Chapter 3

Starting Out for Younger Peers

This chapter leads off with a peer story to show that you are not alone. Get inspired by a person in recovery who has come through a challenge. It isn’t easy living with schizophrenia. Read on for hope.

Max’s Recovery

During the early phases of my recovery from schizophrenia, two things were important to me that I was unwilling to compromise because of a significant mental health disorder: working and further healing. I was tired, not just from the impact of my symptoms or side effects from medication, but from lying in bed and feeling useless.

My parents, specifically my mother and father, were critical in dispelling the idea that my future was limited because of illness. They reminded me to take outstanding care of myself, and my career would follow. Well, they were right on the money.

With the help of my therapist and a good psychiatrist, all reinforcing the concept of self-care, I went back to graduate school in social work. Within two years, I graduated from SUNY Binghamton with a Masters’ in Social Work. The same college I had my initial ‘break’ from first-episode psychosis (ultimately diagnosed as schizophrenia).

As a young licensed social worker, I taught my clients about self-care as well. Later, I would teach self-care at the level of education. Specifically, I taught social work education to new social work students as an adjunct professor at Fordham University at their Manhattan campus. I had come just about full circle since my initial illness.

When my illness was first blossoming, I was an English major at Binghamton University with dreams of becoming a professor. One decade later, I was teaching young therapists how to be future social workers. In some cases, these future social workers would be future therapists, reinforcing the importance of self-care to their patients, like how my therapist did ten years ago.

Today, I am confident, knowledgeable, and polished in my education and skills. This wasn’t always the case. Schizophrenia had struck me at the most inopportune time, right at the peak of intellectual ability and personality development. Research indicates schizophrenia often becomes diagnosable at this point in the development of young adults. This fact about schizophrenia is sad and difficult for many people to manage (and understand), but it doesn’t have to be the terminal point in your career or education.

There are a few things to keep in mind as you pick up the reigns of your education again, or for the first time:

• You oversee how far you take your education, with or without a mental health disorder.
• The limits of your career and skills are where you set them.

So, when you go back into the classroom, remember that you choose the career you want. Please, don’t let your symptoms, as tricky as they may be to deal with while going to school or to work, dictate what you want to do in life.

Should work or education prove to be ‘too much’ or triggering, look inward, and ask yourself: are you taking the best possible care of yourself as possible? If you cannot identify the reason or roadblock that is triggering you or activating your symptoms and making it difficult to work or study, consult with a therapist. Troubleshoot with a psychiatrist.

Just don’t give up or throw in the towel because of a label. A mental health disorder is only as disabling as the power you give it to rule over your life. Sure, there will be days when you just can’t make it to work because of your symptoms, and that is OK.

Just like the flu, some signs make it too uncomfortable to go in and do our job correctly. Heck, going to work or school in such cases might even be a bad idea, should you be contagious from the flu or tired from depression to get your work done correctly. These are blips and moments and should not influence your potential for lifetime achievement!

Max isn’t the only one out there doing well in recovery. Research proves that it’s possible to succeed at working at a job. Today success stories abound.

Researchers at the Boston University Center for Psychiatric Rehabilitation conducted a longitudinal study of sustained employment among people with psychiatric conditions. The research busts the myths of poor job retention. People diagnosed with schizophrenia held jobs along with those diagnosed with bipolar and depression. Eighty percent of all participants had at least one psychiatric hospitalization in the past.

According to the research, “More than half of study participants were employed in administrative and professional jobs associated with higher occupational ranks; thirty percent in semiprofessional, technical, clerical or sales positions; eight percent in skilled and semiskilled manual jobs; and the remaining four percent in unskilled menial jobs.”

This research study clearly shows that peers have successfully managed working at jobs. Make no mistake about it, if you want to find work, you deserve to try, and if one job doesn’t work out, the next one could be better. It does take a fair amount of persistence and shoe pounding to get a job so read on for clues about how to make it happen.

Some of the benefits of working include (and are not limited to):

• interacting with people every day to develop social skills.
• distracting yourself from your symptoms by working on projects.
• saving money for a rainy day.
• increasing your self-esteem and confidence.
• reducing the impact of your disability.

As you start to explore the kind of job you’d like to have, here’s a list of strategies when you’re starting out:

Attending an IPRT

An IPRT is an Intensive Psychiatric Rehabilitation Treatment program. Here, you set a goal with a completion date. You meet with your counselor and other clients to move forward on taking action to achieve your goal.

Unlike a lot of traditional day programs, an IPRT is goal-focused and you’re actively coming up with a solution to your life problem. For over a decade, I’ve done public speaking at an IPRT in Queens, New York. There I talk with the clients and give them hope and talk about strategies for succeeding at achieving their goals.

Any rehabilitation program needs to be time-specific and results-oriented. The longer you’re drawn out in the system, the more discouraged you’ll get, unless you’re seeing actual self-improvement.

Obtaining Social Skills Training

The UCLA Psych Rehab Program offers social skills training, as does other centers throughout the U.S. Ask around. A therapist where you live might know of a program near you.

In this training short-term goals are set using specific actions to take leading to the long-term objective. Like its name refers to, social skills training helps clients become more at ease interacting with other people, so that you can be integrated into the mainstream and succeed in dating, holding a job, living independently, or whatever your goal is.

There’s a high link between social skills and community and social functioning. In my twenties I must have intuitively recognized this because I valued having what I called “social graces.” My mentor Dr. Robert P. Liberman, M.D. had been the director of the UCLA program until his death. He verified that dozens of the clients at this training center were successful at getting and keeping good jobs in their fields.

Using Cognitive Enhancement Therapy (CET)

Cognitive remediation or Cognitive Enhancement Therapy (CET) can help people with mental health challenges that experience cognitive impairment.

Cognitive impairments affect people living with schizophrenia and impede their normal functioning in work, school, and relationships. A correlated impairment is not being able to perceive social cues to engage in social interactions. This can lead to isolation.

CET training is used together with medication and therapy in a holistic approach. Sessions focus on computer exercises and group exercises to improve social cognition. There is also individual “coaching.” CET can offer psychoeducation talks on proper nutrition, sleep, and exercise.

Joining a Clubhouse

A Clubhouse is a place where mental health peers meet to socialize and take part in activities. At Fountain House, the clubhouse I joined, I attended a poetry workshop on Thursday nights after I got out of my law library job. You can find a Clubhouse near you at https://clubhouse-intl.org.

For you, a Clubhouse might be an option for finding a job through its employment unit. To join a Clubhouse, you will often have to get your therapist or psychiatrist to fill out a form and write a letter championing you as a good candidate for membership.

Dressing the Part

As the expression goes, “Dress for the job you want, not the job you have.” When you...