Understanding Mental Illness and Dementia

As a clinical psychiatrist who practiced in New York City for nearly three decades and who works in  a state psychiatric hospital, I have—for all these years—attempted to understand the inner world of those with mental illness, including schizophrenia. That inner world can resemble the Wild Waters of the Elmer Keene painting that hung in my waiting room.

We cannot presume to fully understand another’s experience. We can only try to find some understanding and empathy.

To better understand these inner worlds, I read firsthand accounts written by patients and family members. Early in my career, I published reviews and a guide to these books (A professional's guide to books for families of the mentally ill - PubMed). The goal was to improve the understanding of family members living with mental illness—by encouraging mental health professionals to read and recommend books on the topic. We ran psychoeducational groups to teach family caregivers about the  causes and treatments of mental illness and how best to help their relatives (FAMILIES OF MENTALLY ILL: GETTING INVOLVED - The New York Times).

In the decades since, I’ve expanded this work to medical students, co-writing an Innovative Medical Education article with a student: The Use of Personal Accounts in the Study of Severe Mental Illness (EJBM 29.1 Woesner.pdf). As an academic psychiatrist and training director, I’ve run medical student training programs to reduce stigmatization and increase empathy toward people with mental illness ( A Preclinical Medical Student Program: Student Reactions to Interviewing Psychiatric Inpatients  )

Early in this journey to understand mental illness, my role as physician took a sharp turn. Like the families I was treating, I became a caregiver. Over decades, first my father and then my husband developed Alzheimer’s disease, which—in the later stages—has symptoms like those of schizophrenia. Delusions, hallucinations, agitation, and cognitive problems. Because I cared for my husband at home, I had a window into the inner world of dementia while I struggled to relieve his anxiety and despair and instill joy. Our relationship deepened. I read every firsthand account—books and articles— that I could find and began writing my own books in the hope of helping others.