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Overcoming
All-Russia Public Association New Choices

MESSAGE CARRIED BY OUR BOOK


You are looking forward to reading quite a number of narratives by persons with mental health problems and their relatives who are all members of the All-Russia Society of Persons with disabilities New Choices and our peers from various native and international community-based support groups, such as European Federation of Associations of Families of People with Men-tal Illness (EUFAMI) and the National Alliance for the Mentally Ill (NAMI). Our characters, being common people afflicted with uncommon fates, are going to share with the reader their experience in overcoming or coping mental disorder, describe their hit-and-miss way to recovery, thus facilitating their followers way to this goal. Our book is believed to be of use to all patients determined to assist themselves to win a victory over their severe disease and to help them avoid feeling their way to recovery by their own experience, thus saving their time and efforts. Our studies may be helpful for all those taking care of mental patients: their relatives and friends, professionals, that is, psychiatrists and general practi-tioners, healthcare managers and decision-makers, clinical psychologists, medical staff, social workers, employment specialists, as well as for employers, high school and university teachers and their students, mass-media people, and legislators in short, all caring, considerate people involved anyway in mental health problems, willing to gain an insight into mental patients souls, share, and hence, relieve their suffering and burden, help them in word and deed. Our collective (team) work may contribute to a fruitful and versatile discussion of some ways to provide the most efficient and safe aid and support for people with severe mental problems and their families.

Jean Marais Le Passe-muraille(Paris, Montmartre)

All-Russia Public Association New Choices

Overcoming
Persons with mental problems and their families are disclosing their personal histories

Moscow 2011

Overcoming: Persons with mental problems and their families are disclosing their personal histories.

Recorded by:

Nelli Levina & Evgeny Lyubov (comments)


Edited by:

rof. Isaak Y. Gurovich


Translation:

Rina Lyubov

Sponsored by Eli Lilly Vostok S.A.


Printed in the printing-house New Choices Edition 100 copies Copying without the authors' consent is prohibited. For more information contact the New Choices on e-mail:levinan36@gmail.com

New Choices, 2011


Igor Ermolaev. Design, prepress, 2011

The message, carried by our book


Whatever you want will certainly come true; If it didn't happen, you hadn't really set your heart on it; And if another thing happens, don't get d isappointed: Actually it is just your dream, though in disguise.
Alexander Block

You are going to enjoy quite a number of confessions narrated by members of the New Choices All-Russia Public Association for persons with mental problems and their families. Our authors, common people aficted with uncommon problems, share their experience in coping with mental illness, describe their random way to recovery, thus helping their readers to get well. The book is believed to be of use to all patients determined to win a victory over their severe disease by showing them a better and shorter way to recovery. The authors' experience might be helpful for all those taking care of mental patients: relatives and friends; professionals, i.e., psychiatrists and general practitioners, healthcare managers, clinical psychologists, medical sta; social workers, employment ocers, employers, high school and university teachers and students, mass-media people and legislators in short, for all caring, considerate people involved in mental health, willing to understand mental patients' feelings, share and consequently relieve their suering and burden, help them in word and deed. Our team work may start a fruitful discussion to provide ecient support for mentally aected patients and their families.

Overcoming

A long way to recovery

Abstract

This book is supposed to attract attention. For the rst time in Russia, a wide range of mental patients and their families oered narratives about severe mental attacks or a chronic mental illness, experienced by them. The authors have much in common: resilience, persistent optimism, desire to overcome their disease and rehabilitate. This collection of true stories seems attractive both for mental patients and their caregivers. The former may use the authors' pattern in getting over their mental disorder. A lot of readers have to deal with similar problems and will get optimistic seeing that the authors have overcome and enjoy life values again. The latter are going to consider dynamic restoration of the self in mental patients. Psychiatrists will mark how their patients appreciate adequate treatment, discussion, encouragement as well as how they get injured by neglect, disrespect or faulty therapy. Our authors' experience is going to impress caregivers far more than any abstract knowledge. The proof of the pudding is in its eating. The authors share their troublesome experience in struggling for recovery and also promote real partnership with psychiatric sta for ecient personal and social rehabilitation.
Professor I. Ya. Gurovich, Vice Director of the Moscow Scientic Research Psychiatry Institute

Overcoming

Introduction
A dream without a purpose is a dream, and a purpose without a dream is a boring chore, but a dream with a purpose is able to change the world.
Black Elk

In the good Soviet novel The Gordian knot a young man got aicted by tuberculosis. Farewell, the pilot school and his sweet TayaThe guy got desperate, as a result, his recovery got protracted. Youve become mentally disturbed its a real trial. Your hopes and plans have been scattered. Will you be able to pull yourself together, to dream and hope again with such a diagnosis? Will you rebuild your shattered life or just drift in depression and fatigue? Keep in mind that the weakest goes to the wall. They say, everyone can write a novel about himself or his nearest and dearest. And also: If you want to learn something, write a book about it. The authors of these true stories describe their ordeal as well as ways of restoring their self and leading a worthy life in spite of their aiction. Our team narration is just a sort of observation without a farfetched happy end. However, our authors, having endured a lot, sound optimistic about their prospects. Every reader will assemble this book, like a jig-saw puzzle, in his own way and get as much as he has put in. (It is common knowledge that nobody can get more than has been put in). Besides, you neednt read the whole book, half the book or just any part will do, you can stop anywhere its always like that with dictionaries, by the way. The more you seek, the more you get. (M.Pavitch The Hazar dictionary)

Let hope and love make us stronger


Your New Choices
Overcoming

A long way to recovery


It does not matter where we stand, but it matters where we go
Oliver Holms

My soul is healing
At the age of 21 I fell ill out of a clear sky. I developed an obsession that a world-wide battle between the good and the evil was under way and everybody was involved. All people surrounding me were pushing me to the evil forces. I dreamed of escaping to a safe country, because my evil relatives were about to sacrice me. All along I felt prophetic, encouraged the good supporters, re-read the Book of Revelation both in Russian and English. My family took me to a healer who lived 300 km away. While traveling, I was blind to all these picturesque landscapes. I anticipated a car crash, demons hovered over me. Finally I found myself in mental hospital, but witches caught me even there and secret service agents tracked me. The ceiling was on the brink of collapse, I was able to move bulky objects just by concentration, toys looked animated My neuroleptic had no positive eect but screwed up my eyes, another medication was administered yet I wasnt responding to treatment. My soul felt bruised and ached so much... My medication made me vague, unable to focus. After discharge I gave up all the drugs and was shortly re-hospitalized with delirium: everybody tortured me, wanted to do away with me. I was homesick and tried to get away. No go: the sta kept an eye on me and even tied me to my bed. How humiliating it was! Meanwhile I developed second sight and could tell fortunes by transparent dots whirling around me. There were Italian, Spanish, English-speaking patients in our ward and I guessed they had been brought there to spy on me. I was kept alive only while I was writing poetry; evil doctors stued me with poisonous drugs. On discharge I was taken to holy places but even there people seemed in cahoots with the evil. At last Ive got a new, mindful doctor. He was the rst to explain what medication would be administered and why. Next he increased the dosage of the neuroleptic I had tried, but given up as useless, a year before. This time it worked miracles. My deOvercoming

A long way to recovery

lirium, delusions of persecution, visions are gone for good. Adhering to my wonderful neuroleptic, I work as a translator but mostly from home (for the time being).
Alla (Moscow)

Comment: Allas story shows how persistent psychosis can be relieved by adequate therapy. Medication mustnt have unacceptable, adverse side eects, making a patient suer. Dosage is also relevant. Driven to despair, Allas relatives tried healers and holy places but only eective treatment can exorcize the devil of illness.

Keep smiling

As a youngster I used to be gifted, gay and attached to my family. I was a born leader. My friends proved true supporters when I began skidding on my life way. About 10 years ago my life took a bad turn: I fell ill. What triggered o my disease? A year before my breakdown I was attacked by a drunken bully. In spite of my oriental combat skills, I just let him batter me in line with the clich: A warrior should not act on the defensive, a warrior should be invulnerable. I really did not feel pain, yet sustained brain concussion which would tell on my mental health later. By the end of my university course, my parents had divorced but I did not care. The thing is that I was being obsessed by a xed idea: 1961 copecks would go up in value on January 1. So, without sleeping a wink, I was busy buyind such copecks. I got all worked up, was about to mortgage our apartment
Overcoming

My family had to call an ambulance and the paramedics tried to give me a tranquilizing shot. Having guessed that they meant to make me a drug-addict, I resisted desperately. The ambulance people had to drag me out by force and take me to mental hospital. After discharge, I suffered from insomnia, anxiety. Day-and-night I would walk about the city talking rot to passers-by. Neuroleptics made me weak, inert, unable to focus; so I decided to do without them. Consequently, I got utterly out of control and was brought to hospital 2-3 times a year. My sister attempted to treat me with homoeopathic peas and took me to a clairvoyant Due to my new antipsychotic medication I feel safe and sound now. I do a lot of reading, gardening, cooking, writing poetry. Besides, I go in for sports again to keep t. I work as a communication manager, help people master computer and make their living. I lead a normal life and hope that in a while my doctor will reduce my antipsychotic dosage. My best regards to the doctors who have given me a second chance in life.
Andrew ( Kirov)

Comment: Andrew believes that his psychosis was triggered o by his head injury. The medieval doctor Celsus said: It does not matter what causes an ailment, it matters what cures it. Andrew was traumatized by violence (compulsory as it was) during the initial hospitalization. His rejection of antipsychotics can be explained by their adverse side eects. Now he is getting adequate treatment, far more ecient than homeopathic peas. As a result, he works, enjoys life, appreciates his family and friends and trusts his doctors.

Wait and see


Everything has always been wrong with me. Dragging my foot, I began toddling only at 1.5, had trouble with lacing my shoes, writing, etc. Animals and plants were my only friends. Aged 12, I was already sick and tired of such existence, planned to commit suicide but thought better of it. Two years later I went into convulsions with foam at the mouth and these ts made me give up skating and biking Since the age of 16 Ive been taking new therapy for convulsions. I am not drowsy any more, started painting in water-colors, playing tennis. The New Choices association made me optimistic. My mother always backs me up. I hope Ill be assisted in nding a job as soon as possible.
Michael (Tula)
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A long way to recovery

A long way to recovery

Comment: Michael has improved (due to adequate therapy). Now he is apt at socializing, working and studying.

Not in vain

Thanks God I have been living a life of value - due to my parents, colleagues and other considerate people. In 1986 the Chernobil disaster shocked me so much (I believed the nuclear war to have broken out) that I had to spend three months in mental hospital. Though disabled, after graduating from the Agricultural College I worked as an agronomist for 19 years. Ive brought up two daughters, the married one having given birth to Vika, my adorable little granddaughter. Unfortunately, my wife divorced me because of my mental illness, however I dont blame her. I look after my aged father as well as after my children. My aid and care are needed and it keeps me going. I try to carry on as if I were right as rain, nevertheless I watch out for the signs of relapse to consult my doctor without delay. Being less concerned about stigma now, sometimes I take part in trade union meetings against social injustice. I also joined the Isoterra club and have never been hospitalized since then. Instructed by the Isoterra lectures, I got to know how to relieve my disease and avoid breakdown. In our Isoterra I in touch with gifted people, we write poetry, songs, translate verses. Creative activities help me to handle my disease, so does my work. I am Jack-of all trades: do joining and plumbing for our mental hospital and also tidy up our hospital yard. My superior and colleagues appreciate my
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diligence: I am respected and relied on, occasionally encouraged with a bonus. Ive already found placement in our hospital for a few clubmates. I make a point of being helpful.
Andrew Tsimbal (Yaroslavl)

I am designing my life
I used to combine studies in law with work. ve years ago a disaster broke out: I developed hallucinations, delirium, got depressed, withdrawn. I had to take therapy in mental hospital for the interminable two months. After discharge everything around looked bleak, drab. Fortunately, I was still keen on my work and studies. To cheer up I frequented night clubs, went on the binge. My drinking bouts must have provoked four more hospitalizations. The latest one seemed crucial: I attended social skill classes, took a rehab course and assisted the priest in the hospital chapel. At last Ive realized that I need to assume responsibility for my life. Ill make a qualied lawyer and succeed rain or shine.
Sergey Gubinsky, aged 28 (Vologda)

Comment: after acute psychosis a mental patient usually sinks into depression (half patients complain of drab existence, some of them indulge in hard drinks, in fact deteriorating their distress). After being discharged, a patient especially needs his doctors care and adequate therapy to turn over a new leaf and rebuild his self.

Racing against disease


According to my doctor, I am too ambitious: since childhood I have been exerting myself to take the cake. Though frail, I used to win regional boxing championship, get prizes for gymnastics and chess, go swimming in freezing water. In high school I did a lot of cramming to get a golden medal andfound myself in psychiatric hospital. However, I managed to enter the pedagogical college, join the college amateur music band and choir, get qualications as a physics teacher. Next I marOvercoming

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A long way to recovery

A long way to recovery

ried a good girl and had two sons with her. My life seemed settled, I did without hospitalization for a number of years Unfortunately I had to try on job after another: I worked as a school teacher, laboratory assistant, researcher, engineer. My failures made me high-strung and caused relapses of my mental illness. Meantime my younger son died, so did my spouse. Grief-stricken as I was, I began coming to life. I took up jogging, volley-ball, went to see my relatives. Such activities relieved my depression. Once I thought of something special: running a distance of 42 km at the International Moscow Peace Marathon. Though my doctor, coach and relatives advised strongly against it, I kept practicing and covered ve km daily. On the Marathon day at noon 3 thousand professional runners, beginners, fans, old people and schoolchildren surged into the Red square. Soon after starting I lagged behind due to the nasty weather and intolerable knee-ache. It took me 4.5 hours to come hobbling to the nish (many other participants hit the distance within 3 hours), however I was awarded with a MMMM-17 medal. On top of everything else, I sat up all night long at the railway station having missed my train. Nevertheless when I came back home at last I was proud of my achievement and so were my Isoterra pals and my grandson (the cute mite of a child put on my medal immediately). What next? I might try parachute jumping.
V.I. Korobov, aged 72 (Yaroslavl)

Comment: Mr. Valery has been making best of a bad job all his life. Hes won a victory over his illness thanks to his optimism. The pessimist sees diculty in every opportunity. The optimist sees the opportunity in every diculty. (W. Churchill). Sure, V.I. tends to overdo things a bit.

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Let bygones be bygones


Lets dwell on the events of 25 years ago. A shy, fragile 13 year old was a spitting image of her mother, a meek martyr, beaten up by her drunken husband. The girls rst sweetheart, Oleg by name, was an irreproachable knight, fairy prince in her eyes. When her father asked: Who is the man of your life? the girl answered in a small voice: My sweetheart. Wrong, your father is-roared her beast of a father thrusting a knife into her lower abdomen. Pain, blood, hospital 20 years later the nightmarish experience was brought back to the young woman. Choked with tears, she was brooding most of the time. Her depression was aggravating: she felt her heart bursting. In mental hospital she was successfully treated for insomnia, obsessive fears and memories. For ve years the young woman has been doing well for herself. She works as a bank clerk, studies English, has bought an apartment on her earnings. Now she is going to buy a car. Depression is out of the question. The woman practices sewing, knitting for her nearest and dearest, goes out a lot, adores music. She is looking forward to traveling, exciting meetings, big events. She is eager to enjoy life.
Natalia (Tomsk)

Comment: Natalia is getting over her depression, she refuses to identify herself with her former self (weak, like mother), that is why she speaks about her life in the third person. The young woman feels on top of the world.

Lets figure up
I was hospitalized with acute psychosis but the therapy hardly helped. I kept suering from lack of concentration, insomnia, behavior disturbances. My doctor recommended me to go on the disability benet. After a two-month hospitalization my illness gave me a break. My life made sense again. Unfortunately, a year ago I relapsed and could not avoid re-hospitalization. I was shocked by deplorable standards of treatment. A doctor is in charge of 20 patients. He has neither time, nor motivation for high-quality treatment. A low level of stang and treatment is also typical for psychiatric outpatient clinics. The healthcare system is

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A long way to recovery

A long way to recovery

to blame but thats patients who suer, dropping out of study and work and becoming disabled. Loss of functioning has economic consequences not only for the individuals concerned but also for the wider community. Top-notch therapy might cause reduction in disability rate by 15-20%, the expenses paying o within eight years. And patients torments have no money equivalent at all.
Ilya Libman ( scow)

Comment: both society and patients would benet by ecient therapy. To ensure complete rehabilitation Ilia and his fellow-suerers badly need public assistance along with adequate therapy.

My scheme
I have been ailing for 30 years and my sleeping-draughts kept increasing in dosage. It was high time to do something about it. To begin with, I found out how many hours of night sleep are needed for adequate functioning in the daytime. What turned out? Though I lay in bed for 8 hours, I was soundly asleep only for four hours! I started decreasing the dosage bit by bit providing 4-hour sound sleep. In the long run I am going to do without sleeping draughts making me somnolent all day long. Once a month I take prolong (a long-term neuroleptic) to relieve excitement and get rid of somniferous addiction.
Valery (Perm)

Comment: medication should be administered on a regular basis. Psychotropic addiction is a common myth. Interrupting his therapy an out-patient actually risks relapsing. If the therapy interferes with an out-patients everyday life and work, the dosage is sure to be reduced but under his doctors supervision. Valerys evaluation of his medication eect is essential, however, he should consult his doctor instead of experimenting on his own.

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I am supported by my therapy, club-mates and pets

Since childhood I have been getting intensive neuroleptic therapy for schizophrenia. Nevertheless, I managed to get a university degree in biology. Unfortunately, I have never been able to work. Being keen on psychiatry, I enjoy reading about mental diseases. I also study psychiatric pharmacology by manuals and discuss it with my doctor. For resocialization I frequent the Isoterra club. There I make and sustain relationships with other disabled persons and dont feel all alone, face to face with my illness any more. Its among the Isoterra fellow-suerers that Ive met my sort of woman (she used to teach at the university). I have got an extraordinary hobby: breeding of grass-snakes. Caring for them really keeps me on the move. My Isoterra pals always give ear to me when I retell about my dear pets. Moreover, Ive recently hit the headlines with my terrarium! A new antipsychotic breathed new life into me. Ive become easy-going, active; write mystic poetry, appreciate arts. My therapy relieves anxiety, distress, auditory delusions. I really rely on my medicaments: feeling low, I just open the cupboard to look at my pill-boxes and my spirits soar up...
Anton Bichkov (Yaroslavl)

Comment: Anton is worth respecting: he is conquering his illness courageously. On the other hand, he could be recommended to take all his manual information with a grain of salt and God forbid him to take therapy by guide-books.

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A long way to recovery

A long way to recovery

We are a team

I was unlucky enough to develop a mental disease. No use raking up the past in search of possible causes. Having taken a two-year family therapy course in Stavropol psychiatric hospital I am getting on well with my family. I became hand and glove with a number of poets and artists. All together we set up our Club of Letters. When our artists organize exhibitions all the club members attend. We also come to encourage our poets when they appear in public. We go out a lot: see lms and plays, listen to music. Besides, we co-operate in translating songs from English, composing music, painting pictures. By joint eorts we are determined to do away with our ailment. Things are sure to shape well through social activities. Due to my misfortune I found myself in creative environment. Every cloud has a silver lining.
Igor Vandar (Stavropol)

Comment: Igors constructive approach enables him to rebuild his shattered life. This creative person does without futile analysis of his past. He who looks back is doomed to stumble. Its beyond ones power to avoid disease but its within ones power to seek ways of healing it.

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There could be no other way

I got aected with schizophrenia two years ago and have been twice admitted to hospital. I suered from hallucinations, delirium, whispering voices. Intensive psychotropic therapy was prescribed. After discharge depression associated with suicidal ideas developed. In the aftermath of the crisis I felt ill at ease, mist. It was my doctor who recommended the Isoterra club to me. The Isoterra lectures acquainted me with up-to-date medication and ways of handling my illness. My voices left me alone at last. I mix a lot with my fellow-suerers and we understand each other perfectly. Jazz music also cheers me up. In the Isoterra I am wrapped up in attention. Unfortunately in hospital the approach is opposite. An in-patient is just stued with pills, the stu does not care about

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A long way to recovery

A long way to recovery

the side-eects (headache, tremor, etc.). The doctor is too busy to give ear to his patients complaints. If a patient rejects pills he gets an injection. For the time being, the individual approach is no more than a dream. However, we optimistically hope for new medication developments, efcient therapy. Look on the bright side, there could be no other way.
Elena (Yaroslavl)

Step by step
Keen on psychology, I was aware of a crisis possible at the age of 17-18. At the rst sight I was prospering. Having passed my exams with honor, I was reading science a great deal to excel in my eld. Everybody said: Have a break but I remained deaf to their advice. When I felt overtired and apathetic I hoped it would pass. However these were the initial signs of my stalking illness. Finally I got alarmed and turned to a psychotherapist. He applied hypnosis, medication, verbal therapy. Besides, I resorted to herbal therapy, diet, self-training, aerobics. I have been practicing psychoanalysis. My familys support also helps a lot. The information vacuum is unacceptable: to alleviate your illness it is vital to pick up as much information as possible. A patient keeping abreast with recent ways of treatment is armed against his disease. Catch any chance of improving, inhibit your laziness, apathy, didence, fear of being snubbed. Step by step regain your self-esteem through activities. Become sure of winning and your illness is bound to recede.
Ira (Yaroslavl)

Comment: reading psychology is not a must but you should recognize the illness symptoms and see a doctor. There is no panacea for recovery (e.g., in some mental patients psychoanalysis even enhances psychosis as well as homeopathy may delay recovery). However, if youve caught the rst signs of your illness on time and consulted a psychiatrist at once you are apt to succeed. The information vacuum being dangerous, you need to read brochures, pamphlets for patients and their families, consult public organizations for mental patients if you fear psychiatrists (by the way, a visit to a psychiatric neurological clinic is not led, and thus has no social consequences).

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Not a recluse any more


Id like to share experience in getting over my social phobia. As far as I remember, Ive always been shy, dident. Gradually I got alienated from people, kept myself to myself. I felt inferior to everybody, an outcast. In a while, I could not venture to go out. Therapy only reinforced my obsession. Feeling ostracized, excluded and isolated, I was considering suicide. In the long run, I went to mutual support classes and formed friendships there. We came together and took turns to describe how each of us had managed to overcome his shyness and go out of his shell over that week. Within our circle we felt all equal and needed by each other. The socializing experience, obtained in class, helped us in everyday life, some of us having trouble even with shopping. Unfortunately, our group has been dismissed because of nancial diculties. However, social phobia does want attention and treatment. Due to mental problems, many persons lose their social skills, drop out of society. Their rehabilitation is a priority.
Nikolay Zinoviev (Moscow)

Comment: a person suering from social phobia feels confused with strangers. Afraid of humiliation and rejection, he attempts to eace himself, sometimes even always stays in. Nikolay is quite right: social phobia may be a manifestation of a mental illness. Good for him, he already uses his social skills out of his circle, in the wider community. It is a pity Nicolays group has been dismissed but on-line you can look up another social skill group. Having noticed that your shyness is turning into phobia impairing your life, consult a psychiatrist urgently.

None but the brave deserve the fair


I was a 19-year college student when I was admitted to hospital with schizophrenia. Acute psychosis was followed by depression. After discharge I sank into torpor, aloofness. My family did their best to guide their strange daughter, take her out of harms way, shield from real life, in short. As a result of their guarding attitude I just felt inferior, dierent. Unlike my parents, my fellow-student never made fuss of me. Instead, she incessantly chatted about her love problems, asked for advice and bothered me with the question: What have you been doing with yourself all day long? At rst, she awfully got on my nerves but bit
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A long way to recovery

A long way to recovery

by bit she made me come to my senses. I stopped planning suicide and started thinking of a love-aair. I resumed reading, going out, sports. My friend, God bless her, encouraged me. She was my only link to real life, I actually lived by her and gradually learned to manage on my own. Though my doctor and parents urged me to quit my college and go on the disability benet, I had it my way. I moved to another city, went on studying, found a job. My new friends consider me amazing, maybe a bit eccentric. Although it sounds paradoxical, psychosis might oer an opportunity of turning a new leaf. Schizophrenia has something in common with creativity: an ability to perceive everything in an extraordinary, special way. If a schizoid patient manages to understand and control his divided self he is apt of becoming a highly sensitive, creative person. Quite a number of talented people suered from schizophrenia, e.g., Dante wrote his Divine comedy after acute psychosis. Actually any of us faces just two options: to stagnate in frustration and apathy or overcome to live and create
Lena (Blagoveschensk)

Comment: a quotation from I. W. von Goethe seems appropriate. Until you make up your mind you are torn by doubt, a chance of turning back prohibits your activities. But as soon as you come to an ultimate decision, Divine Intent sides by you. Start acting, and your dream will come true. Courage imparts strength and supernatural power. Go ahead! Young people in the rst episode of psychosis tend to get pessimistic. They need to attend mutual support classes and get information by lectures and workshops on psychology. Having discovered some ways of treating their symptoms, mental patients get the better of their frustration and doubts. It is relevant to have friends (or relatives) encouraging to rehabilitate, like in Lenas case

Triumph via suffering


Besides mental problems, I have bad joints and spine. I am subject to obsessions, hesitations. What I really enjoy is indulging in morbid fancies and hallucinations like a drug-addict (only my narcotic is inside my mind). Being not of this world, I have socializing problems. Ive been taking medication since the age of 26. I am eligible for the disability benet but I would not jump at the opportunity. What helps me persist? I have been converted to religion. My disease prevented me from completOvercoming

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ing my thesis, I can hardly move, my marriage (not to mention motherhood) is unlikely but God loves me. God helps me deal with my miseries. My job ts me, I ght obsessions successfully, stand pain humbly. Besides, Ive written an article in my eld and displayed it on-line; being at home in English allowed me to participate in the workshop Patients for patients security in Dublin. Having failed to work by profession, I mastered proof-reading. Not to gain weight, I do gym exercises, swim, keep to a strict diet. As reading enhanced my obsessions, I began embroidering with beads instead. It is important to boast of your achievements, that is why I attend a support group. My priorities are dierent now. Good luck if a day has passed without obsessions. Any work will do, given I am up to it. Some fellow-suerers wonder: Why do you make yourself act if you prefer to live in a dream world, a fantasy place? The game is not worth the candle. Of course, this perpetual strain does not let me relax, but it lets me triumph over my illness and even live happily, well, in a way.
Tatiana Belyaeva, aged 40 (Moscow)

Comment: Tatiana lives up to Democrituss postulate: If you dont desire much, a little will seem much to you. However, optimism should be supported by adequate therapy (Tatiana appears to underestimate medication). Tatiana is making progress towards recovery through her meaningful activities.

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A long way to recovery

A long way to recovery

I love people
I am Gemini by horoscope. It might have inuenced my fate. My parents were not getting along and eventually divorced. My father attempted to take me away from Mum but, in the end, I stayed with her. My mother was industrious, always busy at work or bustling in the kitchen or the garden. She taught me to knit, wash, iron clothes, plant strawberries. If the harvest was abundant we used to sell surplus fruit and berries. I fell ill when I was 9, was in and out of hospital. However, I did not drop out of school, illustrated the wall newspaper, painted pictures, took part in archeological excavations on the Volga left bank. My Mum remarried to a kind man: he made some furniture for me, taught me to play chess. Its a pity I failed to become an artist or a teacher. But what really matters is that Ive become a good person. I am hard-working, love people, especially children. I dream of buying a washing machine, a TV set and a fridge. To earn a bit in addition to the disability benet I am going to work as a dish-washer or a hospital attendant. I live together with my boy-friend, Ivan by name. He is a real treasure, does everything at home: paints, repairs, xes, saws wood. Besides, Ivan is aectionate and attentive: takes me out, gives presents. I also do my best: cook delicious food, clean the house from top to bottom, do laundry. With our give-and-take relationship, I hope well never split up. I attend the Isoterra club to go in for arts and to mix with intellectual people.
Natalia Rosova, aged 27 (Yaroslavl )

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A long way to recovery

A mindful doctor
The surest way to happiness is to take care of people, to help them in word and deed, that is, to love them.
Doctor F. Haass

The main doctors function is to instill optimism and hope of recovery.


F. Rabelai

The rst visit to the psychiatrist sticks in a patients memory. A seless professionals empathy, care, skills, knowledge, authority promote recovy p g y ery even with protracted mental diseases. Doctors working for recovery ( they are not so scarce after all) fruitfully cooperate with patients, take their experience into account to select safe and ecient therapy, get close their patients and assist in resolving psych heir i n assist resolving psychiatric, c, p with their patients and assist in resolving psychiatric, social and personal personal iss issues. issues.

A friend in need is a friend indeed


About 15 years ago I was hospitalized with schizophrenia for the rst time. Since then Ive had a number of relapses accompanied by depression. I dream of a psychiatrist understanding that his abstract knowledge is insucient for my recovery and my experience should be taken into consideration. Such a doctor would approve of joining our eorts. The clich that a doctor always knows better what his patient needs does not work well as a matter of fact. A doctor just cannot imagine how his patient is tortured by the therapy side eects. I know better than to call for giving up necessary medication but it should be administered with care. The medication eect varies with dierent patients and stages of a mental illness. A doctor is supposed to consider his patients complaints but, actually, he never does. We lack information on mental problems. The New choices was the rst to bring me up to date concerning recent medication developments, social aid to mental patients. As scientic achievements in psychiatry foster hope for recovery, a journal is needed to describe the progress in psychiatry from the point of view of both professionals and patients. Mental problems should also be highlighted by TV to attract public attention to my vulnerable, neglected fellow-suerers.
Igor Perekatov (Moscow)

Thank you, doctor


When I was subjected to compulsory treatment I felt embittered, at odds with the whole world. The therapy including labor as well as the psychological approach has made me a dierent person after all. I wrote poetry and recited it at amateur concerts, published my verses in the hospital newspaper, frequented the hospital orthodox church.
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A mindful doctor

Our chief physician was strict but fair; when she reprimanded me I felt ashamed, whereas in prison I had been even proud of my conicts with the management. Due to our chief physicians eorts the hospital facilities were not worse than in a hostel (but for the guards). On discharge my doctor wished I would keep away from the hospital in the future. He gave me a great deal of useful recommendations (how to patch up quarrels, watch out for the rst signs of delirium, etc.) I am grateful to the hospital sta for my conversion to religion (I was baptized by the hospital priest). Our social worker patiently trained us for the hospital concerts and polished my amateur poetry. Ive been out of hospital for a year and get out-patient treatment. In our club I do sculpturing and painting. Taking part in exhibitions, Ive been rewarded with valuable gifts. Chess is my passion. My chess championship was prized with a cruise. There is a y in the ointment: my club-mates have physical restraints, so I am the only mental patient there. That will be all for now.
Valentin Dryanov (Habarovsk region)

Comment: any disease is characterized not only by suering but also by precious experience. Valentin was lucky to come across kind and caring professionals who gave him start in life. He found companions among persons with physical restraints and should not feel special. Disabled persons have many common problems and solve them together. Diagnosis is transitory, life is continuous.

On the run
I was getting on in the Arts gymnasium, was popular with my schoolmates, close with my cousins. At the age of 16 I had to go to hospital. After discharge my life changed crucially. My school friends boycotted me, my cousins never gave a ring. My Granny took me to see her elderly friends but I missed my contemporaries. When Granny had died, Mum became my only companion. I entered the university to study languages and literature but dropped out after a 8-month spell in hospital. According to Granny, a person must be useful. However, I had remained utterly idle and isolated until my doctor recommended me to restore my students rights. Now I am getting education (Ive decided on the correspondence course to facilitate the task). Next, I

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joined a jogging group organized by my doctor. At rst, it did not work: I got out of breath because my pills had made me awfully fat and my legs failed me. By now Ive been jogging along the Volga for two years. Ive become unrecognizable: slim, sure of myself, calm. My doctor is not only my jogging partner but also my bosom friend. I got close with a member of our group (he has a medical degree but is not able to work). His 80-yearold mother is always happy when I drop in: they havent had visitors for ages. I try to draw out my boy-friend and he is gradually coming to life. He takes care of his pets, smiles, jokes, has resumed drawing (he was good at it before his illness). To encourage him I gave him an album How to draw animals as a present. He got enthusiastic but for the time being managed to draw only a fragment of a chicken. Never mind, his skills are about to come back. As to me, I am getting ready for my exams now. Ultimately, as I hope, Ill make a qualied social worker to help my fellow-suerers. No doubt, I still need some help myself, but since I began jogging I havent come near hospital.
Daria T., aged 26 (Saratov)

Comment: Darias story involves typical challenges a young patient faces after discharge. The acute symptoms are gone but loneliness, inertia, medication side eects come instead. Being real professionals, Darias doctors stood by her, helped her to cure her soul, mind and body. Her supporting a weak fellow-suerer is also relevant. While most sane persons mind their own business and never give a helping hand to a mist, Daria did it, just on the run. Let that nice girl never get out of breath.

A mindful doctor

We've found shelter

An animal has a burrow, a bird has a nest


I.A. Bunin

Psychosocial rehabilitation involves providing out-patients with a safe and comfortable lodging. In the SU homeless people were never distinguished as a population group. In 2002 during the all-Russia population census142 559 people (0.1% of the population) claimed to be homeless. But actually there are over 4 million homeless citizens in Russia. One per three mental patients is homeless, cold and hungry or resides for years in a nursing home. At present, mental patients are likely to get accommodation only in a few hostels, described below

Im happy again
Twenty years ago, thinking that my diagnosis (i.e. schizophrenia) was wrong, I would refuse to take therapy. As a result, I dropped out of work, had at least one hospitalization per year and was eventually deprived of my apartment. Having no choice, I had to stay in mental hospital for 9 months and got utterly distressed. By now Ive been accommodated in our rehab hostel for 5 years, work as a shop-assistant, am in love again and write poetry again. I feel enthusiastic, vigorous, self-condent, in short, happy.
Ludmila Marusheva (Pervouralsk)

Comment: in Ryazan region the rehabilitation hostel The halfway lodge has been set up.

Boris lives this way


While I was out in hospital, my lodging was broken into and pillaged and wrecked. Our state farm, where I had worked as a vet, got ruined. Thus I lost my job as well and had to spend a year in mental hospital. Now I have been put up in a hostel. We have all modern conveniences there, I cook my meals, iron my clothes, etc. But most of all I enjoy freedom. For example, I can go out to have a chat with my inmates on the bench whenever I like. Being employed as a kitchen-help in our hospital, I also apply my professional skills: have cured the hospital dog with antibiotics, take care of our tortoise. When I put aside enough money, Ill repair my own lodging. I mean to set my young son on his feet (for the time being he is staying with my mother-in-law). Meantime I pay his keep and come up to stay with him over the weekend. In a while I am going to bring him up myself. We appreciate our hostel for supporting us. I only regret that some people next door look down on us and that we go out to the theatre, cinema, on tour, etc. too rarely.
Boris
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Weve found shelter

All people deserve respect


6 years ago, in the aftermath of a skull injury, I found myself in a plight: I was homeless and had not a penny to bless myself. Fortunately I got accommodation in a hostel. Until I was paid my disability benet, my neighbors had been providing me with food and cigarettes. Our social worker placed me in a workshop for disabled persons. After some training I began repairing shoes in the workshop and our hostel. I had some trouble with renewing my ID (it had gone missing) but, thanks to our social worker, this issue was resolved at last. Then I got employed as a locksmith in a rehab centre. It was just a streak of luck: I met Olga there and moved to her place. However, I drop in to the hostel from time to time. I owe a lot to my ex-inmates and the sta: thanks to them I respect all people no matter if they are ill or healthy. It is cozy in the hostel, and everybody is so compassionate. How are things? I sew and repair at work, adhere to medication. I am going to be all right.
Vladimir Nesterenok (Pervouralsk)

I have a name, dont I


I rst lived with my father, next moved to my brothers, found a job, took up with a nice guy. We had been living happily together until I was bitten by an encephalitis tick. Encephalitis impaired my speech and memory. two years in mental hospital had no eect: my speech would not improve. Finally, I was accommodated in our rehab hostel and taken care of. Everybody was so friendly over there, called me by my Christian name. Under the guidance of our social worker things settled into shape. I entered into our arts workshop and proved to be good at drawing congratulation cards, painting pictures; I even dabbled in writing poems. Besides, I went to the Housewife and Needlework clubs and learned to bake pies, make soups and so on. I am going to repair my apartment and move in there with my boy-friend (he gets both his disability benet and wages). What else? Our social worker got in touch with my cousins, they wont fail me. All together, well hold out against all odds.
Tatiana Frolova, aged 28 (Pervouralsk)

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My manor
I am staying with my girl-friend in the hostel. The sta is patient, always ready to give a piece of advice. We are regaining our daily rhythms and internal discipline. There is no comparison with mental hospital: we are allowed to go out, see my relatives (my brothers seem to be fond of my girl-friend). In a while, well move on to live independently on my premises in the village Winner. Probably, well grow vegetables. For our future household weve already bought some odds and ends. To tell the truth, we are a bit scared of living on our own. However, time is ripe for making our way in life. Our hostel experience will be of use. God is gracious.
Nikolay Chuprakov (Omsk)

I am my own woman
I thank God for lodging me in a hostel where Ive become self-sucient, independent. Before my mental aection I used to be a skillful cook. Though out of practice, I love playing the hostess: o and on I have my friends for dinner and treat them to delicious meals. I enjoy bustling at home: washing-up, scrubbing oors, etc. Weve planted tomatoes in boxes and are looking forward to the harvest. My drawings are exhibited in our assembly hall. My pen-friend (he lives in another town) arrived to see me and oered to move in with him. It didnt sound attractive after all. I am about to buy a country cottage on my savings and well settle down there with my boy-friend (he is staying in hospital for the time being and actually cant do without me). God be with me.
Gallia Bikmulina (Omsk)

Riding Rainbow
Ive been staying in the hostel for two years. Working as a carter I am attached to my mare, Rainbow, by name, and groom her with pleasure. In summer I intend to build a bath-house, a shed, plant vegetables (Ive alOvercoming

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Weve found shelter

Weve found shelter

ready bought the seeds). Meantime I raise a calf, a pig and chickens. I am aided by my friends and the sta. The faith in our Lord supports me.
Ivan Afanasievitch Mihailo (Omsk)

We manage all right


Our two-storey hostel with all modern conveniences has places for 30 residents. Besides a number of bedrooms for 2 persons, there is also a dining room, recreation room, laundry, gym. The sta comprises a psychiatrist, lawyer, psychologist, round-the-clock supervisor, a few social workers. A sewing workshop, the Housewife club, botanical, sport and musical circles are attached to the hostel. Draught championships are held. We celebrate holidays and birthdays all together. The sta is charged with providing our residents with pensions, settling law problems, placing for employment, delivering lectures for mental patients and their families. Our residents are taught not to waste money, see to themselves. A number of challenges are dealt with by the resident council. Our patients call on their hospitalized friends and orphans, make presents for them: sew baby clothes, kerchiefs, slippers. For these activities our hostel has been honored with a certicate. In the children ward we staged a performance Farewell, autumn and made puppets and setting for the children theatre Bunny. A video lm about our activities was shown on TV. Our move-on branch (a 3-room apartment in the neighborhood) is intended for self-supporting, working residents
N.A. Bagautdinova

A cozy home
My life story may serve somebody a lesson. As my parents were heavy drinkers I was admitted to an orphanage at the age of ve. At school I was an average pupil, had my ups and downs. I got the profession of a turner. At the age of 18 some signs of my illness occurred: anxiety, itch for mischief. 4 years ago I was admitted to hospital. A year later I got accommodation in our rehab hostel (returning home was out of the question because of my relatives debauches). It was in our hostel that I rst felt really at home.
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I went in for sports to keep t, learned to play the guitar. Our social worker placed me as a loader. A year later I suspected my boss of cheating, we had a row and he red me. The hostel sta lent me a hand again. As a result, I made both ends meet by sweeping the yard. In summer I began dating a girl and we decided to hire an apartment and move in together. To aord it I badly needed a well-paid job. I was lucky to get employed as a guard. Since 2008 Ive been enjoying a quiet family life. Yet I often come round to our hostel to see the friends next door and sta members: thanks to their encouragement and consideration Ive regenerated.
Alexander Holmogorov, aged 26 (Nigni Tagil)

Ive extricated myself


Due to a helpful lawyer I managed to get out of the psychiatric nursing home. But where could I go? After my mothers death my neighbors had deprived me of my apartment. The lawyer and doctors settled me in a hostel. In the long run we sued my neighbors and Ive retrieved my lodging. Ive been working in our labor therapy workshop for 4 years, get 1400 rubles in addition to my pension. I enjoy mixing with my colleagues, it keeps up my spirits.
Sergey Trelov, aged 48 (Nigni Tagil)

Comment: in economically developed countries nursing homes usually house elderly mental patients with somatic neurologic pathology because they need round-the-clock nursing. Yet 20% of chronic patients reside in sheltered lodging. In Russia typical nursing home residents are Sergey and the like. Is it reasonable?

What a woman needs


Hi. I was the seventh child in our family. After my parents divorce I was placed in an orphanage. Unfortunately I havent seen my siblings ever again. For a while I stayed with my foster-parents but then they were deprived of parents rights and I had to return to the orphanage. After graduating from the railway college I worked by profession and got education by correspondence. 14 years ago I fell ill and was admitted to menOvercoming

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Weve found shelter

Weve found shelter

tal hospital. After discharge, nding myself without sustenance, I settled down alone in a decrepit shack and actually starved. The only option was to move back to hospital. I had to spend four morose years there. At last I was accommodated in our hostel and enjoyed life again. The favorable conditions improved my capabilities. I learned to make toys and childrens clothes, re-discovered everyday and social skills. Our social workers placed me in the Labor Workshop (N.B. the authors solemn capital letters have been kept) and I sewed bed linen and work clothes there. Now I am being trained to shape clothes. I get on well with my colleagues and superior, have 1 300 rubles in addition to my benet. I moved on to the rehab apartment, manage without supervision. My room-mates and I take cook and clean in turn. Weve also painted the walls. I signed in for dress-making classes (in our club Nugget). We go to the theatre and movies, celebrate all the holidays together.
Sveta Klipova, aged 31 (Nigni Tagil)

Comment: the move-on apartment opposite the hostel, though in a shabby building, is immaculately clean. The girls dream of a pussy-cat to make their home cozier. All dressed up, the girls frequent dancing parties. Their Mummy, i.e. the social worker in charge of the girls, trusts them but checks their expenses, just in case. Once she noticed the girls to waste half their earnings to get to the workshop by a xedroute taxi. Youd better catch a bus, its much cheaper, with your disability discount-Mummy recommended. We prefer to ride like all the others-the girls explained unanimously. By the rehab team the fare expenses have been acknowledged reasonable. Svetas needlework exhibited in the New Choices Moscow branch reminded us of the girl. How was she getting on a couple of years later? Sveta answered readily: last summer I took up with a young man, moved to his place, and, ultimately, got married to him. For the rst time in my life Ive found a real family. I call my parents-in-law Mother and Father. Theyve given us a separate room in their apartment. Ive quitted my workshop and work as a dress-maker in a fashion-house, making good money. Ive got everything a woman can desire: a loving family, well-paid job, cozy home.
Svetlana Yurievna Klipova, aged 33 (Nigni Tagil)

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Three corner-stones
In 1981 I got employment in a vehicle depot as a mechanic. In 1983 a car crash left me with a skull injury. For a couple of years I worked as a loader in private shops. I signed in for guitar classes but in 1986 symptoms of epilepsy appeared and my musical plans miscarried. Yet in 1991 I managed to retrieve my job in the vehicle depot. Unluckily my well-being never lasted. After my mothers death everything went wrong: I dropped out of work, was kicked out of my apartment by my cousins. Homeless, I was picked up by a bum who hoped to sponge on my pension. My psychiatrist gave me a hand: found a job in a church for me, got in touch with a lawyer who agreed to sue my cousins for free. Meanwhile the bum got rid of me and, as beggars should not be choosers, I found refuge in mental hospital. Looking through magazines I got fascinated with stories about distinguished persons. They all sought self-expression, I was eager to follow suit, but how could I go about it in hospital? I picked up a pencil and a strip of torn wall-paper and attempted to draw. My random creative activities went on. When an arts studio was set up for our patients, I joined without hesitation and dedicated myself to art. Our tutors were professional artists endowed with extraordinary intuition and critical vision. Under their guidance I developed quick eye for peoples features, mimics, gesticulation. Alexander tall, lean, grey-bearded, silent, was painting an image. The hospital joiner had just given him a board cut-o. Persistence yielded results. A couple of days later the image of the Holy Mother took shape against the snowwhite background. Only then it occurred to us that the artist was the famous Ivanov himself, not a namesake of his. While Alexander was painting for the hospital church, I was daubing owers on trays for the hospital canteen. It took my breath away to watch Ivanov at work. Unexpectedly he said: Try to paint an image. Ill explain how to go about it. I began with copying then bit by bit tried to create. Alexander, strict and meticulous, instructed me. My rst self-sucient work was John the Baptist. Ive got to know that religion rests on three corner-stones: faith, hope, love and that real art makes people compassionate, urges them to seek harmony in themselves and the world.
Comment: our collection of stories Three portraits is devoted to the blessed memory of A.B. Ivanov, a true artist.

Weve found shelter

Being begins with doing


Goethe

Labor is a must

My disease dissociated me from people, restrained my working and studying activities. The lack of education and practical skills further deteriorated the situation. In search of a solution I joined the Family club. I began with German classes. Before my illness I was good at drawing, now I had to start from scratch. All my assorted shreds of skills and knowledge were getting integrated through the club activities. Thus, by taking more and more complicated classes I was steadily making progress towards rehabilitation. Next, I began to work at a factory and, at the same time, entered the university. I also participated in the New Choices editorial and publishing board. Our printing-oce is provided with orders by a great deal of Moscow psychiatric units. Weve published a collection of poems by the New Choices poets, made (from A to Z) the book youre holding in your hands, regularly issue the New Choices newspaper. Our printers have trouble in acquiring necessary skills due to cognitive diculties caused by the therapy side eects (drowsiness, lack of concentration, impaired memory, etc). In addition, they dont keep to schedule but come just when they feel ready. The central feature of our activities is an individual approach
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Being begins with doing

to each printer depending on his health, abilities and desire. The pace of work and the task are determined by our printers themselves: they should feel up to the job. Another feature is the activity eciency for the disabled person himself. Our printers operate all the equipment available, fullling all the stages of the technological process. It provides exible distribution of the tasks, but most important is that our printers do not carry out automatically one and the same routine operation. The wide range of their activities ensures working experience, self-assurance and helps to solve problems also in everyday life. Our supervisor, a professional printer, instructs us in handling the new equipment (our sponsors donation). We face a challenge. The best placement and support model focuses on helping people return to competitive employment rather than to sheltered work. Unfortunately, general enterprises are reluctant to take on disabled persons. Even if a disabled person has overcome all barriers and got the vacancy, he usually just encumbers his healthy colleagues who do not care about supporting or making allowances. So, on the one hand, disabled people can mostly count on sheltered employment in labor therapy workshops where they are supported by social workers, volunteers, their family, etc., as well as enjoy easier work conditions and a shorter working day. On the other hand, their employment and salary are stable, only given a labor therapy workshop is able to compete with general enterprises, yet we might hardly be in the running due to our workers mental problems. This vicious circle must be broken: only labor is apt to re-integrate a disabled person into society.
A.N. Kulikov (Moscow)

Comment: the public association for disabled persons in Calgary (Canada) has adopted the New Choice printing-oce experience. Alexey having graduated from the Moscow University with honors, works as a social work coordinator for the Moscow Scientic Research Psychiatry Institute and, certainly, remains the head of our printing-oce

I can do without hospitalization


After graduating from the university I worked as a foreman in Tadjikistan. Having come from the Urals, I could hardly stand the stiing heat. Besides I was bitten by some venomous insect. To remove the stress
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I indulged in spirits and drugs. As a result, I developed delirium and delusions. I returned home and my father had to take me to psychiatric hospital. Then I managed to work as a locksmith for half a year, but drinking and smoking triggered o a re-hospitalization. After 6 months I was discharged in a satisfactory state. Within this remission I worked for 4 years, then, after not sleeping a wink for a month, was admitted to hospital again. I had to give up working and live on the disability benet. For a long time I had at least one hospitalization a year. In the end, I brought the situation under control. To begin with, I emerged from alcohol addiction. Seeking some occupation, I resumed carving on wood, took part in a mental patients exhibition and was honored with a certicate. It cheered me up a bit. My fathers death, followed by my grandmothers decease caused a relapse. My doctor explained that the stress had been too much for me. Now I am getting ready for a new exhibition. The art-therapy relieves my inward discomfort through expressing emotions. For ten years Ive been working as an odd hand for 4 hours per day. Teaming with healthy people as well as labor, though unqualied and underpaid, impart self-assurance. Ive been doing without hospitalization for four years.
Andrew Azov (Asbest)

Side by side
I was getting on at the university. In my 4th year I got married, gave birth to a daughter. Shortly my husband walked out on me and I had to make my living. I began buying cheap stu abroad and selling it in Russia with prot. During these shuttle trips I was occasionally cheated and robbed which provoked a nervous breakdown. At the age of 25 I was admitted to mental hospital. After discharge I had to wind up my shuttle business but, between hospitalizations, snatched at any job (I thought it humiliating to live on the disability benet). When I found out my diagnosis I was shocked. My mother (she had concealed my diagnosis for ages) went out of her way to comfort and reassure me. Eventually I made up my mind to take things easy. For two years we had wasted a fortune on a recent remedy, run out of money, so, half-heartedly, I accepted the disability benet. Now I have this remedy injected for free and it proves to be ecient. With my doctors help Ive got a secretary job. In the New
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Being begins with doing

Being begins with doing

Choices I socialize with my fellow-suerers and we work for recovery together. I owe a lot to my devoted mummy.
Milana Kadushina (Asbest)

Comment: most patients are ignorant of their diagnosis and it does not really matter. There is no special medication available, e.g. for schizophrenia. Milana is obviously making progress: she takes therapy, works, appreciates her family. She has put despair and frustration behind her. Milana, active by nature, is creating, re-building her self.

I make furniture
Ive been working in the labor therapy workshop for 20 years. Many years ago I used to make albums, raincoats, bags and so on. Now I specialize in making furniture. I am accustomed to work: before my illness I was a driver and carved on wood as a hobby. I get on well with my colleagues and my superior. They think much of me: I have been honored with certicates and gifts for excellent work. In spite of earning only 1 300 rubles, I am fond of working.
Gennadiy Vasilievitch Lebedev (Nigni Tagil)

Comment: according to sociology surveys, work is enjoyed by not more than 10% of Russian people, including our Gennadi Vasilievitch.

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I cocial worker

My illness might have begun due to stress. Five years ago I had a love aair, worked as a night nurse and hardly snatched three hours sleep. For lack of appetite I lost 15 kg in 1.5 months, but could drink the sea dry. Then I experienced an acute hospital admission. Having dropped out of work, I felt as if drifting in the void. Eventually I managed to shake o depression: joined the organization Family and mental health, took psychotherapy, drawing classes, made friends. Having moved away from painful self-preoccupation, I volunteered to coordinate social work for our organization. For three years Ive been arranging parties, tours, outings. I am going to organize a meeting with our former members who have returned to normal functioning, i.e., work and have a family.
E.A. Kuchina (Moscow)

Comment: Evgenia has recovered through meaningful activities. She was lucky to nd a job in her organization (some of the New Choices branches also oer vacancies). It is reasonable of Evgenia to invite those recovered from a mental illness for sharing experience. It brings back to me a recent international workshop for mental patients. A former patient narrating about his work for recovery and showing his kids pictures attracted more audience than a celebrated professor.

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Being begins with doing

Being begins with doing

Julyas employment

At last I found a job for my daughter. For many years I did my best to place her by means of the employment oce and want-ads. Yet enterprises made up various excuses not to take on the disabled person. For ages I did not see I was getting anywhere. At last our persistence has been rewarded: Yulya works as an advertisement operator for a printing oce. As she has a bonus job, I have been allowed to help my daughter standing near her table. The team and the superior have been extremely helpful and understanding. Now Yulya, having got into the swing of things, manages without any support and is proud of her earnings.
N.V. Klimok (Tver)

Comment: such approach, that is, supported employment is the best way to psychosocial rehabilitation. In some regions (e.g. in Sverdlovsk or Omsk) a placement and support team functions, linking disabled persons with employment oces and directly with employers. However, mostly, a person has to seek employment by himself. Yulyas progress shows that a mental patient should not be bribed with a tiny pension and disposed of, but needs to be given a second chance. Yulyas colleagues are likely to realize this.

In search of a suitable job


I had pinned my hopes on becoming a student and making new friends. Failing the entrance exams discouraged me: I became apathetic, idle, weird. Some initial psychotic symptoms appeared: I scrutinized my
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teeth for signs of decay, insisted on eating exclusively meat-balls, etc. I turned to the employment oce but, having no qualications, was offered only cleaning vacancies. Feeling humiliated, I found fault with everybody, got hysterical. I was treated with antipsychotics. Yet, next year I entered the chemistry college but dropped out because of concentration problems. At length I experienced an acute hospital admission. After being discharged I went to the New Choices musical and computer classes, swimming pool. My next step was to enter into the printing-oce. I learned to operate the equipment, began socializing. Having regained condence I signed in the secretary college but proved to be too absentminded for this profession. Eventually I had to apply for the disability benet. The employment oce oered me to work from home, but it did not t I badly needed socialization. My medication had made me obese, so I went in for jogging, kept to diet and slimmed down by 35 kg within 1.5 years. A year ago I accepted a wire-cutter vacancy in the Screen centre. There are a lot of advantages: a short working day, 15-minute break per hour, free lunch. However I got bored with the monotonous chore and found a more intellectual job with the Prospect society: for 1.5 months I placed clients for employment applying my computer skills. Not having maintained the job, I am back cutting wire at the Screen centre (for the time being). I enjoy shopping, movies, go for outings. People surrounding me do not seem full of enmity any more, though making contacts is still challenging.
Alexandra E., aged 25 (Moscow)

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Being begins with doing

Being begins with doing

Surmounting
I am an expert in childrens mental defects by profession and a creative, active person by nature. My mental discomfort is derived from childhood. Suering from a birth trauma I grasped all my mothers care and attention (however, my mothers temper snapped now and then). Feeling neglected, my father got into the habit of drinking, while my sister became jealous and spiteful. ten years ago I had to apply for the disability benet. In spite of utter lack of compassion from my family, I went all lengths to get over the severe illness on my own. I found a shop-assistant job in a tiny boutique. To keep that position I did my utmost to become exible, adaptable and hard-working. I am learning to inhibit relapses through meaningful activities. Dear friends! Be optimistic and brave. Never give in. Your eorts will pay o. All barriers are surmountable.
Tatiana (Moscow)

Comment: monstrous upbringing and awful childhood cannot trigger o mental disorder but, certainly, make an individual vulnerable for stress. Recovery is characterized by general, unsheltered employment and normal family relations. Adequate therapy can settle even long-time family conicts. Being a creative, active person Tatiana has not let her illness get the upper hand.

Breakthrough
Since the age of 16 I used to spend two months a year in hospital. Each outburst of my illness had the same pattern. Insomnia was followed with delirium. Under a delusion that assassins were after me I took to my legs. When I eventually returned home, the ambulance had already been waiting for me. In hospital, I soon came to my senses and agreed that I was just ill and in need of therapy. After discharge, I felt inferior: it seemed to me that everybody was snubbing me. Only my work (I tune up cars) rescued me. Screwing up nuts obviously relaxed me. Now I attend rehab classes in our clinic. To improve my health Ive given up smoking and drinking, every morning I do press-ups and take a cold shower. I realize that medication is indispensable but kindness is the best remedy. I try hard to be nice to people and they respond accordingly. Nobody is to blame that Ive fallen ill. I always control myself at work and at home. To
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relax I took up drawing. In spring I apprehended a relapse coming on. Having consulted my art-therapy psychologist, I decided against interrupting the classes. I persuaded myself that if I was able to draw I was not ill at all. This approach had a stabilizing impact on my health. I felt rewarded when a fellow-suerer of mine said: You deserve respect: you work, have a wife, kids and provide for them
Sasha (Kirov)

Comment: lets piece out a health recipe: medication (necessary) + work to your liking + art-therapy + kindness. Go ahead, Sasha!

Take it easy
Till the 5th form I was an excellent pupil, then-an average one. In my teens, I fancied taking pictures, though, short-sighted as I was, it was challenging. After school I worked as a tractor driver for our collective farm. At the age of 18, the draft board rejected me as unt for the army service and referred me to the mental hospital for check-up. Thus my mental disease was diagnosed and the initial hospitalization ensued. In a while, I took a course in TV repair. Having failed to get a job by profession, I entered a factory and really enjoyed operating machines. To improve my sight I underwent eye surgery. In 1992 I was re-hospitalized. I had always been daggers drawn with people, and my aggression kept aggravating. The trouble with me was that all people seemed enemy (except my parents who invariably backed me up). Within 14 years I was always in and out of hospital. During a long-term hospitalization I wondered why my mother had stopped visiting me and learned about her death. I felt shocked and awfully scared. Now I was due to reside in a nursing home. I pleaded with my doctor to refer me for rehab so that I could live at home. The social and everyday life skill classes as well as psychoeducation classes promoted my recovery. With my health stabilized, I got a part-time job of a cleaner. Ive regained condence and applied for a full-time job. Do at least a wee bit, whatever you feel able to do. Dont chew on your mistakes, but learn by them. Never accept defeat. Take your time and make headway step by step.
Yuri Tokarev, aged 40 (Stavropol)

Comment: you might fail to get a job you fancy, but keep in mind that any kind of working activities will organize you, give you condence, self-respect and relieve your illness.

Being begins with doing

Mother's heart is an inexhaustible source of miracles


P. Beranget

Our children

At the onset of disease it takes time for the family to face the facts. The parents rush about arranging check-ups, trying healers, turning to religion, et cetera, leaving no stone unturned. My son was easy-going, an excellent student. In his 4th year, a virus infection made him a dierent person, withdrawn, indierent. With these precursors of disease, my husband left us (it is typical, isnt it?) and I confronted the challenge alone. I had to work by a exible schedule. My son never agreed to hospitalization of his own accord. I was busy providing for the family, getting prescriptions, medication, etc. Now I realize Ive not concentrated enough on his rehabilitation: he stuck at home smoking or drinking tea all day long. Eventually, I accompanied him to the New Choices organization. We decided on embroidery classes. During the break we go through a soothing rite: make a circle holding hands and tell each other something nice. Our club-mates and the sta are all so kind, friendly. We celebrate holidays together, hold competitions. The New Year Magic eld competition brought prizes for all the participants. For our classes weve got a furnished room with a tea set and even with gym equipment. The sta provided us
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Mothers heart is an inexhaustible source of miracles

with sewing machines, threads, cloths. However, dont count too much on somebodys assistance: working for your childrens rehabilitation is mostly your responsibility. Sad as it is that we have to nurse our grown-up children, we have no choice.
N.M.Gorbatenko (Tula)

My kind Alyosha
I am so eager to see my son recovering. He is such a good person. To help him I took the New Choices psychoeducation classes. Alyosha has been taking his atypical antipsychotic for 10 months. He is much of a reader, goes shopping. Unfortunately, his memory is still poor: for three days Ive been telling him that he is turning 26 but it slips his memory again. It makes me sad to recollect how good he was at math at the Polytechnic college, how accomplished in everything he turned his hand to. A quotation from Alyoshas letter: I used to play tennis (illegible), swim in a river and a swimming pool, ride a bike, climb the mountains. Now I am learning to type texts by computer, I want to learn (illegible)work.
Marina Petrovna (Shelehov, Irkutsk region)

Comment: decline in cognitive capabilities (absent-mindedness, impaired memory) is likely to be temporary. Alyosha needs to keep training (reading, operating computer, etc).

The thin end of the wedge


My Anton had two passions: math and sports. Hands down he entered the university to study applied mathematics. Anton passed the winter session with honors but during the next term could not grasp the lectures and failed the summer exams. It did not occur to us that this was a precursor of his illness, and Anton re-entered the university. In September he got delirious (Ive caught AIDS, turned into a woman, etc.) and was admitted to hospital with schizophrenia. Next year Anton tried to study again but early in his second year had a relapse. For a few years our son was in and out of hospital, tried dierent neuroleptics but did
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not respond to treatment. Anton got slovenly, could not handle money, focus on reading. He got alienated from his previous contacts: it was tiresome for his friends to speak to Anton for he listened only to his voices. Anton became a chain-smoker scattering ash, burning matches and cigarette-stubs all about the place. Since Anton is prescribed new therapy, his mental health has obviously ameliorated. Aggression is out of the question, he has been staying away from hospital for seven years (touch wood). We have all learned to co-exist with Antons illness. Being resilient by nature, Anton never complains, helps about the house, attends the New Choices English classes. From time to time he threatens to leave for the US and get married. As to the latter, we really dont mind.
L.B.Feldman (Moscow)

Comment: the bright, gifted young man got mentally aicted. First, he became moody, then, appeared delirium and extreme excitement, leading to hospitalization. The following active stage was typically characterized by torturing voices. A few years later the disease receded, Anton does without hospitalizations. This improvement is determined by adequate therapy, Antons resilience, his familys support and the New Choices facilities. Antons parents look on the bright side.

As long as there is life there is hope


Since childhood my son was sensitive, meditative and stubborn. While kids were running, screaming, ghting, Matwey was admiring owers. He was not like everybody else(as his nursery teacher put it), he was
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Mothers heart is an inexhaustible source of miracles

Mothers heart is an inexhaustible source of miracles

an observer. When Matwey turned six, his father divorced me. Matwey became sad, nervous, especially after his father had left our city forever. When my son went to school he was getting more and more withdrawn. Sometimes he hid all his school day long under his desk. His schoolmates teasing him, Matwey dropped out of school but was taught at home. In his teens, he got jealous of my second husband and, next, got hostile to me. On the one hand, as I got under his skin, he felt like escaping as far as possible, on the other hand, for want of social and everyday life skills he could not survive without me. These ambivalent sensations exasperated him. Hating my second husband, Matwey had to settle down with his grandfather (my father). Matwey fell a prey to obsessions and unfortunately, his voices instructed him to abuse and even beat the poor old man. Papa tried to keep to his room until Matweys aggression subsided. Due to adequate therapy schizophrenia has receded. Having entered the Commercial college, my son studies English and German by correspondence. I help him with English, and Papa-with German. We hope Matwey is going to be qualied as interpreter. It would suit him: such work can be carried out from home. Matwey is eager to learn, hes got duties and a goal in life. God knows whether we are going to succeed, but we do our best.
Marina S. (Samara)

Comment: without family backup a mental illness is protracted. Support skills can be picked up at psychoeducation class conducted by professionals as well as by experienced amateurs like mother Marina.

We will survive
Three years ago my 15-year-old sons behavior became odd, unruly. He got rude, sulky, missed classes, listened to top-volume music at night, mocked at everybody. Though smart and gifted, he fell behind the class. We mistook these changes for typical teen-age negation. When he attempted suicide, we had to hospitalize him. Yet we still hoped naively that his illness would be cured. For a few years Sasha was in and out of hospital. As he refused to see his psychiatrist I bribed Sasha with gifts to lure him to the clinic. And what did I hear from the psychiatrist? That Sashas illness was my fault. Shocked and worked up, I took the Family education course. Unable to grasp it, I decided to repeat the course. My fellow-students were new but the problems under discussion remained
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invariable. I realized it was no use lamenting, I had to act urgently. Sasha suered, unable to get adjusted to life, and my mission was to help him out. A year has passed. Sasha is coming to life: consults his psychiatrist on his own accord, takes therapy, operates computer, looks after himself. God is almighty: my son will survive.
Mother (Nni Novgorod)

Support is available

As a child Sergey preferred to speak with gestures. Thanks to adequate speech therapy Sergey managed to nish the construction school. He applied his skills to build a wonderful country cottage for us. In the early nineties Sergey had a lot of trouble making his living: some of his employers got ruined, some failed to pay his salary. These hardships made Sergey edgy and upset. Once he returned home at dawn. He was tipsy, excited. For the 5 following nights he did not sleep a wink. His rst hospitalization ensued. For two years our son was in and out of hospital but during remissions tried to resume working. Since 2001 Sergey has been administered a new antipsychotic easing excitement, anxiety (unfortunately his delirious ideas are persevering). With a height of 180 cm Sergey weighs 120 kg. Being overweight, Sergey developed a bunch of somatic diseases. His conduct remains inadequate: Sergey forgets to wash himself, brings strangers to our place. From time to time he implores us not to die, not to leave him alone, but feeling worse (depression, headaches), blames us for making him disabled. In 2001 we joined the New Choices association and our life changed for the better. Instructed by psychoeducation and law workshops, we worked out an adequate approach. Now Sergey
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Mothers heart is an inexhaustible source of miracles

Mothers heart is an inexhaustible source of miracles

fetches medicaments in the out-patient clinic, goes shopping, calls on our relatives, even cooks. He is hospitalized more seldom. Yet we are awfully scared: what will become of him when we die? How can we prepare him for living on his own? We hope to solve this problem.
Valentina Petrovna and Vladimir Sergeevitch (Moscow)

Comments: the family should be taught to help their patient eciently. Sending his son on errands, Vladimir Sergeevitch willingly repaired the New Choice oce in the Moscow Psychiatry institute. The parents approach is reasonable: to develop Sergeys everyday life and hygienic skills patiently, from scratch; to send their son on errands, praising him for any minor achievement. Sergeys parents came up with another important problem: it is necessary to heal not only a patients soul but also his body. That is why a psychiatrist ought to consult his colleagues working in other spheres.

Will you forgive me, sonny?


3 years ago I stopped hospitalizing my son by force as well as compelling him to take medicaments. Observing my son, I restrain my temper. As a result, my son got considerably relaxed. Feeling worse, he even takes medicine of his own accord. Yet, his ways of thinking and behavior are special, strange and he turns a deaf ear to any recommendations. Your illness, my little one, made me take stock of my life, looking back at my unhappy childhood. My father was drinking heavily and beating up my mum and me. The sense of panic pursued me into my adult life. Since you were a kid, I have been concerned about your health and well-being. I incessantly took you to doctors, guided you, instructed, urged you to enter the college (where you broke down completely). Eventually, I realized that, my father having damaged my life, I avenged myself on you. You could not call your soul your own and it must have paralyzed your will, caused the mental aection. Being unable to solve problems, you blame me. My precious, I am so sorry for crushing your will by my exaggerated care.
V.V.Semashk (Rostyov-na-Donu)

Comment: Valentina deserves respect for acknowledging her fault, becoming more tolerant, exible. But to let her son drift, just observing and repenting, is unpardonable. Her sons relaxation is temporary
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and pregnant with a new outburst. Being frustrated and miserable, he tends to depression. Meantime his special behavior can be corrected by adequate therapy and support. A mental patients family is usually obsessed with a sense of guilt. It is often provoked by the patients delirious accusations (I am disabled and the fault lies with you, etc.), his hatred. V.V. is misled by a common myth: actually, schizophrenia is not caused by wrong upbringing. Instead of lamenting over her alleged sins, Valentina should urgently consult a psychiatrist to help her son.

Before and after


When my son turned 21, he began hiding from people, next he failed to recognize even us, his parents and feared us. (The forerunner of his illness had manifested two years earlier, when he proved unable to study at college). Our son was hospitalized by force. After being discharged he escaped from our place and wandered day and night about the city. For a few years our son was in and out of hospital. He got aggressive, never admitted that he was ill and needed treatment, suered from auditory hallucinations. Each compulsory hospitalization was followed by further degradation of his personality. Eventually, it dawned up on us that we must struggle and conquer the disease. With the New Choices we did not feel abandoned any more. We actively attended the meetings, workshops, cultural events and hoped for rehabilitation. Unfortunately, the fathers death triggered o a relapse. To deal with my sons severe psychosis the antipsychotic dosage was increased which led to overweight. As a result, my son weighed 150 kg and developed diabetes. Awfully upset, he disagreed to take therapy. Through the Moscow Psychiatry institute we found a competent psychiatrist who recommended adequate therapy. Now my son is losing weight, the psychiatrist comes to see him at home. I feel optimistic again.
Mother (Moscow)

Comment: accompanying somatic diseases (and adverse side eects) should be treated in a multipurpose clinic by a GP and experts in somatic diseases. A psychiatrist should pay attention not only to neurological disorders (tremor, restlessness) in patients but also to overweight, traumatizing patients, repelling the latter from therapy and causing a bunch of complications.
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Mothers heart is an inexhaustible source of miracles

Mothers heart is an inexhaustible source of miracles

Reforms are urgent


Like leprous outcasts, mental patients and their families are doomed to secluded existence on the margin of society. My son has been ill since the age of three. As a teen-ager, utterly unable to socialize, he pleaded with me to help him out. I tried in vain to nd a social skill group for. Mental patients usually get only more or less adequate therapy but they should be also taught to live in society. To teach mental patients to cooperate, a club with a gym, chorus, dancing classes is badly needed. A mental hospital looks like prison, the ward is overcrowded. There is no privacy even in the toilet and bathroom. Patients dont walk enough or dont walk at all. Physical and labor therapy are out of the question, instead, a patient is stued with stupefying pills making him bed-ridden. (A patient is no trouble when he is like this, with the sta not lifting a nger for such a ridiculous salary). For the rst thing, medication should be integrated with labor therapy, psychological intervention at all phases of recovery process and with gym exercises to keep a patient in shape. Mental patients should not be parted from their relatives who must be instructed in taking care and spend with him as much time as possible. A mental hospital ought to deal with somatic diseases as well. I failed to have my sons alimentary canal treated: being unt for a general hospital, he has twice escaped without completing treatment. It is taken for granted that after relieving acute psychosis a mental patient needs follow-up support. Without rehabilitation measures a patient has little opportunity to contribute meaningfully to society. Healthcare assignments have to be increased, for mental hospitals want reorganization, maintenance and control.
G.P .Tsvetkova (Moscow )

Comment: assessment of psychiatric aid from inside, that is from the viewpoint of a patient and family, is relevant and must be taken into consideration to properly organize healthcare.

Time is moving on and we move with the times


Not so long ago mental patients problems were just hushed up. My son has been ill since 13. I had no idea where to refer for help. I even thought
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of standing in a busy thoroughfare with a poster: People! Help us out! Currently mental patients parents assert themselves demanding support and society responds to their needs. Thus, parents call for latest medication, rehab centers. I suppose that rehabilitation for a group of patients with schizophrenia supervised by a psychiatrist would be most ecient in a quiet rural setting, among picturesque landscapes. Nature is a better healer than any remedy. The family would welcome such an initiative.
L.M. Zabashta (Sankt-Peterburg)

Comment: 70 years ago a famous psychiatrist took his chronic patients on hike up and down the Caucasus rocks and for some of them it worked out (intensive emotions sometimes make good but more often make harm).Outings, certainly, cannot replace medication, the latter being vital for mental patients, but can impart positive emotions promoting recovery.

Towards the stars

As the mother of a mental patient, I took part in the congress of the European Union of Family Associations for Mentally Ill persons (EUFAMI) in Torun (Poland). Plenty of enthusiastic participants from all over the world were addressing a wide range of issues urgent for mental patients and their families. One of the challenges deals with the optimum correlation of independence and protection. To rebuild his personality, a mental patient must be as independent as a healthy person. His family ought to give him freedom for development. At the same time the patient cannot be left to his own devices needing his familys support and protection. How can the
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Mothers heart is an inexhaustible source of miracles

Mothers heart is an inexhaustible source of miracles

golden mean be achieved? Only intuitively, through parents love. Another problem involves respect for a mental patient as a condition of rehabilitation. First of all, a patient should be respected by his family. He ought to be encouraged gently, in subtle ways. Unfortunately, sometimes the perpetual stress is too much for the parents and they need psychological intervention themselves. Not so long ago mental patients families had no say in the matter. Now Russian public associations, rst of all the New Choices, work not only for mental patients but also for their families. The congress motto Lets reach the stars is not picked haphazardly. It reects hope, desire to overcome as well as suering: climbing up is always dicult and stars are unattainable (for the time being).However, our destiny has given us no choice but working towards our guiding stars recovery and reintegration into society. The EUFAMI president Inger Nilson, a grey-haired woman, who had endured a great deal, concluded her ocial speech in a home-like way: I am often asked how my daughter is doing. Shes recovered, got married. In January my granddaughter was born. These simple, genuine words inspired all those present with hope and condence.
Irina Shichvarger (Yaroslavl)

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Mothers heart is an inexhaustible source of miracles

The club hopes


Everyone should be a place where to go
F.M. Dostoevsky

Soul i obliged w Soul is obliged to work ... So bi work


N. Zabolotsky Zabolotsk Zabolotsky k

There is no time to lose

My mental illness compelled me to stop working as a nurse. My disability was a devastating blow. For 10 years I was in and out of hospital. By now my health has improved. I do my best to rehabilitate and nd a job within my powers. Work is our primary challenge, and neither our doctors, nor family can place us into employment. Getting along with the family is also a tough job. I dream of a family of my own. To prevent relapses, I adhere to my therapy, as well as inhibit frustration and suicidal ideas. What about bad habits? I dont drink and give my word to drop smoking in a while. The Isoterra club enables me to develop my creative potentialities. Ive already attended the Isoterra over 100 times. A person should feel useful and enjoy free choice. I doubt that our doctors are aware of this common truth, but the Isoterra certainly is. The sta members help us to remove pressure by socializing, lecturing, listening to music. Volunteering students talk to us (it is essential, isnt it?), conduct classes. My hobbies are embroidering, carving on wood, writing poems. My drawings have been exhibited in Moscow and Germany, illustrated our collection of poems In the prime of life. When feeling low, I comfort myself: Our Savior would never try us beyond measure. Dear
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The club hopes

readers! Dont drift, but act. Hope for the better, resort to your familys and doctors help. Work for rehabilitation and youll succeed.
Luba Pervunina (Yaroslavl)

Comment: a person in recovery has a wider scope of demands and, accordingly, faces more challenges. To provide follow-up support a patients family and professionals should work hand in hand. This quotation seems to deal with convalescence problems: After removing his hunch and straightening up, the young man had his heart in his mouth. Having become taller, he discovered quite an unfamiliar world, revealed new horizons. But most shocking was the fact that he, having always been the shortest of all the passers-by, appeared as tall as the others and-by gosh! even exceeded most of them in height. (M. Pavitch. The Chazar diary). Having joined the New Choices, which unites patients families and professionals, Luba has made her choice. Her great expectations must come true.

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A ray of light

My daughters illness lay dormant till the age of 13. In the 6th form she developed learning diculties, refused to get up in the morning, crossed her grandmother. We accepted this with understanding: Teen age is a troubling time. And a typical teenager she seemed, moody, intractable and isolated. In the 7th form my daughter often cut classes and eventually dropped out of school. Her behavior deteriorated day by day: she became irritable, aggressive, wandered about the city all night long and, nally, attempted suicide. What next? She was hospitalized by force 2-3 times a year. Staying at home between hospitalizations, she behaved unbearably. We were hungry for information on my daughters illness, medication, side eects, but when we asked our busy out-clinic doctor for explanation, he looked as if we were wasting his time. The New Choices club has become our ray of light in the darkness. It provides socialization with other parents, making us realize that we are not alone in our misery, as well as information on medication, psychiatric and social therapy. A long-time neuroleptic has given three years of normal life to my daughter. Now she takes a new antipsychotic that does not screw up her eyes as a side eect. To enhance the New Choices eciency Id like to recommend the following: 1) to inform mental patients and their families of the New Choices facilities (the information may be given on the phone); 2) to employ mass-media for informing society of the New Choices activities to improve the public opinion of mentally ill persons as well as to attract sponsors and volunteers.
V.D. Koroleva (Moscow)

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The club hopes

The club hopes

I believe
17 years ago I sustained a severe skull injury accompanied with brain concussion and amnesia. The accident was followed by intense depression with suicidal ideas. I stayed in hospital for 5 months, and then was re-hospitalized with splitting headaches every year. The therapy hardly had any eect. I was referred to the 2-d disability group. At the same time, I began writing poems. I saw the verses in my night dreams, jotted them down at once and brushed up in the morning. In hospital, poems actually surged on me. A year later I got a bit better. My friend who had had crush on me since childhood did not turn me down in spite of my illness. We got married, and his support works miracles. I even entered the university and studied foreign languages for two years. Unfortunately, my illness took the upper hand, and I dropped out. During remissions I usually work as a receptionist. With my state pretty stable, I havent been near the hospital for 4 years and get long-term (depot) neuroleptic injections in my clinic. I feel happy that I have an aectionate, caring husband (he works as a TV operator). Eight years ago a big event took place: my cute daughter Mashenka was born. I socialize a great deal in the New Choices (I have pen-friends even in Canada). I believe that my illness will be relieved (unless completely conquered) and well live happily ever after.
Elena Nazarova, aged 33 (Tomsk)

Dollies
My daughter was discharged from hospital just on the Medical Professional Day. To commemorate the holiday I felt like doing something nice for the sta. What exactly? I could not aord valuable presents because to care for my ailing daughter I had given up my wonderful job (I used to design setting and costumes at the theatre). An idea ashed across my mind: long ago I was impassioned by making rag dolls. A part of my collection had been sold, the rest given out to my friends as gifts. I could hardly dig up the left-over: two jolly clowns. When I handed the toys to my daughters doctor, she exclaimed: Good for you! Now we can start art-therapy. First of all the sta brought rags and threads, while the head
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of our department donated some money to buy fur shreds. We called the art-therapy in the obsolete Russian style: posidelki(according to Dals explanatory dictionary, country folks get-together for needlework as well as for singing and chatting on winter nights). We displayed our funny dolls in the lounge for everybody to admire our patients achievements. Attendance is optional but vast majority of patients come regularly, especially young ones. We sit down at a long table, scatter pell-mell our strips of cloth, rope cut-os, pieces of fur, threads, pencils and paper and commence creating. The sta understands that creativity derives from havoc and does not mind the mess. Being discharged, the author usually takes his toy home as a keepsake: the birth of a rag mouth might have triggered o his recovery.
Olga Sh. (Saratov)

A good beginning is half the battle


How can you relieve depression? Try to fulll some easy task, e.g. go skiing or at least walk along the street: in case of succeeding, youll feel a winner. Suering from mental strain, splash it out onto the paper as a drawing. In particular, it is useful to draw cartoons making fun of your shortcomings. You may listen to soft music to get in tune for creating. Once I mentally composed a picture in all details but when transferred onto the paper it looked insignicant and bleak. Later I tackled the same composition in water-colors. This time the representation was utterly dierent: bright and cheerful. However, it disappointed me, for I had not managed to reproduce the image I had in mind even by 60%. In exasperation I would have thrown my picture out unless my psychiatrist had talked me out of it. Gradually I came to appreciate my creation. The small, neat church is a centre of gravitation for all the characters Ive depicted, no matter if they are at work or at leisure. I dont make much of my picture: any child can daub like that. But art makes my imagination run riot and it is so exciting. My mum said shed like to go boating along that shallow river. According to my dad, the river teems with rus and gudgeons. My uncle, a big shot, already commissioned a similar picture to hang it in his oce. As to me, I am somewhat less tolerant than my family. I think the picture implies that the author is autistic, withdrawn. Having run down my story, I see for
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The club hopes

The club hopes

myself that I havent recovered yet and still have a way to go. I wish I could work by profession: it is a pity to abandon it, having a 16-year working experience
Andrey Kolevatov (Kirov)

There is no gain without pain


Since childhood Ive been frail, backward and almost blind. My mum shielded me from life and after my parents death I feared people, as if apprehending danger. Nevertheless, a smart crook, having a way with me, cheated me out of my parents cozy 2-room apartment (with Mums abundant library and Dads musical instruments). Besides, my only friend moved to another city and I dropped out of work. Idle and lonely, I would lie in the wretched room I had got in exchange. In the end I decided to commit suicide but failed and was sent to hospital. After being discharged I tried to poison myself with pills, which resulted in re-hospitalization. I managed to escape from hospital to throw myself

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under a tram. After this futile attempt I was led as a disabled person. Working for a while in a labor therapy workshop, I began socializing, trusting people. Unfortunately our workshop got ruined and I was nonplussed again. Luckily I came across the Isoterra club. Ive been attending it for 2 years. In the afternoon we have a good chat over a mug of tea. I adore Antons stories about his pet snakes. We learn to give vent to our feelings through drawing. What else do we do? We model, paint wooden toys, make rag dolls. In the frame of the art project Dierent we go to exhibitions, frequent the Art museum. We stage musical and dancing

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The club hopes

The club hopes

performances under the direction of volunteering students. A collection of our poems In the prime of life has been published. Creative activities and exciting acquaintances make me oblivious of my ailment. All mental patients are welcome in our club to develop their potentialities.
Elena Chevskaya (Yaroslavl)

Comment: realization that you are lonely and not needed by any living soul makes you poor in spirit mother Theresa said. Elena has become richer than many healthy persons

Things look promising


Every patient should nd a way out of the vicious circle of his illness. When oered art therapy, I felt a bit dident. However art classes enable every person to gain condence. Without being humiliated, we are mildly criticized in class so that we should distinguish the problem and solve it by ourselves. Stress is never laid on the art value of our drawings. The main thing for our group members is to create, talk over the drawings as well as just see each other. Unlike my superior at work or my family, my art tutors and my fellow-students never reproach me for being non-standard. I dont feel a black sheep any more. Art therapy makes everybody tolerant, helpful, open-minded. If art therapy so obviously improves mental patients, I can imagine how ecient it can be for solving healthy peoples problems. Art classes relax me, remove weight o my mind. I feel a dierent person.
Nina (irov)

Through snowstorm
I worked as an accountant by several computer programs. Unfortunately I am out of profession now and live on the disability benet. Due to skiing and jogging I used to be slim and supple in spite of osteochondrosis, swollen thyroid and vegeto-vessel dystonia. By now Ive put on weight, become apathetic. 5 years ago a real disaster took place: my only son was stubbed by a scum. Though grief-stricken, in the long run I pulled myself

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together and came to the Isoterra club to draw, knit and mingle with my fellow-suerers. My ecient therapy eases the load I carry. Though a chain-smoker, I am on the point of giving up smoking. Residing with my mother in our own house, during my remissions I cook, clean, work in the vegetable garden. My sisters always stand by me, and I, in my turn, teach my nephews to draw. My drawings have been exhibited in Yaroslavl and Moscow. We also frequent professional painters exhibitions. Once, in December, my club- mates were delayed by snowstorm and I was the only one to show up in the art gallery. However it did not put o the guide and she conducted a tour especially for me. I took it as a token of attention and respect for our club. You mustnt let depression suck you in, you ought to resist, emerge and lead a normal life.
Galina Korzin, aged 46 (Yaroslavl)

Comment: it is great that Galina applies her skills both at home and in the club but time is ripe to nd some easy job. The next stage in Galinas gradual transition to the social world might be work by profession.

Sunny again
Every year aggravations of my chronic disease kept me away from work for a few months. Appreciating my conscientious approach, the superior used to put up with my absences. Eventually a new chief took over and I was red. Living on the disability benet, I failed to get adjusted to my idle, sluggish existence. After my grandmothers death I utterly went to pieces, remaining face to face with my ruthless illness. LuckOvercoming

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The club hopes

The club hopes

ily I took the rehab course in the psychiatric neurological clinic. I made friends with other patients, we sang, chatted over a cup of tea. For our holiday performances I sewed costumes, made settings. I played the part of the Snow-Maiden on the New Year eve, acted as a host for our amateur concerts. I felt happy and as good as healthy through creative activities. However it was the membership in the New Choices club that had a huge impact on me. I signed in for 3 classes, took up dancing, organize excursions, write for the Orthodox news column in the New Choices newspaper. Due to my exuberant activities I was sent to the Moscow New Choices conference, obtained a lot of information there, got in touch both with patients and with professionals. To exclude hospitalizations I am determined to adhere to the treatment. Its worth the trouble. My life is exciting now.
V. (Ryasan region)

Comment: Vs and Galinas stories are alike. Active by nature, both of them extricated themselves from the clutches of disease and found a breathing-space in the club. Fortunately V. realized that therapy stipulated recovery. A quotation from Hippocratus says that pain stimulates treatment. Yet carrying on with treatment till achieving the ultimate outcome is up to the patient. To persevere with this monotonous part is more dicult than with the part of the Snow-Maiden. Persistent therapy, socialization, creative activities are sure to result in re-integration into society.

My ambitions
I appreciate optimistic people, read psychology, have a poetic gift. Besides, I am in on-line correspondence with American and Norwegian professionals. Thanks to my activities I was delegated to the conference in Norway. What about my plans? Well, I mean to interview creative persons, participate in the creative festival Lets have a heart-to-heart talk, have a solo album recorded. My main ambition is to make an expert in art therapy to guide my fellow-suerers to self-cognition and improvement through arts.
Levana, aged 26 (Stavropol)

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Comment: not only does Levana appreciate optimistic people, but she is full of spirits herself. With her experience in ghting with disease she is sure to become an excellent art-thrapeutist.

I am pressed for time

At 21, I began ailing and indulging in regrets. Now I am too busy to be sorry for myself. For 20 years Ive been married to a mentally ill person. Being twin souls, we enjoy utter harmony. We had a pet dog for 14 years, now it is a Siam cat that relieves our loneliness. Though unable to work and on medication, I dont feel actually sick. I am on excellent terms with my family and friends next door. How come that I am doing well for myself? Since 17, Ive been working for rehabilitation. Bit by bit I brought the situation under control. I repeat to my Edelweiss club-mates: Never lose heart, model your life actively.
Galina Zenkina, aged 47 (Orenburg)

Comment: Galina is not a sort of person to accept her disease humbly. In spite of her (temporary?) restrictions shes got integrated into society. Her resilience sets a good example. There is more to it: Auntie Galinas tales are being published in the Orenburg patriot newspaper

Not so different
For me, drawing has always represented happiness, discovery and punishment. I see happiness as creating, discovery as noticing intangible things, punishment as craving for perfection but failing to achieve it.
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The club hopes

The club hopes

My favorite images are light, space, air. I make a point of catching the correlation and peculiarities of components building reality, integrating magic and everyday things. I dream of interpreting sounds and feelings by color and shape to impress the viewers with the eternal mystery of life. I practice drawing mainly to get in touch with people. We are so different that we suer from misunderstanding even speaking one and the same language. When words are impotent, it is worth looking at a picture in silence. To create life or to save somebody from death is beyond my power in this world. Yet, I can draw my own world where everything depends on me. My world is fragile but the real world is not so stable either. Though looking illusive, my world is an ingredient of reality and similar to the worlds of people loving, suering and rejoicing all over the globe. Might we be not so dierent after all?
Svetlana Sivkova (Sankt-Peterburg)

Love yourself
With acute psychosis I used to hate my name. However when my doctor pronounced Maria my name sounded so melodious that I accepted it.
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How do I cope with disease? Being a nurse by profession, Ive always been aware of my organic brain defect. Feeling under the weather, I lie down listening to music, have a nap, take a pill. I am hand and glove with Mum, we need each other. But thats the Isoterra club that really resolves my issues. Under the guidance of a psychologist we transfer to the paper our mood, weather, etc. in color and shape. The image of the Holy Mother for the hospital chapel is our team work. Besides drawing, we talk over our health and everyday problems during the tea break, walk, barbeque out of town. There are close links with other clubs for disabled persons: we visit each other, hold joint events. Having a number of hobbies (beading, knitting, making toys), I try to do things whether I am well or unwell. Yet some time I yield to depression. Occasionally I, on the contrary, feel extremely active, but my euphoria is eeting. The Isoterra teaches to handle such uctuating mood, get rid of obsessive ideas. I take pains to be of use for my club-mates. For example, Vasili has nothing to say for himself and when he manages a distracted smile in response to my banter, I feel as pleased as Punch.
Maria Shianova (Yaroslavl)

Comment: it is common truth that to love others you should rst love yourself. By realizing that others need her and patronizing her weak club-mates, she regains her self-esteem.

Paper walls
15 years ago having failed to nd a goal in life I decided to cut it o and took poison. Nevertheless, scared of death at the last moment, I called the ambulance. All in all Ive had 8 hospital admissions. It did not take
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The club hopes

The club hopes

me long to realize that hospital was a safe, livable place as compared to my family nest, and I actually asked for hospitalization. All kinds of misfortunes occurred between hospitalizations: I pinched whatever came handy, slept in a doorway, got battered by police. How come I found myself in the Pierro art studio? 10 years ago I had no itch for art activities at all, but just preferred to while away time in hospital through drawing rather than lying in bed. Unexpectedly I enjoyed the free and easy environment in the art studio, felt valued, quite in place and even irreplaceable. Sure, things did not go smoothly: I made blunders, dealt with conicts but in the end I won. Rejecting therapy might be unreasonable yet I hate being stunned with drugs. No denying there are a lot of mental patients who adhere to therapy helping them to recover. As to me, to rehabilitate I rely on club activities. Our art studio was set up by the local youth newspaper, which does not care about us any more. But our creative club for young people is thriving. Visitors ood our annual exhibitions in Kaliningrad, Moscow, Hamburg. Our studio and the Association for mental patients families have merged into the Ariadnas clue public organization. I represented the organization at the club workshop in Poland. At rst I felt ill at ease in a foreign country but it worked well after all. It was funny when my pictures name The blood song was misinterpreted into Polish as The cow song and a local zoologist, being intrigued, photographed it. Where else have I been? To begin with, Ive not been to Peter yet, and they say, it is unsurpassed. I sometimes go to Moscow: it reminds of a huge ant-heap, doesnt it?
Sitch (Kaliningrad)

Comment: it brings to mind a quotation from Mayakovski: To die is no problem. It is a problem to live. Seeking (consciously or subconsciously) a way of making up for our imperfection is intrinsic in our deeper nature. With deadlock compensation a person gives in and secludes himself within his illness as if having retired to a convent. Our authors, with positive compensation, develop: learn, stumble, adhere to therapy, transform. For some of them club membership, excursions and socialization with their fellow-suerers is a breakthrough; for the others it is just the rst step on the way towards complete recovery.

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The club hopes

Life with and without mental problems


Impossible is just a big word shielding small people. Impossible is a chance to show ones worth. Impossible is not a fact but opinion. Impossible is not a verdict but challenge. Impossible is not forever. Impossible is possible.
M. Pavitch

A psychiatrist wonders what the illness looks like from inside, what a patient experiences. Thus a professional spares plenty of time for listening to his patients life story and description of his suering. No doctor can adopt his patients experience directly but he can imagine it and show empathy. About 30 years ago a famous professor arrived in a mental hospital as a consultant. When a sta member describing his patients mental problems had no idea what the latter preferred for lunch, the professor (coming from a doctors dynasty and grown up in an out-of-town mental hospital, among patients) remarked reectively: As to us, we used to walk with our patients and talk to them. For ages, patients stories have been considered dubious because the medical science should be based only on facts. Even Z. Freud himself supposed that his description of
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medical cases had nothing to do with the serious science. A psychiatrist has no doubts about the acute phase. But how can despair, damage, hope, grief, anguish be measured? These characteristics of a mental illness are often protracted after relieving acute psychosis. A patients rst-hand knowledge and the scientic medical history should co-exist supplementing each other. The up-to-date medical science takes into account not only explicit symptoms but also a patient evaluation of his experience. Thus English and American authors distinguish symptoms(a patients subjective sensations) from signs(obvious for a doctor). The confessions of the better sort show to common mental patients that everybody is vulnerable. Along with creative persons (Dostoevsky, Tolstoy, Maupassant) some psychiatrists also suered from mental problems. For example, Vasily Kandinsky in the classic monograph On pseudohallucinations considered his mental history. The mental illness was brought about by overstrain aggravated with alcohol and drugs. Early psychosis was manifested by insomnia. Kandinsky explains his depression as follows: My distress was caused by unfavorable life conditions, professional failures, problems in private life and, nally, realization of my illness and its likely consequences, e.g. dementia. Combination of the subjective (qualitative) and objective approaches contributes to understanding of psychotic experience as well as nding the best way of overcoming the illness. Every year 83 million depression episodes occur and each one involves a human being in anguish. Thus the writer V. Garshin, after throwing himself from the top of the stairs, pointed not to his broken leg but to his heart: It aches here. Not long ago professionals, neglecting mental patients experience as far-fetched and of no value, took their descriptions with a grain of salt. Up-to-date psychiatrists, on the contrary, estimate progress by the patients stories (a convalescent is coming into the open). Some professional would wonder if a mentally deranged person is able to describe his symptoms, discover the causes of his illness or evaluate his progress towards recovery. However it is the healthy part of the patients self explaining the disease to protect the patient from the sickly chaos. Certainly, such descriptions, though gurative and expressive, lack in accuracy. A psychiatrist is obliged to explain to his patient and family why the patient is so confused, scared, etc. to provide feedback determining successful therapy. According to our authors, a patient gets better through acceptance of his previous experience as valid with early relapse and especially with remission (relieved symptoms) rather than with acute psychosis. Our authors descriptions of their feelings and
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A long way to recovery

A long way to recovery

everyday problems defy the accepted conceptions concerning emotional deciency, social alienation in chronic patients. Unlike potentially irreversible deciency, curable depression is marked by helpless, hopeless sensations as well as sense of humiliation. Thats where a competent professional comes in, seeing his patient as a personality and partner. Our authors stories show how their self has been re-built, straightened up. When narrating, a patient teaches, learns, listens and hears. Even non-smiling patients should be persistently urged to tell their clubmates about their problems. Our authors experience in handling their symptoms is worth adopting by psychoeducation groups. The relatives excessive emotions, over- involvement can cause relapse. Thus, a psychiatrist as well as psychologist should discuss and gently control his patients family relations. Evaluating the eciency of psychiatric aid, patients emphasize reduction in hospitalizations, adequate therapy (especially if previous medication was characterized by adverse side-eects), empathy. Relieved symptoms are not highlighted (improvement is often explained by strong will or just good luck). A patients self is re-built through assuming responsibility for his fate, regaining self-esteem, interest in life. The restoration, manifested by social and professional contacts and a reasonable approach to therapy, is the central feature of recovery. Ecient treatment determines the life quality (a person in recovery is at peace with himself and with people surrounding him) and adequate selfevaluation. Meanwhile a number of patients achieve a considerably high life quality because they demand very little and accept life humbly. Neglecting a patients experience is derived from ignoring his personality. Patients complain of a formal approach in psychiatry when a patient is just dosed up with drugs. Such a simplied approach would never lead to rehabilitation. A psychiatrist should collaborate with his patient selecting adequate therapy without adverse side-eects. Another function of his is to instruct the patient and his family in spotting early relapse to avoid re-hospitalization. Public associations for mental patients and their families encourage mental patients to retell about their recovery stressing the restoration of their self. Mental patients reports on adjusting themselves to the ailment, conquering it and overcoming stigma have become cornerstones of the international movement for recovery. Daniel Fisher, a psychiatrist and the head of the US national rehabilitation centre, said: I got over schizophrenia. It might sound incredible due to the myth that schizophrenia is an incurable, life-long aection. This false conception secludes millions of people stigmatizing them as mentally incapacitatOvercoming

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ed. Recovery is represented as an active life position, assuming of responsibility, re-integration into society and is based on the assessment of the personality and background, socialization, acknowledgement for support, everyday life achievements. Hope and Doubt are in eternal collision. And if our reader, after weighing his chances, makes an eort for recovery, our book was worth publishing.
Evgeny B. Lyubov, the Moscow Scientic Research Psychiatry Institute.

We dont live in vain if we make friends and love, work and create.
Your New Choices

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contents

3 4 5 6 24 28 36 46 58 74 78

The message, carried by our book Abstract Introduction A long way to recovery A midful doctor We ve found shelter Being begins with doing Mothers heart is an inex haustible sourse of miracles The club hopes Life with and without mental problems We don t live in vain if we make friends and love, work and create