What expectations should I have?

Expectations can often be the source of stress. Sometimes we may not be aware of how unreasonable our expectations for the patients are; for example, we think that their learning and working abilities should be as good as before, we may compare their extent and speed of recovery with other patients, and have unrealistic expectations for the patient’s future and lifestyle, or want the patient to appear well in front of relatives etc. Sometimes we express these expectations with good intentions, such as hoping that it would serve as motivation for the patient to improve or to recover as soon as possible; however, we have to understand that it can be very stressful for the patient, and may even lead to relapse.

Moreover, family members often misunderstand the patient due to their lack of understanding for the negative symptoms, and therefore respond to their behaviour based on assumptions; they may accuse the patient of being lazy, or impair the patient’s confidence etc. As family members, we have to thoroughly understand the negative symptoms of psychosis (i.e. rarely speaking, lack of motivation, losing interest in things, reluctance etc.), different stages of recovery and understand that the patient’s behaviour may have been influenced by their negative symptoms or other aspects of the illness (i.e. they appear to be lacking motivation). Instead of blaming the patient, we need to express our expectations sensibly and encouragingly in order to help the patient recover. The most powerful is the unconditional support and care from family members, so that the patient doesn’t feel alone in leading a new life. If necessary, family members can accompany the patient to social activities and help them develop new interests for their leisure time.

It is perfectly understandable for family members to have certain expectations, for most of the people would have expectations for themselves too. However, when a family member is ill, we have to understand that they are fighting bravely against the effects brought on by the disorder and the medications; if they have to adjust themselves in order to deal with the difficulties, we should adjust our expectations accordingly too. Maybe we can figure out the appropriate expectations for the patient by redefining “success” with consideration of the patient’s ability and condition. We should also avoid comparing the patient with other people as means to prod them into improving - we should allow the patient to make progress at their own pace. Family members and the patient may discuss and establish goals together, which can also be broken down into smaller, more achievable targets; we can also suggest creating a timetable to help with achieving them. When we adjust our expectations relating to the patient, and give them unconditional and consistent support, not only can we reduce pressure on the patient and help with their recovery, we can also help ourselves lead a happier life.