An Illness Yours and Mine: Disentangling Complex Dynamics That Determine Treatment in Schizophrenia

Recovery from a Serious Mental Illness (SMI), such as Schizophrenia, is often believed to result from an accurate treatment plan devised by an expert, implemented with the help of a supportive team of care providers. However, limited attention has been given to various processes at the micro, meso, and macro-level and how that determines the course of treatment, skewing outcomes in services. With the help of a case study, this paper attempts to illustrate these processes at a micro-level, which includes an individual’s own perception of their illness. An individual’s meaning-making of their illness can manifest itself differently in symptom formation and alter an individual’s experience of it. At a meso-level, these processes would include care providers’ and the doctor’s/therapist’s perception and meaning-making of the person’s distress, their own subjectivity engaging with that of an individual’s. ‘Schisms’ in the psychiatric services (the macro level), with the increasing influence of biological model (over psychological) of exemplifying illness and organizing the services, in turn, can affect the ones rendering those services. The case study presents the material chronologically with respect to the family as a unit and tries to recapture the coursing problems, assumptions, and decisions that beset the family members over the years, eventually entangling them together in a net of circumstances. As the doctor and the therapist are the inevitable strands in the course of disentanglement, the paper also sheds light on a therapist and a doctor’s motivation of working with patients who can evoke unease in care providers. The resulting meaning made jointly through the interaction between these complex processes is likely to facilitate recovery and, therefore, need to be addressed.