acceptance

recoveringenabler

Well-Known Member
Staff member
Something I've learned about my daughter is that she lacks insight and/or the ability to perceive herself realistically, which in her case is likely a result of mental illness, a conduct disorder or whatever, but it is clear that her perceptions are often way off. With years of addictions your son's brain function is likely impaired in some fashion as well. However, we as their parents are not responsible for their perceptions.
 

recoveringenabler

Well-Known Member
Staff member
This is from NAMI:

Anosognosia
When someone rejects a diagnosis of mental illness, it’s tempting to say that he's “in denial.” But someone with acute mental illness may not be thinking clearly enough to consciously choose denial. They may instead be experiencing “lack of insight” or “lack of awareness.” The formal medical term for this medical condition is anosognosia, from the Greek meaning “to not know a disease.”

When we talk about anosognosia in mental illness, we mean that someone is unaware of their own mental health condition or that they can’t perceive their condition accurately. Anosognosia is a common symptom of certain mental illnesses, perhaps the most difficult to understand for those who have never experienced it.

Anosognosia is relative. Self-awareness can vary over time, allowing a person to acknowledge their illness at times and making such knowledge impossible at other times. When insight shifts back and forth over time, we might think people are denying their condition out of fear or stubbornness, but variations in awareness are typical of anosognosia.

What Causes Anosognosia?
We constantly update our mental image of ourselves. When we get a sunburn, we adjust our self-image and expect to look different in the mirror. When we learn a new skill, we add it to our self-image and feel more competent. But this updating process is complicated. It requires the brain’s frontal lobe to organize new information, develop a revised narrative and remember the new self-image.

Brain imaging studies have shown that this crucial area of the brain can be damaged by schizophrenia and bipolar disorder as well as by diseases like dementia. When the frontal lobe isn’t operating at 100%, a person may lose—or partially lose—the ability to update his or her self-image.

Without an update, we’re stuck with our old self-image from before the illness started. Since our perceptions feel accurate, we conclude that our loved ones are lying or making a mistake. If family and friends insist they're right, the person with an illness may get frustrated or angry, or begin to avoid them.

Anosognosia affects 50% of people with schizophrenia, and 40% of people with bipolar disorder. It can also accompany illnesses such as major depression with psychotic features. Treating these mental health conditions is much more complicated if lack of insight is one of the symptoms. People with anosognosia are placed at increased risk of homelessness or arrest. Learning to understand anosognosia and its risks can improve the odds of helping people with this difficult symptom.

Why Is Insight Important?
For a person with anosognosia, this inaccurate insight feels as real and convincing as other people's ability to perceive themselves. But these misperceptions cause conflicts with others and increased anxiety. Lack of insight also typically causes a person to avoid treatment. This makes it the most common reason for people to stop taking their medications. And, as it is often combined with psychosis or mania, lack of insight can cause reckless or undesirable behavior.
 

Weary Mother

WEARY MOTHER
wow, I will have to digest this. How then do I respond to him, thinking that he has some sort of inability to acknowledge his own behavior as I do?
 

recoveringenabler

Well-Known Member
Staff member
I think you continue telling the truth, setting boundaries, not allowing his perceptions to be YOUR truth. For me, that meant a lot of professional support.
 

recoveringenabler

Well-Known Member
Staff member
Your son may or may not have a lack of insight, he may have arrested development and be in denial, I don't know. However, whatever he is up to, it doesn't change our role, which is to stop enabling, stop allowing manipulation and guilt to drive us and to focus on ourselves. For me, once I got better at focusing on myself, a lot of it began to make more sense and it got easier.
 

Weary Mother

WEARY MOTHER
Yes they feed you. Interestingly it plays on me to know that even the amount of food they give you seems to be used as punishment. It is not enough to be incarcerated. Prisoners must also go hungry because the state has not money to feed them and that is considered part of the deal. I don't support crime or criminals but have a soft heart for hunger and cold. I went to a party over the weekend where a mixed group of older people (my boyfriends brother) and his children and children's friends threw a Halloween party. There were 30 somethings and 60 somethings mixed. the 30 somethings were all young yuppies, who are into organic food and natural living. There was a gal there who loves to hunt coyote with her dad, running them out of the woods with dogs and then shooting them (not agreeing with this, it was just her thing). She seems pretty happy living as she is and well adjusted. I envied that father who has a daughter who is so responsible, and the other parents who had grown children, all pitching in to make the party work, then cleaning up after. It did not ruin my day but I from time to time can look at that scene and wish it were different on my end. I wondered what that would look like for me and my 2 irresponsible adult children.
 
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