On when Is should be Has

mefullfrightblue.jpgmefullfaceleftblue.jpg He is schizophrenic. She is bipolar. He is a depressive.She is developmentally delayed. He is schizoid.She is mentally ill.

The illnesses may be frightening to some but if we're just talking verbs here none of the above sounds troubling, correct? In fact it's how we refer to people with mental illness and most often how people with mental illnesses refer to themselves. (Did you think I'd say the mentally ill?)They are their illnesses.

And here is how it works for just about every other medical condition. He has cancer. She has heart disease. He has the flu. She has mad cow disease. He has cerebral palsy. She has cystic fibrosis. He has multiple sclerosis. She has a fractured hip. He has AIDS.

This list goes on and on. Almost every medical condition one can think of is one in which someone HAS rather than IS something. Except when it comes to mental illness.

Imagine if non-psychiatric medical conditions were treated like mental illnesses. Lets try it.

He is heart diseased. She is cancerous. He is flu-ic. She is mad cowic. He is a cerebral palsyist. She is a fractured hip-er. He is an AIDSist.

Though rarely used in conversation or by physicians and especially not by people with these psychiatric conditions, its is possible to apply has to mental illnesses. However it is much more common, especially in the case of 'first-axis' disorders that a person inevitably is their illness.

How often do you hear "he has manic depressive illness" or "she has schizophrenia"?

I would be remiss for not pointing out exceptions in both categories. The exceptions are themselves informative. She has a personality disorder. He has OCD.She has an anxiety disorder.None of these are considered first axis and more importantly psychosis is rarely present. Insight is maintained.
There are also a few non-psychiatric conditions where people are branded as their illness. He is diabetic. She is hypoglycemic. He is HIV positive. In these cases we say is because the illnesses are chronic, life-long and and require substantial and regular medical intervention such as insulin injections, dialysis or prophylactic medications.Then there are those conditions which are poorly understood and especially those which are stigmatized.She is HIV positive? He is a leper? Why do we say such things?

But serious psychiatric conditions get the worst of both worlds. They are often poorly understood (by the general public and too often by physicians themselves) and deeply stigmatized. Add to that the necessity for insight in treatment and you have an environment that encourages people with mental illness to brand themselves according to their illness. The paradox is that only when you know you are ill can you begin to recover. Put more crudely; if you know you're crazy, you're not crazy anymore.There is a good deal of research on the process whereby a person becomes their medical condition.The term used is 'engulfment'. People with mental illness are encouraged to learn in great detail about their disorders so that they themselves may recognize the early warning signs of an episode. But the first thing you must do is admit you are ill – are schizophrenic or that you are bipolar.Its key. It means you are gaining insight.
Charmaine C, Williams, MSW. and April Collins, M.S.W.have researched engulfment in their study: Factors Associated With Insight Among Outpatients With Serious Mental Illness. Better to let the experts take it from here.

"The Modified Engulfment Scale characterizes the patient role as identifying oneself as a patient and acknowledging a need for medical help. However, this role is also associated with ideas of being damaged and deviant (7). Thus it is apparent that insight and engulfment are overlapping constructs that have some important differences. The significant association between insight and engulfment suggests that psychosocial interventions that focus on promoting insight must not only address the internalized stigma that threatens self-esteem but also promote the development of an identity that can incorporate health-seeking behaviors without destructive role constriction."

There's no doubt for me anymore that its better for all concerned for me to have this gawddamned, stupid-ass bipolar rather than being it. Otherwise I'd be cursing myself an awful lot.

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