I Am Not Sick, I Don’t Need Help! How to Help Someone Accept Treatment (Ep. 27)

If you care for someone with a diagnosed serious mental illness (SMI) , you know that it isn’t easy to help them begin, or continue, treatment.

You hear “I’m not sick! I don’t need help!”

That phrase inspired our guest to find a way, write a book, and create a movement.

Dr. Xavier Amador is a world-renowned clinical psychologist & forensic expert, and a Family caregiver of relatives with schizophrenia and bipolar. He founded NAMI’s Scientific Council, helped to launch Family-to-Family, Peer-to-Peer  & In Our Own Voices, and wrote the book I AM NOT SICK I Don’t Need Help! 

We talk about:

• Dr. Amador’s family story: his brother Henry, and his son, with Schizophrenia
• What do we do when our loved one says I am not sick, I don't need help?
• Listening: without judgment, and with respect.
• Anosognosia, and how to approach someone who has it
• The Henry Amador Center on Anosognosia  
• The power of your relationship
• Changes - and changes needed - in the mental health system
• Takeaways from the input from families and also people with mental illness?
• Diffusing Anger
• 3 A’s: Apologize, Acknowledge, Agree (to disagree)
• Crisis Communication v. long-term communication
• The LEAP method (listen, Empathise, Agree, Partner) and how families - and law enforcement - can be trained
• Role-play: Addressing Covid Vaccine reluctance with relative with SMI 
• LAI (long-acting injectables) vs. pills every day

Quotes:

“You’re not going to make a delusion worse by listening to it and letting your loved one know that you’ve heard him and that you understand his anger, you understand his fear.” - Dr. Amador

My brother never believed he was mentally ill...but he stayed in treatment for the rest of his life” - Dr. Amador

Links:

Henry Amador Center on Anosognosia: https://hacenter.org/home

Book: I Am Not Sick! I Don’t Need Help: 20th Anniversary Edition: https://www.amazon.com/gp/product/0985206705/ref=dbs_a_def_rwt_hsch_vapi_taft_p1_i0

Who Are the 3 Moms?

Randye Kaye -Broadcaster, Actress, Voice Talent, Speaker, and Author (“Ben Behind his Voices”)

Miriam Feldman – Artist, Mom, Author “He Came in With It”

Mindy Greiling – member of the Minnesota House of Representatives for twenty years. Activist, Legislator, Author (“Fix What You Can“)

Transcript

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SPEAKER_01 0:01

Welcome to our podcast, Schizophrenia. Three moms in the trenches. From the place where schizophrenia and real life collide. East Coast, West Coast, Middle America. With Miriam Feldman, Mindy Gryling, and Randy Kay. Welcome to episode 27. I am not sick. I don't need help. How to help someone accept treatment? We are so excited, and we're going to get to our guest as soon as possible. If you're watching on YouTube, you'll see he's already on camera because every single thread on Facebook and in support groups, this man, this doctor, and his book and methods are brought up. And we have him here tonight. We are three moms, kind of well on our journey as parents of someone with schizophrenia. But many of our listeners are really just starting out on their journey and they need this info. And you would not believe, Javier, the response when I posted on Facebook that you were going to be a guest. So we are very, very excited to have you here. I just want to mention, thank you to our Facebook followers. We're up to 500 on our page and growing every day and on our YouTube channel. And the podcast downloads are past 11,000. And we're just so delighted to be able to be here for you and uh for each other. Thank you to Sean who commented on YouTube. I love you guys. I have schizophrenia. Keep up the good work. Thank you to Linda from YouTube who said, I've read all three of your books. Thank you for providing me with a touchstone, a place of relating, understanding, and belonging. I'm just another mom in the trenches. So that makes us feel really, really good. Our guest tonight is a gift for all of us who love someone with schizophrenia or who might have schizophrenia. And we owe a lot. Dr. Javier Amador. Mindy, you have worked with him, correct?

SPEAKER_02 2:03

We served on the National NAMI board together. And I'm talking ahead of time. He has a granddaughter's birthday right after this program. And when I first met you, Javier, my daughter was with me, and our granddaughter was a baby, and she was in the front pack. And I was campaigning for the board that you were already on. And I got to talk with you and Fred Freese. In case our listeners don't know who Fred Freeze was, he was a man who had schizophrenia, very active nationally, was a psychologist, and he's passed away. But he was my role model because when Jim first got sick, I wanted a positive model. There weren't many then, and he was the one. And we watched his videos. And then I got to meet the two of you that night, which was very exciting.

SPEAKER_00 2:50

Fred was a really, really good friend, a dear friend. And um he's the one who convinced me we were driving from Arlington up to New York in a car together, and he said, You got to run for the board, you got to run for the board. Like, why, why, why?

SPEAKER_03 3:03

And then he gave me couldn't say no to Fred.

SPEAKER_01 3:07

Right. And if if you're listening and you don't know what NAMI is, it's the National Alliance on Mental Illness. And Javier, I attended one of your LEAP workshops and you were there. You were the first one to know my book was going to be published because I got the phone call during intermission in one of your leap trainings, and I remember it really well. So a bit about our guest, Dr. Amador is a world-renowned clinical psychologist and forensic expert and author of many papers. The book that obviously is what speaks to us is in the title of this episode. I am not sick, I don't need help. How to help someone accept treatment. And most of our questions will be about that tonight. You are so celebrated in this field. And I'm gonna, I don't think you and Mimi have ever met, right?

SPEAKER_03 3:58

Yeah, we have. Pleasure to meet you. I read your book a long time ago. Where are we driving? Where are we going? Oh, I'm leaving the eye.

SPEAKER_00 4:06

Mimi in her car for those listening.

SPEAKER_03 4:08

Leaving the eye after, but I'm fine.

SPEAKER_01 4:11

Sitting in a car, just gonna do the podcast from the car. Mindy, why don't you kick it off with the with the first question?

SPEAKER_02 4:18

Sure. So the first question is the title of your book. When I first read it, I used it with Jim. And I have to tell you, I was using it again just last week when another problem cropped up. They never end. But for all of us, maybe you could just answer first this global question. What do you say to families when a family member says, I am not sick, I don't need help?

SPEAKER_00 4:44

The very first thing I say is you're not alone. Uh we're about we're talking about six million Americans with mental illness don't understand they have mental illness. Uh, so it's a really, really big problem. Uh, the second thing I say is that this is a brain disorder issue in the majority of patients, people with schizophrenia, schizoaffective, bipolar disorder, delusional disorder. That's who I'm talking about tonight. In the majority of those folks, the research is unequivocal. It's it's really clear that this is another symptom, like a delusion, like a hallucination. It's a belief that nothing has changed. I'm okay. Everyone around me, just to quote a number of the people I've worked with, patients I've worked with, everyone around is around me is crazy. I'm not the crazy one.

SPEAKER_01 5:29

We've all heard that from our loved ones. Absolutely. And so say more about, well, do you want to get into the leap now or you want to, yeah? So I can jump into it.

SPEAKER_03 5:41

Yeah.

SPEAKER_01 5:41

Yeah, I will just say that uh it's 10 years since my book came out. And my relationship with my son, and I know maybe you'll tell us a bit of your story as well and why you wrote this book, not just as a clinician, but as a brother. My relationship with my son improved dramatically when I said to myself, it's not my job to convince him he has schizophrenia. It's my job to support him in any way I can. And it took so much vitriol away from our relationship when I let go of thinking I had to be the one to change his mind. And that is related to knowing you and your and your methods. So can you say more about it?

SPEAKER_00 6:24

Sure. I mean, let me complete the answer to the question Mindy asked. I say three things when when family members are struggling with a loved one with mental illness who doesn't understand he or she is ill. Three things I say, you're not alone, it's common. Two, this is usually a symptom of the brain disorder. And we we don't tell people to stop hallucinating or stop being delusional. And in the same vein, we shouldn't be telling people who don't understand they're mentally ill, just cut it out. You should, you know, you are meant, you are mentally ill. Uh, and the third thing is that the good news is once we know the nature of the problem that this is a symptom, we can we can change, you know, readjust our position to that person and become supportive in a different way. Uh, this all started many, many years ago when my brother Henry became ill. Uh, Enrique was his his name when we were all in Cuba, Cuba, and then we were refugees and migrated, immigrated rather to Ohio, and he became Henry. And Henry, he and I were really, really close growing up. And when he developed schizophrenia in his uh mid to late 20s, really, uh, and had a very, very severe psychotic episode, and it was a crisis for our family. Our our stepfather had just passed away, and uh we were in the midst of all that, and Henry was hearing voices, he was delusional, he thought he had killed our father, he didn't. Our father died of a heart attack. And the family, all the siblings, we were a blended family because this is my stepfather, or there were nine of us. So we were like the mega Brady Bunch Brady Bunch, uh, for those of you who remember the Brady Bunch, and they all pointed at me and said, You're the psychologist, you deal with them. Well, I wasn't a psychologist, I was a senior in college. I think the reason that they pointed at me and recruited me to, as they put it, deal with Henry, uh was because we had always been really close. And and what happened was, and I'm getting to the leap approach, this is all the foundation of it.

SPEAKER_03 8:23

Sure.

SPEAKER_00 8:24

But what happened was I started trying to convince my brother, like you were talking about, Randy, you know, trying to convince him he had a problem, trying to convince him, you know, we'd really benefit him to see a psychiatrist, trying to persuade him that he needed he needed medication because he he had delusions and hallucinations. And for seven years I kept doing that. And for seven years, he was in and out of the hospital involuntarily, he was homeless for a period. Uh, he was getting picked up by the police. Luckily, he never got charged with the with the crime. But his his life and our relationship fell apart. We became enemies, you know, we had been really, really close. And during that time, I was actually being trained to become a clinical psychologist, and I learned the power of listening. And you know, leading. I mean, we all what psychologist doesn't talk about listening and how important it is. But it's a very, very unique kind of listening in the leap approach. Leap, by the way, stands for listen in a very unique way. Empathize strategically. The A is for agree, look for areas where you agree and you partner on those areas. There are tools, they're not steps. There's three other tools, which I think we'll have time to touch on briefly, that allow us to really engage with our loved ones around what's most important to them. And sometimes what's most important to them is the alien transmitter in their brain, or the conspiracy against them, or the fact that they are uh rock stars and really close to Bruce Springsteen. I mean, I'm thinking of various delusions I've encountered over the years. So, what happened with Henry is as I was learning to listen, I I kind of had the realization in Epiphany that I needed to stop telling him what he needed to do. And I needed to apologize. Uh, so I had a conversation with him in which I I apologized for all the times. Here's what I said to him I'm sorry for all the times I told you you were mentally ill, and all the times I told you you needed to take medication. And then I did something really important. I promised, I said, I promise you I will never do that again. I'll never tell you you're ill and need and need treatment. And I kept that promise. And that was the beginning of a new relationship that resulted in Henry accepting treatment. So for the rest of his life, he died tragically in a car accident, um, being a good Samaritan, actually, by the side of the road. Um, but for 18 years after that shift in our relationship, where I listened, I apologized, I stopped trying to convince him. For 18 years he was in treatment. He accepted a long-acting injectable antipsychotic. For those who don't know what that is, you get an injection once every two weeks, or once a month, or once even every three months. And you're not asking the person to put pills in their mouth one, two, three times a day. Um, so he stayed on a long-acting injectable. He had one very brief hospitalization in 18 years compared to four, about four years when I was trying to convince him he was ill and we were arguing. So, what did I learn? I learned I learned two really important things. One was that I was insane during those seven years. And wait, what I mean, say more about that. Well, I I adopted, or rather, I uh I became a great example of Einstein's definition of insanity. I kept doing the same thing over and over again, trying to convince him he was ill and needed treatment, expecting a different result. And because I was dealing with a symptom of his illness that I couldn't change, I kept getting the same result. He said, I'm not sick, I don't need help. He was the first person to ever say that to me. That's why the book is the book is a quote from Henry Amador. You know, I'm not sick, I don't need help. The book title is. So I learned I was insane, that I could I should just think about approaching this in an entirely different way. And the second thing I learned was the power of listening without judgment and with a lot of respect. So when he talked to me about his delusions that our mother was the devil incarnate, I didn't say, Oh, mom's not, and she's really been wonderful. And I didn't reassure him. I said, So, what you're saying, and this is leap reflective listening, this is an example. So, what you're saying, Henry, is mom's the devil, right? Did I get that right? Now I'm not agreeing with him, I'm joining him. Uh and and I would then empathize with him by asking the question, how do you feel about that? I mean, how are you feeling about mom? I'm really angry and I'm really scared of her. And then with the leap approach, you not only empathize and reflect back the feelings, you're really angry, you're really scared, but you also normalize it. You know, Henry, I'd be scared too. You know, I'd be really pissed off too. Now that sometimes leads, and it did with my brother, to the question, well, do you believe me? And there's three other tools that that we developed that address how to how to handle that. But this approach that I stumbled on in a in a you know in the university of just you know, hard knocks and and trying to figure out what works, uh, in fact reflects, I didn't invent any of this. I I I pulled from some very um uh well-researched uh psychological principles. And there's a lot of research on the power of relationships. So if you can create a relationship with your loved one where he or she feels you're really listening, you're not telling them they're they're delusional in so many words or crazy, you're not telling them they're mentally ill anymore. You've already told them that. If you're listening to this podcast, you've already told, I'm sure, your loved one or very close to telling them they're mentally ill. What I learned was I'll speak for myself, cut it out. Don't do it anymore. Because the result is anger, frustration, and the person running away from me. Um, so listening reflectively, empathizing, normalizing it. I'd feel the same way if I were you, does sometimes lead to the question, do you believe? You know, do you believe the same thing? Are you agreeing with me? I'm not mentally ill. And with the leap approach, which is evidence-based, that's where I was going a minute ago. A lot of research on it. With the leap approach, um you are not worsening a delusion because you can't worsen a delusion by listening to it and being empathic. And you're not worsening the lack of insight because it's not lack of insight, it's not denial, it's a brain symptom called anasygnosia. It's a tongue twister. I didn't come up with it. I wish I could rename it.

SPEAKER_01 15:13

It comes from from the um uh in your book. I think you talk about people with strokes have it as well, where the frontal lobe is impaired, and so they're just not aware they've had a stroke in certain cases. Do I have that right?

SPEAKER_00 15:27

Yeah, no, Randy, they're not even aware if they're paralyzed, they're not aware they're paralyzed. I worked, I worked in a neurology service, and that's when I got the idea to start doing research in this area back way back in 1989. I was working with stroke patients and other kinds of patients with brain injury, and they would have things like paralysis and cognitive deficits, and they were completely unaware that anything's wrong. Uh, and and this is a syndrome or a symptom that was described by the Hungarian neurologist Babinsky. Some people may know the Babinsky reflex in infants when they're born. It's part of the Apgar score. Uh, same neurologist, and he he described people who were paralyzed and, for example, didn't know it. So, in this neurology ward that I worked on, it was a survey, it was not award, uh, the nurses would have to restrain people in their bed and in their wheelchair because they didn't believe, they didn't understand they were paralyzed. Turns out, 30 years later, a lot of research, the frontal lobes are creating a symptom called anasygnosia in our loved ones who have these serious mental illnesses. And because it's a symptom, it tells me I should stop trying to convince the person and instead do what you described, Randy, so beautifully, which is be supportive and embrace that person's experience and become an ally, become a friend. And as parents, we don't often think about uh the idea of befriending our our kids, our adult kids. But you know, there's there's a point at which we stop being the parents we were when our kids were five years old, ten years old, and we are both adults.

SPEAKER_01 17:08

Yeah, um, Mimi, I don't know if you have access to the notes or if you have any questions or responses before we because there's a there's a lot to say. Did you want to chime in with anything? I should Mimi's if you're listening, Mimi's sitting in her car. She just came from the iDoctor, and so she's hanging out.

SPEAKER_03 17:24

But it you know, I'm gonna let you guys just take it with the questions because I know we have plenty of questions and I'll be listening. Okay, all right.

SPEAKER_00 17:33

I'll try to answer more briefly. Sorry, Mindy.

SPEAKER_02 17:36

I have one really quick one that I just popped up with. Um, did your mother ever, since we're all mothers and a lot of our listeners are mothers, um, did your mother ever get used to the leap system?

SPEAKER_00 17:49

She she did. It took her about 10 years because a lot of his delusions were about her. And I know a lot of mothers are are dealing with that, where their loved one thinks that they're being poisoned by their mothers. That's one I hear a lot, or they were sexually abused by their mother. My brother had a delusion that our mother had sexually abused him when he was three months old. Well, I know it's a delusion because you don't remember things from three months old. Uh, but my mother, you know, understandably would cry and and say, How could you say that? and reassure him, I would never do something like that to you. And she she didn't understand she was talking to the illness, right? She thought she was talking to her son, and that's a very important distinction that we all need to make is separate the illness from the person. And when you're talking to the illness, uh, don't take it personally. You know, it's not personal. But she she eventually got it, Mindy. Take the answer, finished my answer. She got it, and she started not taking it personally and and and had a wonderful relationship with him the last eight years of his life. Really wonderful relationship.

SPEAKER_02 18:59

I think all the three of us have profited from using that method, and and now we have good relationships too. But I'll it's really a really good, hopeful message for for all of our listeners who are new to this.

SPEAKER_01 19:12

And and I'm just going to add as a uh you know, a motherly PS, it isn't always easy. You know, it goes against our grain of wanting to fix our children. And it it it's it's it's a constant effort to remain in that place. And it's true of any kind of parenting. I have three young grandchildren. I I know you have a granddaughter, Javier, and one one is frightened of things. We just came from the farmer's market and um somebody had a Frankenstein mask on, and she's four years old and she was not having it. We had to go all the way around the food truck so she couldn't see. And there was no logic. I could not say to her, oh, it's, you know, all I could do is say, oh, you're really scared of Frankenstein. What can we do to stay away from Frankenstein? But the cheerleader in me wanted to go, oh, it's only a guy with a mask on. See, you know, I wanted to fix it. And in her brain, with very little frontal lobe development quite controlling things, I can use the leap method on her as well. And once we sort of accepted that she was genuinely frightened, we worked, we worked around it. And now it's not as frightening when a four-year-old is scared as when your son is telling you he has delusions of killing you. Or so I I'm I'm just gonna throw in and I do want to talk about uh the uh the Henry Amador Center on Anasignosia since we're talking about it. Well, we posted on Facebook that you were going to be a guest, and I don't think we have time to answer all the questions, but it gives you a sense of what some of our listeners where they are. Because we've all at least uh try, you know, used your method to great success much of the time. It does not there are times when it's not gonna fix everything, but it certainly stops it from making things worse. And my son has thanked me for being his ally, which is a recent development. So but here's a woman, Karen. Um, I'm just gonna use a first name from Facebook and just wants to talk about uh diffusing anger with leap techniques. Uh she's particularly dealing with someone with a mood disorder, so it's too effective. So that's a you know a little bit of everything. And by the way, she says, thank you. And I love you, Dr. Amador. I'm so grateful for the guidance you offer. It's made a big difference in our lives. But are there some ways when someone's highly agitated to diffuse the anger? And it's probably the same method you mentioned, but maybe you can role play it a little bit for her.

SPEAKER_00 21:44

Yeah, um, I'll role play it and I'll give it some context. We at the Henry Amador Center, we uh train police officers, we train 911 dispatchers, we train probation officers, but we train first responders, including hostage negotiators. And with the hostage negotiators that I've trained, there's two in particular, said to me, You know, Dr. Amador, what you're teaching is exactly what we learned when we were learning, learning to become hostage negotiators, which is put up your hands. You know, I mean, you're not as a mother, you may not need to do this, but you know, you it's it's nonverbal communication. I'm safe, there's nothing in my hands. And you say, tell me what's going on. And then you reflect back what's going on. Well, you're trying to kill me, and and and I, you know, if you don't stop it, I'm I'm gonna hit you with this, you know, whatever. So I'm trying to kill you. Is that what you're saying? I'm trying to kill you. Oh, no wonder you're angry with me. Now you may think, well, that's crazy because I'm reinforcing the delusion. The nature of delusions is they are fixed, they're fixed false beliefs. You're not gonna make a delusion worse by listening to it and letting your loved one know that you've hurt him, that that you understand his anger, you understand his fear, and that you're sorry. And when he asks you, well, are you admitting it or cut it out? We we we call it the three A's in the book. You acknowledge, you apologize, look, I'm really sorry. You acknowledge your fallibility. I could be wrong. Maybe I, you know, maybe I'm doing something to you, but I don't think I am. I have no memory of doing it. And then you agree. I hope we don't we can agree to disagree about this. I hope we don't have to argue about this. So you can give your opinion. I'm really sorry, and and maybe I'm crazy and don't remember, but I don't want to argue with you about this. Can you tell me more about what I'm doing to you? Don't be afraid to have that conversation. So, long story short, when we teach first responders, police officers, how to de-escalate an angry person, we teach them this exactly. Uh, the person says to the police officer, you're just trying to kill me. You, you know, you're with my parents, you're trying to throw me in the hospital. We tell we teach the police officers to reflect that back. So you don't want to talk to us because we're trying to kill you. Is that is that right? I wouldn't want to talk to me either. And that actually opens the door to the person calming down and being willing to talk.

SPEAKER_01 24:07

And we we did a show a couple of episodes ago on um crisis intervention training. And so uh crisis intervention team training, and they talked about that method and and and doing it. And that is, I was attending one of those with you. That's how I know you from that, and they were police officers in there. And when you say put up your hands, I think that's absolutely accurate. Maybe you're doing it with words, you don't have to literally show you have no weapons, but by saying, I'm so sorry.

SPEAKER_00 24:37

Right.

SPEAKER_01 24:37

That is kind of a surrender, and it it can be very disarming in a good way and effective.

SPEAKER_00 24:44

So that's the good thing about surrendering is I'm choosing to be on the winning side. I love surrendering. I you know, I surrender to the anasygnosia, I surrender to the delusions. I want to be on the winning side. I want my my loved one to feel like I care about him and that I really, really want to understand.

unknown 25:05

Yeah.

SPEAKER_02 25:06

Um, well, I I have both of your books here, the one that um I read first from 2000, and then on the board together, some of us got to give you input when you came up with the 2007 version. And you mentioned um, you know, we all learn from the school of hard knocks, and obviously you've done a lot of research and use a lot of research as well. But if you were going to write another version of I am not sick, I don't need help today. Are there any things you would that bigger things you would change?

SPEAKER_00 25:39

Yes, and news flash, you need a third copy, and I'll send it to you for free. Just let me know.

SPEAKER_02 25:43

There's a third copy of it.

SPEAKER_00 25:49

Oh, good.

SPEAKER_03 25:49

Oh, good. I knew it. Okay, I knew there was more than two.

SPEAKER_00 25:53

And and the big change is that um emphasizing much more the power of your relationship. So in the other two editions that you have, we talk a lot about looking for those things your loved one wants, like a job or some money from you, or an apartment, or uh a boyfriend, a girlfriend, you know, things that we can leverage to convince them to accept treatment. In the this maybe there'll be a 30th anniversary edition, we'll see. But in this edition of the book, I do away with all that. And I say, because there's a lot of research on this, plus, I've now had 20 years experience consulting with families and working with them. The relationship, the relationship, the relationship, that's what matters. And the the thing about this approach, the leap approach, first and foremost, it it heals broken relationships. Then a close second is through that healed relationship, you're in a much better position to ask your loved one to consider accepting treatment. And when they say why, and this is in the new book, when they say, Well, why should I be in treatment? You don't say because you've got problems. You simply appeal to their heart and say, because I'd like you to. Well, why do you why would you like me to? I just would. Well, you think I'm mentally ill. You know, I don't want to argue about that. I I promised you I would never tell you again, and I encourage people to do that. I'll never again, I'd never again tell you that you're mentally ill. So I'm not saying this, you know, to try to convince you you're mentally ill. I just would like you to try it. You know, and and sometimes you can say things like maybe it'll help you be less angry, maybe it'll help you be better prepared for the people who are trying to hurt you, which is a truthful statement. Not that people are trying to hurt him or her, but that he'll be calmer and more vigilant and more aware if if he's in treatment. So the book is different in that way. It's all about relate the power of the relationship.

SPEAKER_01 27:52

And we all know that that the words we use in in any relationship are powerful. Um I would have to say, and I'm sure you've heard this, that it isn't I think the relationship is extremely important. And the healthier my son becomes, the more he values relationships. And but it is about knowing your loved one and it is about listening. And we had a Facebook question that echoes what I think a lot of uh people are thinking because your your method works so incredibly well in crisis. But when you're in it for you're a long hauler, they have COVID long haulers, we're schizophrenia family long haulers. So when you're in it you're in it for the long haul, Amy uh asked on Facebook to touch on your experiences with uh patients in long-term recovery, in the long haul, the family characteristics. What do you think are the most important factors for a long-term recovery? Is it anything different from this sort of crisis hostage negotiation phase? But after they get out of the hospital and they then want to go off their meds, then this cycle continues. And is there anything in long-term recovery that you'd like to add?

SPEAKER_00 29:16

I'm gonna be redundant, but I'll get specific. Relationship, relationship, relationship, where your loved one feels he can talk to you and he can say to you, you know what, I don't feel like taking these medications anymore. And you're not gonna get defensive and pedantic and say, You please don't stop, you really need to keep taking them. Instead, you're gonna say, Oh, so you don't want to take them anymore? Can I ask you how come? And you get into a conversation, what I would call leap conversation, where you're being empathetic. So you're telling me you don't need them, is that right? Okay, I can see why you don't want to take them. You normalize it. If I were in your position, I wouldn't want to take them either. So developing and maintaining a relationship where your loved one feels he or she can talk to you about anything, you know, within reason, right? Like going off medications, not keeping an appointment, uh, the delusions they're experiencing if they're if they're having delusions or the hallucinations, if they're having hallucinations, being open with you and your um being soft in your response, absorbing what they're saying, uh, you know, practicing these tools that I've been touching upon. Uh and by the way, these tools, I didn't invent them. I mean, thank you for the kind words in the introduction, but I've stolen all this stuff. Um, you know, they're timeless psychological truths. Woody Guthrie, the folk singer who wrote the tune we all know, uh, This Land Is Your Land, and many others, was accused in an interview of stealing traditional gospel hymns, the melodies. And you know what he said? He said, Well, yeah, of course I stole them. All the good melodies have already been written. And that's the leap approach. You know, I've sort of cobbled together some timeless psychological principles that that have proven to be really effective in creating trust, trusting relationships. And through that trusting relationships in the long haul, you're gonna be you're gonna be there. You're gonna be next to your loved one with your arm around them, your arms around each other, hopefully, and and be able to have these conversations that lead your loved one back into treatment.

SPEAKER_01 31:30

Okay, we have about eight minutes left. So I just want to give that sort of gold post so we know there's a lot of questions. But Mindy, you had quite, do you want to pick something else from you had a lot of very interesting questions that you had?

SPEAKER_02 31:47

Yeah, I have way too many to ask. And I I know that um other people that have set in questions with Facebook too. So I'm gonna pick this one. So, what improvements do you see in the mental health system over the time that you've been working, working on this? And by the way, before you answer that, I'll say one of the reasons I think you're so listened to, and you're you are very humble about what you've done and cobbled together all this other information. But I think you're listened to so well because you are a family member and you admit in your book, and I hope the 21st anniversary edition didn't delete that part, you know, your own human frailties and arguing with your brother. And so then we are ready to listen to you. You're using the leap method with your readers because you're we're listening to you, we're empathizing, but you're agreeing with us and you're hearing hearing our pain. But could you um just separate from the leap method, have you noticed any big improvements in the mental health system over the last 20 plus years and especially with um serving people of color?

SPEAKER_00 33:01

Um, yes, I have actually. Um, and it gives me a lot of hope for you know people who are living with mental illness. Um in terms of people with color, there's a lot more culturally sensitive training going on in our training programs. Um I'm very soon going to be working at the University of Utah with the psychiatry uh fellows and post uh the PGY threes and PGY fours. I don't know if you know what that is, but it's postgraduate years, three and four, psychology interns, and that's part of my agenda. And I have literature I can share. A lot of literature has been written about how we meet people where they are, and that means culturally meet them where they're where they are. The other big advance I've seen is the advent that you've mentioned, both of you have mentioned it, which is of CIT, crisis intervention teams, where our law enforcement community has learned that that they can do their job much more effectively and frankly spend less time uh with someone by spending the time learning how to listen and engage people who are in the middle of a crisis or a psychotic episode, and the police get called. So, CIT training has been a really powerful uh innovation, and it and more and more communities have that. Culturally fluent psychotherapists are far more common today than previously. And the third advent I would say is our long-acting injectables. We have many more than we had before. The power of a long-acting injectable, and I'm not getting any money from pharmaceutical companies, let me just disclose that. No, I'm not. I think it's important to disclose that. With my brother and with many, you know, probably thousands of people I've worked with with mental illness, the power of long-acting injectables is that the person only has to make an appointment. They don't have to every morning put a pill or two pills or four pills in their mouth and fight their resistance. I don't need this, I'm not sick. You know, or and maybe do that two or three times a day. And where do those pills typically end up? In the trash can, in the toilet, in their pockets. In the long-acting injectables, uh, we need more of them than we currently have, but we have many more than we used to have.

SPEAKER_02 35:21

I we're hoping for injectables for Clazapine, because that's a miracle drug for my son and for me.

SPEAKER_00 35:28

Really high on my list.

SPEAKER_02 35:29

Yeah, and it's not an injectable.

SPEAKER_00 35:31

Yeah, I know.

SPEAKER_01 35:32

That would be huge. We have uh just a few minutes left, and I want to make sure that we have time to let our listeners know how they can find your programs and especially low cost. So that'll be the last couple of minutes. But we did have a question that came in from Sarah on Facebook. Oh, actually from our schizophrenia Three Mumps in the Trenches page. And a lot of the questions that came in you have already answered, but this one was maybe you and I could do it as a little role play. Okay. Um, how do you suggest we talk to someone with a severe mental illness about the benefits of getting a COVID vaccine when they are believing all the prevalent misinformation around there?

SPEAKER_00 36:15

Well, let me reveal because I because I can that I have a 21-year-old son with schizophrenia. I finally have his permission to talk about it. He has he has anastignosia. The reason he's allowing me to talk about it, like his uncle Henry, was because he can talk about it, but I don't have it. Um, and he won't get the vaccine. So I'm I'm dealing with this directly. Okay. So how do you so you want to role play this this young man?

SPEAKER_01 36:43

Sure. Listen, Dad, I I don't want a microchip put in my arm. So I am not getting that vaccine. I don't care what you say.

SPEAKER_00 36:49

So, son, let me see if I understand the the vaccine has microchip, the microchip in it, and that's why you don't want it.

SPEAKER_01 36:55

Yeah, I read it on the internet. Everybody knows that.

SPEAKER_00 36:58

Well, then, you know, given the fact that you're what you're telling me, if I understand you, is that it's a fact, right? Is that what you're saying? That there's a microchip. Yeah, it's well, you know, I wouldn't want to take it anyway. I wouldn't want to take it either if I were you.

SPEAKER_01 37:14

But you could see why you don't want to what's that? You took it. You have a microchip in your arm.

SPEAKER_00 37:19

Well, I have a I have a different belief about it. And you know what? I hope we can respect each other's beliefs about it. I respect your belief and and I hope you'll respect mine.

SPEAKER_01 37:29

But you said I can't, I can't see um other members of the family if I don't have the vaccine.

SPEAKER_00 37:35

So and I'm really sorry about that. Because you know, that is that is my belief that with the vaccine you'll be less likely to infect other members of the family. But I really get it. I get it. You don't want it because of the the chip, right? Do I understand that? Right. I get that. I'd still like I'd still like you to get the vaccine so we can see you. And I'm so sorry that we have that rule. I'm really sorry. I wish I I didn't have that rule. I really do, because we miss you.

SPEAKER_01 38:06

Okay, Dad. Call CBS, make me an appointment.

unknown 38:09

It's not quite that easy.

SPEAKER_00 38:12

It wouldn't be that easy, but but if you have multiple conversations like that, the resistance goes down. Uh, you can also, if your your son or daughter needs money, say, hey, I'll I'll make you a deal. See, here's the thing, real quick. Just because somebody believes that there's a chip in the vaccine doesn't mean they are going to logically then, no matter what, refuse the vaccine. Uh the the what we see in a lot of people with schizophrenia, for example, is what we call translogical thinking. So the person holds a belief and they hold the opposite belief and they don't need to reconcile the two. It's it's it's almost a skill, frankly. So the belief in this this example is my mother or my father really wants me to get this vaccine and they think it's safe. Now I know it's not safe because of the because of the chip. But they really want me to get this, and I miss seeing them. So I'll go and get it. And and both beliefs can exist side by side. I'm getting a little technical, but I I guess what I'm trying to get at though is with multiple conversations where you empathize, acknowledge, and respect your son's belief that there's a chip and don't fight with him about it. And then you apologize for your belief that that you need this from him, not your belief that there is no chip. I wouldn't get into that argument, right? That's a not right you're wrong argument. That's going to get you nowhere.

SPEAKER_01 39:45

And I will say, as the recipient and the role play, the frequent apologizing kind of wore me down in a good way. Like it was like, oh, he's sorry again. Oh, he saw you again. So that is a perfect example to end on. Except that I would like you to uh mention how people could get in touch with you. A lot of people mention how do families get trained in this. And I know family to family has a similar class when they talk about communication skills and they I I I think they mention you by name, but they use a lot of these communication techniques. But where can families go for training and your book and your center? What links would you like us to know about and spread so that people can keep getting better?

SPEAKER_00 40:32

Well, the the book, I'm not sick, I don't need help, is on Amazon. It's on all booksellers have it. So uh Mindy apparently didn't know there was 13 years she's been sitting on an old book. Um I would strongly encourage people to go to the Hacenter.org. It's not the Ha Center, it's HA Center stands for Henry Amador. Uh, our board of directors really wanted to name our nonprofit, which has been in existence for four years after my brother, in honor of my brother's example. He never believed he was mentally ill, but stayed in treatment for 18 years for the rest of his life. He's a great example of what we do. So we offer trainings, live trainings in person. We're hoping to do our first one in the next six months that we because we've been on pause like everybody else because of COVID. But we do virtual trainings where which are live with me. And I do multiple role plays, three, four role plays with participants. It's a two and a half hour training. Uh, you come away with not only the skills, but the opportunity to practice. Uh, you can also get an on-demand training that's a three-hour training. So there's lots of training opportunities at hacenter.org.

SPEAKER_01 41:45

Okay. Thank you so much. So, any final words before we let you go to your granddaughter's birthday party?

SPEAKER_00 41:52

Well, well, you've you've mentioned a few times you're not getting to all the questions. So I just wanted to say I think what the three of you are doing is really important and really wonderful. And as a parent of somebody with mental illness, I'm really grateful. And for that reason, since you said you didn't get to all the questions, if you ever wanted to have me back in the future, I'd be I'd be more than happy to do it. That's a deal. We will thank you.

SPEAKER_01 42:17

Thank you so much. Thank you for taking the time to be with us. And for all of you listeners, we have another episode next week. We'll be talking to someone with an amazing story about schizophrenia. And we've got a lot more ahead this season. So thank you for listening and thank you for joining us, Dr. Amador. Thank you.

SPEAKER_00 42:34

Thank you for having me.

SPEAKER_01 42:35

Hey, thanks for joining us for this episode of Schizophrenia Three Moms in the Trenches with Randy Kay, Mindy Gryling, and Miriam Feldman. To get in touch with us or to learn more about our books, please visit our websites at Miriamfeldman.com, MindyGryling.com, or RandyK.com.