Now that I have tried to explain just what is Anosognosia in my last two blogs and how to cope with these periods of behavior that will surely creep up from time to time whether you have Bipolar or know someone who does, let's look at what needs to be done after the period has passed.
Because Anosognosia results in some type of reckless or extremely "unusual" behavior or risk taking, and because individuals with Bipolar rarely take responsibility for the period of Anosognosia, your plan of action should include the spirit of forgivenness on your part.
As far as the person with Bipolar who experienced Anosognosia, hopefully he or she will be remorseful and work hard to correct their contributing behaviors. However, keep in mind up front that a period of Anosognosia can include memory loss, too. This means a person who experienced it, may not remember doing certain things or saying certain things. This is how embarrassment and shame factor into the stigmas associated with mental illnesses ("Crazy"). Part of the reason for this is that the mind will simply force such experiences into File 13 because the emotion of embarrassment or shame or humiliation is too great to deal with at the time. It is like an emotional safety net.
So, let's look at forgivennes. Each of us should be compassionate about mistakes our loved ones make in life and not judgmental. We should be able to forgive and move on. Especially if it is 'spilled milk.' Of course, this is easier said than done if a person with Bipolar has caused you legal expenses, physical harm, etc. and I am not talking about serious criminal behaviors.
The first thing YOU have to do is get your own anger in check. Take all the time you need, but do not approach the individual with Bipolar with verbal assaults, blamings, accusations, etc. These are emotional triggers for both of you and result in negative outcomes (i.e., stress, high blood pressure, headaches, etc.).
The second thing you can do is discuss the behavior with the individual in a very passive way judging with instinct when is the best time to breach the subject after the individual has stabilized. My recommendation is to use Reflective Statements.
Let's take a step backwards and refresh our memories about Reflective Statements. These are strategies taught by the National Alliance on Mental Illness (NAMI) that teach family members how to:
1) Acknowledge the reality of the situation;
2) Direct it to the individual's feelings (not yours); and
3) Communicate your understanding of the situation.
Now, to employ those strategies if a person has created a scene in a store and security had to be called (hypothetical), when all the dust has settled and the person is stabilized, tenderly bring up the situation that resulted in you bailing him or her out of jail by beginning with a Reflective Statement such as,
"I know how upset that cashier must have made you when she would not take your check." (Remember, in the previous blog post, bounced checks was an issue).
Then tenderly direct the conversation so that the individual's feelings are the focus. An example could be: "It must have been embarrassing for you and it is alright that you felt that way."
Next, you want to "disconfirm" the negative reaction such as, "However, I think you did a good job when you stopped arguing with the cashier and asked the Security Officer to call me. I got there as soon as I could." Now, this is the ideal time to discuss a "better" plan without making the individual feel totally at fault and be willing to learn a new, positive pattern of behavior (i.e., avoid beligerent behaviors).
You can also discuss with the indivudal how maybe writing a note to the store can improve customer service in the future and slip in an apology. Be creative!
Of course, if your loved one has no recollection of the event or flatly denies any responsibility for the situation, do NOT harp on it. Forgive them and move on. There will be opportunities for you to always discuss positive behaviors so you should pick and choose your battles very carefully or you will be forever stressed out.
When the Anosognosia has passed, ask yourself "Is it worth it to bring it up again?" The wrong thing to do would be to argue with the individual over spilled milk, take his or her opportunity to shop away, blame them every day for your financial burdens due to their behavior. Expect success overnight. This will be a process and patience will be necessary.
In the event a true catastrophic event happened involving Anosognosia (serious recklessness), remember your family member needs support, comfort, empathy and especially if he or she is confused which can easily be the case. In this type of situation, please contact your local NAMI organization or Crisis Intervention Program for more detailed, professional help or follow the advice of police no matter how painful it is on the surface.
Lastly, in stressful situations, both you and your loved one need to learn how to cope and manage with skills that work the best for both of you. Only you two can decide with professional guidance what those coping skills turn out to be. Anger, guilt, resentment, grief, are all real emotions that cause stress!
Talk to your doctor about brain disorders and
Visit NAMI at:
www.nami.org Visit American Association of Pastoral counselors at
www.aapc.org Agnes B. Levine
Founder/President, Levine-Oliver Publisher
www.levineoliverpublisher.com, Facebook me!
Agnes is also the Author of the book, "Cooling Well Water: A Collection of Work By An African-American Bipolar Woman" (ISBN 13 0-978-9754612-0-4. Available for sale now at
www.levineoliverpublisher.com or
www.amazon.com. This Collection of Work tells my story of becoming diagnosed with Bipolar and learning to cope and manage the brain disorder to live a life of purpose, peace, and happiness.
Posted By: agnes levine
Sunday, April 5th 2009 at 4:57PM
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