unfortunately still in 2012, many still believe in the myth of a “happy childhood” for all children. One of my daughters, who has now been diagnosed as being Bipolar, was already struggling/suffering when she was only 8 years old. Please tell us about mental illnesses in children and how parents can best help them.
Paul Komarek >> The most important thing for any parent is to love and support your child, no matter what, and never lose faith that your child will find their own success and lead a meaningful life. Some practical things do help. The more you can keep to a routine at home, and make your home life seem ordinary and supportive, the better. Keep your child involved in community or school activities, whatever provides a feeling of connection and success. Beyond that, it’s important to take on the role of your child’s advocate, and become engaged in the struggle. You will need to figure out what you are facing, locate allies and resources, and work out a way forward. It helps to keep good records, and to find support for yourself. Unfortunately, none of this feels very satisfying as you are going through it. It helps to realize that nobody does all of this perfectly.
Lorna: Your book brings hope. You wrote, “But there is a real basis for hope. People can and do recover, symptoms can be reduced or completely eliminated…Always hope for healing. The medications do work and new ones are being developed all the time.” What are some of the steps one must take to recover or reduce the grips of a mental illness?
Paul Komarek >> I’ve learned that the medical model connects with recovery, but is not the essence of recovery. Recovery involves getting your life back to its capacity. You get pretty far by answering four questions:
- What helps you make the most of your talents?
- How can you reduce the areas where you are vulnerable?
- How can you improve your ability to cope with stress?
- How can you deal with the risk of something going wrong?
These questions are just enough to keep us focused on what’s useful. The first question helps us find and support our strengths. We can’t win any struggle with our weaknesses. We all have talents that are useful in the world, and internal capacities like character strengths, our faith or spirituality. We can discover and learn the conditions or strategies that help us make the most of these gifts. The second question, reducing vulnerabilities, is about our daily maintenance. Answers here may come from the medical model, or from some alternative model, or from what we have learned from family life or our daily routine. A person’s allies also fit in here, whoever we have to check in with and keep us on track. The third question is about improving our ability to handle stress. Because stress makes symptoms worse, it must be attended to. The final question puts us on the lookout for risk. We know that symptoms of these illnesses will vary from time to time, and can create problems for others or threaten our safety. We need to take the right precautions.
Paul Komarek >> People have told me that this is the first book they have ever encountered that makes recovery from mental illness seem normal and achievable. I’m gratified to hear that people are much less frightened by the subject matter once they get into our book, and that readers find our work hopeful, even inspirational. Church groups find it useful too. One minister told me it says what he needs to know in a paragraph or two, instead of multiple pages or even chapters.
Lorna: You wrote that families and friends have a role in the recovery process and your book has essential information to help people with symptoms and family members collaborate and support each other. What are some of the ways family and friends can help?
Paul Komarek >> The key role for families is everyday love, kindness, companionship and support. Try to stay positive, and treat whatever trouble comes as something to work through or a risk to be dealt with in the future. When people focus on their relationship and keep thinking of each other as allies, it’s easier to authorize disclosure of information, work on plans together, and trust in each other’s good intentions. A friend’s key role is simply to maintain the relationship or connection as a friend, and perhaps take the lead with social outings or organizing what to do together. This will probably take more work than the friend has been used to. Beyond that there are other tasks or support roles that range from providing transportation to reality-checking.
Lorna: Your chapter entitled Crisis, Violence, Suicide points out the importance of having a psychiatric emergency contingency plan and alerts you to the warning signs of a mental health crisis. Suicide is the third leading cause of death among young people aged 15-24. Please highlight the most important steps family and friends must take to prevent a family member from committing suicide.
Paul Komarek >>: Stay with the person, talk to the person, and know who to call. Suicide prevention is where a small dose of practical training can save lives. There are known risk factors. A few common patterns happen over and over. People receiving mental health care are assessed for suicide risk at practically every medical appointment. Families can learn what to look out for.
Suicide happens when a person’s resilience is overcome by the force of a triggering situation. People develop tunnel vision and lose capacity to generate options. They also lose resilience if they are using drugs or alcohol, or if they have “crossed boundaries” or attempted suicide before. Fortunately, most people who are contemplating suicide are ambivalent about it. They leave clues, consciously or unconsciously. You may hear a stray comment or see a Facebook post about ending it all, or learn about the person giving away a valuable possession. Sometimes a person will become extremely agitated, or will suddenly become calm. Or a person who has been very depressed will become activated after a new medication kicks in.
If you pick up on one of these signals, stay with the person and talk with the person. Ask what they are dealing with and if they are feeling safe. Don’t avoid asking about suicidal thoughts or impulses. This does not increase the risk of suicide. Do treat every suicide threat seriously. Try to get the person to seek help immediately from their doctor or the nearest hospital emergency room, or call 911. It is also important to limit the person’s access to firearms, medications, or other lethal methods for suicide. You can reach the US national suicide hotline by calling 1-800-273-8255.
This is tough, tough work. I have known families who have kept 24-hour watch on loved ones for days at a time to make sure people come through safely.
Lorna: This is such good advice! Paul, your responses are just like your book and will be so helpful for our readers. Thank you so much for this interview and your much needed book. Please tell us what is on Paul Komarek’s To-Do list for the coming months. How can folks buy your book and how can we follow you online?
Paul Komarek >> I am currently working on ways to help ordinary people find a meaningful role in supporting people with mental illness. We’ve managed to convince ourselves that the topic is so complicated only experts have a say in how people can make progress with these illnesses, but that’s not really the case. Ordinary people help each other deal with the effects of mental illness every single day, in every culture on earth. On top of that we have the great social issues involving people with mental illness – stigma, social isolation, neglect, homelessness, violence, criminalization and imprisonment. I’ve had the opportunity to learn about practices that exist today with the potential to fundamentally change how all of these issues play out.
Andrea and I are writing about these in our new blog “Redesigning Mental Illness.” http://redesigningmentalillness.blogspot.com. Andrea and I are also creating opportunities to meet with people in recovery, and their family members or allies, to talk about what works for them. We are organizing our first conference in Cincinnati on September 18. Details will be posted on our blog.
Also Andrea and I are working on an international edition and a Spanish-language translation of Defying Mental Illness which we hope to release in 2013.
The best way to follow what we are doing is through our publishing website, Church Basement Press.
Defying Mental Illness 2013 Edition – Kindle Version on Amazon
Defying Mental Illness 2013 edition – All ebook formats on Smashwords – includes Nook, Apple, Kobo, Sony, and PDF versions.