User:Scarpy/Schizophrenics Anonymous

1964-1985
Schizophrenics Anonymous was founded on October 15th, 1964, at University Hospital in Saskatoon, Saskatechewen.

SA has also undergone fission, with Cleveland group establishing itself as Better Health, Inc. And Incthere are other organizations on the periphery of this movement.

Schizophrenics Anonymous had its first meeting in Canada in 1964. A man using the pseudonym of Gregory Stefan, who had been in and out of mental hospitals, went to an AA meeting and happened to meet there two people who were not alcoholics:

I told them I was not an alcoholic either; that I was a schizophrenic. They replied that they were also schizophrenics, but that they had found something in AA that they had not found in any other group: this spirit of fellowship. It had given them a place to come twice a week for social contacts and friends.20

On October 15, 1964, eight schizophrenics met with Abram Hoffer, director of psychiatric research at the University Hospital in Saskatoon, Saskatchewan. Gregory Stefan had brought these people together after the encounter at the AA meeting. According to Hoffer, Stefan was thinking: "If it does this for alcoholics, and these two schizophrenics, why don't we have a similar organization for schizophrenics?"21 At the first meeting, Hoffer was present; after that, he "refrained from attending meetings, having informed the group that they would be on their own."22

Then there are the twelve steps of SA, starting with the admission that the person was powerless over schizophrenia, and followed by eight traditions. They end with the assertion of anonymity as their spiritual foundation. 24

Like alcoholism, SA maintains, schizophrenia can be arrested, but despite the use of the word cure, one is constantly admonished never to go off vitamin therapy. And certainly do not rely on psychoanalysis, dismissed by one of the leaders of a New York group with the rather flippant remark: "SA is not concerned with our members' past, but with their future."

The basis of the SA approach to aiding schizophrenics is chemotherapy (and especially the use of vitamins) combined with some measure of self-help. For any member to question the efficacy of vitamin therapy is a form of heresy. All the honest and valid answers known on schizophrenia have been obtained by a handful or doctors or whom SA members are the true followers.27

It was a banding together of lonely people. As stated by Stefan: I am especially keen on this idea of Schizophrenics Anonymous. Schizophrenia is a very lonely disease; an intense feeling of loneliness was the most common complaint I heard from fellow schizophrenics.23

Schizophrenics Anonymous denies the definition of schizophrenia as a split personality. "It is a biochemical disease which upsets body chemistry... and is characterized by (1) changes in perception such as seeing, hearing, tasting, etc., (2) difficulty in judging whether these changes are real or not."24 Its cause is clear: biochemical changes which lead to the production of toxin materials prevent the brain from working normally. But there is a cure: "The niacin therapy is a successful treatment."25

Every new member is given a test (known as the HOD test, after Hoffer, Osmond, and Desmond, the men who initiated it), to determine if he is schizophrenic. On cards, the test lists such statements as: "Sometimes I find myself talking inwardly to myself"; "Sometimes I have visions of God or of Christ"; "Sometimes the world seems unreal"; "I often hear my own thoughts outside my head"; and "I hear my own thoughts as clearly as if they were a voice." The individual places the cards in a true or false pile, and each affirmative answer entitles him to a given number of points. A high score means that he is a schizophrenic, a low one that he is normal.

At one meeting, a woman asked, "What if you feel that you have some problems similar to those discussed here tonight, but you got a low score, say only nine points, on the HOD test?" Immediately the group leader took the floor. In a ringing voice of denunciation, like a fire-and-brimstone preacher, he told the woman that she had probably lied to herself and to the examiner when she took the HOD test. Therefore she was even more schizophrenic than the others because she could not recognize her symptoms. She'd better get into the program and start taking vitamins mighty quick.

When I pointed out to one of the best-adjusted people present that the leader seemed to be too ill himself to give therapeutic advice, he smiled as if I had complimented the group. "Of course," he said, "that's just what qualifies him. He's a real schizophrenic!" What seems to have been lost in SA's effort to emulate AA is a differentiation between role models in the two forms of disability. An alcoholic need only stay away from drink to be identified as arrested—perhaps a superficial standard, but one that does provide legitimacy for the role he assumes in seeking to aid the newcomer who might still feel uneasy about his ability to overcome the bottle.

However, the degree to which a person formerly depressed, paranoid, or in other ways suffering from mental illness (schizophrenic or other) is now functioning in a less self-defeating manner is not so easily measured, particularly by untrained laymen who may be more distressed than he. Thus in SA, as in many other groups, there is the almost inevitable problem that the persons giving advice are not only untrained and ill-prepared for that function, but that they may advise out of their own needs rather than those of the patient. That this problem is to some extent true of the trained professional cannot be gainsaid, but it is a shortcoming not inherent in his being professional; on the other hand, it does inhere in the very condition of mental illness. It is indisputable that the leader of a self-help group all mentally ill persons acts as a therapist; this is not the less true whether the people have been diagnosed by others or by themselves, or whether they are under the care of professionally trained persons or are receiving no such aid. But when these leaders are extremely ill, as is often the case, one is reminded of the words of Gregory Stefan: I believe that a therapist must always be stronger and healthier than his patient; for in this critical confrontation, either he succeeds in lifting the patient up to his level or the patient may well drag him down. The stronger of the two personalities— whether it is healthy or sick—is likely to win out.28

SA's Cleveland chapter has recently disassociated itself from the parent organization to become Better Health. Inc.29 While there seem to be some programmatic differences between the groups (Better Health has condensed the twelve steps of SA, and has revised and adapted the eight traditions, now called ten guidelines), the suspicion continues that disassociation represents the same port of fission found in the homophile movement: a struggle for hegemony, leadership, and power leading to the search for programmatic differences, rather than those programmatic differences in themselves leading to a new, Land necessary, regrouping of forces.

20. John Ralph McDonald, "Schizophrenics Anonymous: An Experiment in Group Self-Help" (master's thesis, St. Patrick's College, University of Ottawa, 1967), p. 36. The passage quoted is from a taped interview of McDonald with Abram Hoffer, in which Hoffer is quoting Stefan. 21. Ibid. 22. Ibid., p. 39. 23. Gregory Stefan, In Search of Sanity: The Journal of a Schizophrenic (New Hyde Park, N.Y.: University Books, 1965), p. 232. 24. "Introducing Schizophrenics Anonymous International," booklet, n.d. 25. Ibid. 26. Ibid. 27. The two men whose theories are most closely followed are Abram Hoffer and Humphry Osmond. Hoffer, director of psychiatric research at the University Hospital in Saskatoon, Saskatchewan, and Osmond, director of the Bureau of Research in Neurology and Psy- chiatry of New Jersey Neuro-Psychiatric Institute, have collaborated cm a book, How to Live with Schizophrenia (New Hyde Park, N.Y.: Uni- versity Books, 1966). Hoffer is also author of Niacin Therapy in Psychiatry (Springfield, Ill.: Charles C. Thomas, 1962). 28. Stefan, In Search of Sanity, p. 234.

Flint
Another counseling support recommended specifically for individuals with schizophrenia is the self-help group (Bhanji & Tempier, 2002). A study (Salem, Reischl, & Randall, 2002) of the self-help group Schizophrenics Anonymous (SA) looked at member engagement and change brought about by participation. Salem et al. found that individuals with schizophrenia who participated in Schizophrenics Anonymous group activities were able to adopt a proactive role in managing their illness. The study revealed that 1. SA serves individuals with schizophrenia who live independently, in supervised settings, and those residing in mental health institutions. 2. participants view professionals as the best equipped to help them with medication and symptom management, but view fellow SA members as best equipped to help them with feelings of loneliness or to talk to someone who understands. 3. participants have a sense of identification with other SA members that they do not feel with their primary therapist. 4. participants find SA helpful when they feel a sense of identification (referent power) with other SA members and believe fellow members and leaders have valuable knowledge and expertise (expert power).

5. the majority of members report that attending SA has helped them manage their symptoms, increase their knowledge of their illness, combat feelings of loneliness, make friends, and improve their social lives. (Salem et al., p. 2) A second part of the study found that SA participants had 1. decreased feelings of shame. 2. enhanced feelings of self worth. 3. addressed issues of stigma. 4. found a safe place in SA to talk about their illness. 5. developed more realistic expectations and new goals for themselves. (Salem et al., p. 4) Schizophrenics Anonymous provides a unique type of help in dealing with schizophrenia that members do not ordinarily receive from professionals or from other mental health organizations.

Salem, D. A., Reischl, T. M., & Randall, K. W. (2002). Schizophrenics Anonymous evaluation final report: Member engagement and change. Lansing: Michigan State University.

SCA, publish your conference proceedings please
Regardless of the specific mutual-help group, the information presented in a typical meeting may range from suggestions on coping with depression to methods of refusing heroin when risky stimuli are encountered. In Schizophrenics Anonymous, information is provided on managing symptoms, coping with interpersonal difficulties, recognizing the need to seek help from others, avoiding social isolation, and realizing that the disorder is caused by chemical imbalances in the brain and that, therefore, hallucinations and delusions should not be taken literally (Randall, Salem, & Reischl, 2001; Walsh, 1994)

Outside of Schizophrenics Anonymous meetings, members have few outlets to share their experiences of hallucinations, delusions, and hospitalizations (Randall, Salem, & Reischl, 2001), explaining why helping relationship-like discussions are among the most common activities in meetings.

Schizophrenics Anonymous includes a step that emphasizes reconciliation with others, stating that the recovering person should forgive and release anyone who has injured or harmed them in any way (Randall et al., 2001).

Randall et al. (2001) also argue that personal identity in Schizophrenics Anonymous evolves through the internalization of community narratives, which, again, are reflected in the individuals’ personal stories (see also Mankowski & Rappaport, 1995, for a discussion of personal and community narratives and the reconceptualization of cognitive scripts in mutual help).

Schizophrenics Anonymous who explained that it was only when she was able to release herself from feelings of shame and failure that she was able to overcome her resentment toward others who had harmed her (Randall et al., 2001).

1985-2005
Joanne Verbanic, the founder of SA

Schizophrenics Anonymous (S.A.) is a self-help group for persons who have schizophrenia or a related illness. It was founded in the Detroit area in 1985 by a woman with schizophrenia in conjunction with the Mental Health Association in Michigan. At present, approximately 40 Schizophrenics Anonymous groups are operating in the United States and Canada, and all groups are managed by persons with a schizophrenia-related illness. The official S.A. statement of purpose is as follows (Mental Health Association of Michigan, 1992): To help restore dignity and sense of purpose for persons who are working for recovery from schizophrenia or related disorders; 1. To offer fellowship, positive support, and companionship in order to achieve good mental health; 2. 3. To improve our attitudes about our lives and our illness; 4. To provide members with the latest information regarding schizophrenia; 5. To encourage members to take positive steps leading to recovery from the illness. Schizophrenics Anonymous is a recovery-oriented group with six steps, including: 1. I Surrender...I admit I need help. I can't do it alone. I Choose...I choose to be well. I take full responsibility for my choices and realize that the choices I make directly influence the quality of my days. 2. I Believe...I now come to believe that I have great inner resources and I will try to use these resources to help myself and others. 3. I Forgive...I forgive myself for all the mistakes I have made. I also forgive and release everyone who has injured or harmed me in any way. 4. I Understand...I now realize that erroneous, self-defeating thinking contributes to my problems, unhappiness, failures, and fears. I am ready to have my belief system altered so my life can be transformed. 5. I Decide...I make a decision to turn my life over to the care of God, as I understand Him, surrendering my will and false beliefs. I ask to be changed in depth.

Meeting format
The Schizophrenics Anonymous Group Leader's Manual (Mental Health Association in Michigan, 1991) includes a recommended meeting format which is followed closely, but not precisely, by the leader of the Franklin County program. Group participants gather in their designated church meeting room, and sit on folding chairs in a circle around two or three tables. The leader promptly calls the meeting to order, conducts a one-minute moment of silence, and then reads an affirmation chosen from the book Daily Affirmations (Lerner, 1985), originally written for Adult Children of Alcoholics. The affirmation is not always chosen for the specific date of the meeting, but may instead have special relevance to the group or a particular member on that day. Any references to alcohol or God as a specific being are omitted from the reading. Next, the leader asks all participants to introduce themselves by first name and diagnosis. Once this is done, he asks if there are any announcements. These are usually contributed by the professional facilitator, who informs the group about new educational resource handouts which the members may be interested in obtaining, upcoming consumer-oriented Mental Health Association or other community system activities, or any temporary changes that are upcoming in the church meeting room schedule. Some participants also share information about upcoming consumer events being sponsored in their treatment centers or neighborhoods. Finally, to end this formal portion of the meeting, the leader selects several readings from the S.A. program manual, including stories of founding group members who have benefited in various ways from program participation. Each member reads one paragraph from a selection and then passes to the person sitting next to him or her. No one is required to read who would rather not. The readings always conclude with the S.A.

Steps for Recovery and Guiding Principles. This entire portion of the meeting consumes approximately twenty minutes, with the remainder of the meeting reserved for member sharing. Shared discussion is the essence of this group, as Wetzel (1991) also found in a support group for persons with bipolar disorder. The meeting concludes with the Serenity Prayer recited by members standing in a circle with hands joined together. The Franklin County leader's format differs from that in the Leader's Manual only in the order of tasks and in not always including the S.A. preamble in the weekly readings.

Attendance / Demographics
During the 18 months from January, 1992 through June, 1993 the group averaged 9.3 participants per week. This figure does not include the professional facilitator, who attended 67 of a possible 74 meetings. The group became more well-attended over time. Dividing the group's duration into 6-month segments, average attendance was 7.1, 10.2, and 10.6 persons, respectively. A total of 46 persons attended meetings. Approximately two-thirds of the members who stated a diagnosis reported that they had schizophrenia, and the remaining one-third experienced schizo-affective disorder. Some participants declined to state a diagnosis or were not sure of the specific nature of their illness. Thirty participants (65%) were male and sixteen (35%) were female. Forty-two members (91%) were Caucasian and four (9%) were African-American. There were six members (13%) who participated in at least 75% of the meetings. An additional two members (4%) attended between 50% and 75% of the sessions, and these eight members comprised the core membership. Eight persons (17%) attended only one group, and ten other persons (22%) came for three or fewer visits.

10 persons (22%) attended at least 50% of the meetings for time intervals ranging from 12 to 56 weeks. That is, they were regular participants for limited time periods, eventually terminating their involvement for a variety of personal and situational reasons. Other persons, of course, had limited involvement for reasons not made clear to the group leader or facilitator.

A final note about attendance pertains to the group's policy on "visitors". This issue was not processed until the facilitator received the first of many requests from students and professionals to attend meetings as observers, generally for purposes of completing school assignments or getting exposure to a group process. The members unanimously decided to oppose anyone attending the group who did not have schizophrenia or a related illness (although only one dissenting vote was needed). One evening, a nursing student appeared with no prior notice and was very sternly asked to leave by several members of the group. Clearly, the S.A. members consider that the group is theirs alone and tolerate no violations of this source of support and privacy. The group did host two visitors from another county who were preparing to start an S.A. group of their own. Still, the members made clear that no professionals from that location should attend the meeting.

"Now we have come to the part of the meeting where each of us can share with the group how our week has gone, what is on our minds today, how we are dealing with symptoms, and what step we are working on. Everyone will get a chance to share, and please remember not to interrupt anyone in the process of talking. When it is your turn please make clear whether you want feedback from the group or just want a chance to talk. Also keep in mind that anything is permissible to talk about except sex, politics, or specific religious issues. Who would like to begin?"

From the content of the leader's introduction to member-sharing, two important characteristics of this S.A. group are revealed. First, while S.A. is considered to be a "step" program, it is so in a much looser sense than, for example, Alcoholics Anonymous. There is no expectation that members work through the six steps systematically; nor is there an expectation that they necessarily be addressed at all. Instead, the steps serve as an organizing framework for participants when sharing their personal material.

Secondly, discussions about religion, except in a broad sense of spirituality, are discouraged and even terminated by the leader or facilitator when they occur. It is this group's experience that some persons with strong religious preoccupations base all of their sharing on these ideas and attempt at times to dominate discussions by preaching their religious values to the others. This is rarely appreciated by the larger group and has been cited on several occasions as reasons why a member stops attending the meetings. Typically one or more group members will react negatively if a member persists in presenting specific religious themes. Participants are encouraged to recognize their spirituality as it pertains to finding or creating meaning, or a "higher purpose" in their lives, that goes beyond a preoccupation with the self. In many cases these commitments involve religious attachments (Lantz and Belcher, 1988). However there is a great diversity in spiritual orientation among the members, ranging from secularism to mystical religious fanaticism, and the leader has found that group cohesion is maintained when dogmatism of any type is prohibited. No one comes to S.A. specifically because of its religious theme as outlined in Step Six, and it seems beneficial in the Franklin County group to minimize attention to formal religion.

There has, in fact, been some open opposition to reading Step Six, which refers to "God, as I understand Him" during the meetings. Several members want to avoid the concept of God altogether, while others have objected to God being referred to in the masculine gender. Others choose not to recite the first line of the Serenity Prayer, which includes a reference to God. The group leader has been consistent in handling this relatively minor but ongoing controversy within the group about religion. He maintains that no one need accept the religious framework of S.A., but Step Six can be used as a framework for considering one's value commitments, whatever they may be. The member-sharing portion of the meeting has evolved in structure since the group's origin. One by one, in random order, members volunteer to talk about their recent daily challenges in living with schizophrenia. Because this S.A. group is 90 minutes long and consists of 9 - 11 people on average, each person shares material for approximately five to seven minutes. If a member is experiencing a particularly difficult time, he or she might share and receive feedback for up to fifteen minutes. The group leader ensures that each member is given a chance to talk, and it has become the facilitator's role to set limits if a member monopolizes time in presenting or giving feedback. Individuals are formally invited to speak only if the meeting is drawing to a close and they have not yet participated verbally. Participants generally invite feedback after they share, but the leader makes clear that if a person wishes to talk without comment from others (an option that is frequently chosen by members who are very sensitive to the impressions of others), this is permissible. Katz (1993) has also highlighted the important point that emotional disclosure is a supportive exercise even without feedback. New members are asked not to share at a meeting until they first observe several others in the process, so that they can become oriented to the group's norms.