Lack of an Explanatory Model

As has been said many times, mental illness differs only in that it cannot be easily seen and understood. We can see a cut and understand a broken bone, but many lack the ability to understand things like Schizophrenia, especially since the only visible parts of the illness may be the sufferer’s behaviors. How families deal with it can worsen or improve these things.

Looking at the example in Zambia with Shazrin’s family, we can see the negative effects that can occur when a family blames a sufferer for their illness, which we know they don’t have the luxury of control over. Shazrin’s brother was overly invested into her wellbeing, and took any sign that wasn’t an improvement as insult to himself. This, combined with the severe dyadic relationship the two of them had, resulted in a situation where Shazrin couldn’t deal with the illness on her own terms, in a way that allowed her to cope[1]. She knew she was sick, and she likely knew the toll it put on her family, but she wasn’t given opportunity to deal with it in a way she desired, and instead it made her situation worse and worse. She had an understanding of her illness, but she hadn’t an opportunity to utilize the understanding in a meaningful way for her health.

An individual’s relationship to their illness can go a long way into helping cope with it, but one cannot ignore the effect the patient’s family has on them. In a family, and society, where we expect people to ‘control themselves’ despite the fact that, if suffering from certain mental illnesses, they don’t always have the ability to do as such in the way desired. These expectations and the patients inability to meet them leads to an increase of stress, which science has shown can exacerbate the effects of not just physical illness, but mental illness as well [2].

As a result of this increased stress, some people suffering from mental illness leave their homes and live on the streets. And from there, it tends to only get worse and worse. This happened to my Uncle, who was diagnosed with schizophrenia as a teenager, long before I was born when he was  only 17. His relationship to his illness was always, and is still, one of incomprehension. He doesn’t understand why he hears voices and gets the impulses he does, but he despises the medicine he was required to take due to side effects. My grandmother, his mother, had died, and (so I’ve been told) between the grief of her passing, my mom graduating school and leaving for college, the stress built up for him and my grandfather. My grandfather, reportedly from my mom when I ask, would be split between being as controlling as Shazrin’s brother was of her in regards to her brother’s actions, to being apathetic towrads anything he did, including theft. Eventually, his crime and drug usage increased, and he was arrested. While in jail, due to his untreated illness (which is insanely common in our prison system) his actions caused him to go from being in jail for 10 years, to still being in jail now at the age of 49. He is under treatment now, but between his lack of treatment when he was young and through a fair portion of his adult life, as well as our political culture where we seem to rather lock up, rather than treat, mental illness sufferers, he will probably never be functional in society today. This lack of comprehension, paired with his family’s complete lack of, or complete over, involvement made for a bad situation that could only get worse.




[1] McGruder, Juli. Chapter 10 – “Madness in Zanzibar: An Exploration of Lived Experience” in Schizophrenia, culture, and subjectivity : the edge of experience, edited by Janis Hunter Jenkins.

[2] Mills, Harry, PhD, Natalie Reiss, PhD, and Mark Domback, PhD. “Mental And Emotional Impact Of Stress.” June 30, 2008. Accessed July 15, 2016.

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