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No One Knowns For Certain How Much Impact They Have On The Lives Of Other People. Oftentimes, We Have No Clue. Yet We Push It Just The Same . Jay Asher

Pammy was able to function well and live independently with the support of her sister. Yet, loneliness and yearning for proper friends had been her constant cry. Pammy had little to no contact with the rest of the family, and this quote perfect described her situation.

People look at me with fear, not empathy, when I tell them about my diagnosis. And although I have scars—emotional and physical ones—from this disorder, I do my best to hide them. After all, the doctors say I’m functioning just fine”.  (Syrena Clark, 2016).

Stressful Environment As A Contributing Factor

The book did not shed light on the possibility of where Pammy’s illness might have originated, although the cause of schizophrenia is still a mystery to this day. But according to Biological Theories, “Research has identified two sources of constitutional vulnerability: gene factors and environmental factors…illness can be inherited” (Maddux & Winstead, 2016, p. 324). Pammy and her sister grew up in a stressful environment due to their father’s high expectations.  When Pammy was relieved that Carolyn was accepted to Harvard Medical School, she reported, “I couldn’t do what you’re doing. Your going takes the burden off of me” (Wagner & Spiro, 2005, p.145). Pammy seemed to be under great pressure to meet and keep her father’s high standards and expectations for her future.

Photo by Stefano-Pollio on Unsplash

 Also, the Diathesis-stress models suggest that “The interaction between vulnerability and stress is critical” (Maddux & Winstead, 2016, p. 318). Although the book did not talk about the twins family history, which could shed light on whether there was a possible “illness inheritance.” There were a few signs of a stressful atmosphere in the household or rather the relationships with the twins and their parents. The twin’s father in one incident had Pammy’s “head under the faucet, soap in her mouth…after threatening, swearing, slapping, thudding, kicking her” (Wagner & Spiro, 2005, p.22).  This was the only incident of abuse reported and the longest interaction between Pammy and her father.

Pamela & Her Father’s Turbulent Relationship

There was no form of communication or interaction stated in the book between the two after Pammy’s first hospitalization until toward the end of the book more than 30 years after.  Pammy experienced deep depression most of her life, and then met the full criteria of a schizophrenia diagnosis.

Suicidal Thoughts & Effects On A Person Living With Schizophrenia

Pammy was very suicidal and had hurt herself on countless occasions by cutting her wrist or arm or burning herself with a cigarette. According to at least one study, suicide is one of the main causes of death among patients suffering from schizophrenia and luckily Pammy was not among the 4-5% with successful attempts (Maddux & Winstead, 2016, p. 331). Pammy was able to survive her illness partly because of the support of her sister Carolyn. According to Professor Saks, “With proper treatment, someone who is mentally ill can lead a full and rich life. What makes life wonderful – good friends, a satisfying job, loving relationships – is just as valuable for those who struggle with schizophrenia as anyone else” (Saks, 2007). Pammy had a few faithful friends who stayed by her side: Mariah, Marcia, Selden, and Bryce. Pammy also enjoyed her job as a poet, and as a writer, she won numerous awards. She has proven that people who have schizophrenia can still live a full and meaningful life with the help of pharmacology, good relationships, and psychotherapy interventions

Photo by Eva Blue on Unsplash

Treatment of Schizophrenia (Mental Health In General in the 1960s and the 1970s)

 The book also shed light on the backwardness of the treatment and the awareness of schizophrenia among mental health professional. The terrible side effects of the medication Pammy experienced was undeniable and hard to believe.

Prolixin Injections & Clozaril – Side Effect Experienced By Pamela…

 She was taking chlorpromazine and Prolixin injections, along with Parnate (which required a special diet). The side effects of Parnate and Prolixin were horrible. Pammy spent many sleepless nights, weak and underweight. She was later started on Clozaril after FDA approval in the United States. On Clozaril, Pammy started to gain a lot of weight, had sleep problems, dry mouth, and drooled every night. As shown in this study the side effects of Clozaril “57 centers in the USA, involving 1493 patients, demonstrated that SGAs like clozapine and olanzapine led to significant weight gain and caused metabolic side effects” (Cetin, 2015).

During this time, psychotherapy was not a major factor in treating schizophrenia, and problems with this approach are clearly seen in Pammy’s situation.

The Cruel Treatments Of Patients Psychiatrist Hospital – In 1960 to 80s

Photo by Jan Jakub on Unsplash

Pammy also helped the readers understand and somehow feel the cruelty that was going on among psychiatrists and nurses who administered treatment to patients as if they were less than human. Pammy accounted that “Doctors think agitated patients are so overstimulated they need solitude” (Wagner & Spiro, 2005, p.214). She was restrained and put in an isolated room because, when she was terrified, she lashed out in misguided ways of protecting herself from whatever danger she perceived.

“During the age of the use of FGAs; physicians were still more inclined towards an attitude of omnipotence with less regard for patient’s understanding, assuming that all problems would eventually be solved pharmaceutically” (Cetin, 2015).

In 2003 Pamela underwent electroshock therapy, which seemed to be relatively successful in preventing suicide at the time the book was published.

I like Pamela’s story because it is a story of hope, perseverance, courage, and survival. She fought to survive through the thick and thin. She found what gave her meaning in life and that meaning held her throughout her struggles. Writing gave Pamela a voice, and this voice overshadowed every other voice speaking in her head. When her self-talk became more positive than negative, a new light brightened her darkest moments. With new treatment of schizophrenia and talk-therapy, there is hope to combat or eliminate the symptoms of schizophrenia.

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