Pills, Skills, and Will

By Stephen Luce Jr.

My psychologist, Dr. J. Mark Pratt, says “What you do most is what you do best.” Certainly, full-time paid employment takes up most of my time, and I am so grateful for that. Coming in close second, however, is mental health treatment. Appointments with psychiatrists/psychologists, mental health support groups, obtaining required blood work from the lab, filling pharmacy prescriptions, going to church, reading literature, and praying/meditating. Also common is doing volunteer work, helping friends and family with tasks, and listening to them when they are troubled. These activities give me positive thoughts that I am contributing to society and help keep me away from the negativity that has been a hallmark of my mental illness.

Thus it has become a life that I truly believe is one worth living. In the early stages of recovery (the late 1990s) I did not share this view. But I survived those tumultuous days and have now entered into an expansive place where peace, even joy, is a common experience.

The psychiatric and psychological treatments that have made this possible cost my mom, Gwen, a lot of money. Although, I have been able to remove this burden from her more recently. It occurred to me that if I could write a book delineating the various aspects of my treatment program, I could share these helpful concepts with others, virtually for free. That is the spirit in which this book is published, and I hope you can utilize it for increased mental health and well-being!

• Language: English
• Publisher: Austin Macauley Publishers
• Release date: Feb 28, 2022
• ISBN: 9781647507435

Stephen Luce Jr.

Stephen Luce Jr. lives and works in Silicon Valley, California. He has been most fortunate to have been treated for mental illness by psychopharmacologist Dr. Reed Kaplan, and psychologist Dr. J. Mark Pratt for most of the past 25 years. Also, he benefitted greatly from La Selva, a residential mental health treatment program at which he lived for more than six months. He is thankful to his mom, for working so hard to pay for this top-notch treatment until his full-time employment was able to take this load off her strong shoulders in about the year 2012! Stephen has a law degree from Pepperdine University, but realized he was never going to be able to become a lawyer so thereafter went to De Anza Community College for A.A. paralegal degree. Unusual career path, yes, but it enabled Stephen to first get his foot in the door in the legal industry as a paralegal, and ultimately as a “knowledge manager” at a legal recruiting/headhunting firm where he has worked fulltime since 2006. Stephen very much enjoys having employment in the legal sector, and is most grateful for how his career has evolved to date. While he tries to plan and stay ahead and be strategic, he also sometimes feels like Paul Newman’s character in Cool Hand Luke “I never planned anything in my life!”

Book preview

About the Author

Stephen Luce Jr. lives and works in Silicon Valley, California. He has been most fortunate to have been treated for mental illness by psychopharmacologist Dr. Reed Kaplan, and psychologist Dr. J. Mark Pratt for most of the past 25 years. Also, he benefitted greatly from La Selva, a residential mental health treatment program at which he lived for more than six months. He is thankful to his mom, for working so hard to pay for this top-notch treatment until his full-time employment was able to take this load off her strong shoulders in about the year 2012! Stephen has a law degree from Pepperdine University, but realized he was never going to be able to become a lawyer so thereafter went to De Anza Community College for A.A. paralegal degree. Unusual career path, yes, but it enabled Stephen to first get his foot in the door in the legal industry as a paralegal, and ultimately as a knowledge manager at a legal recruiting/headhunting firm where he has worked fulltime since 2006. Stephen very much enjoys having employment in the legal sector, and is most grateful for how his career has evolved to date. While he tries to plan and stay ahead and be strategic, he also sometimes feels like Paul Newman’s character in Cool Hand Luke I never planned anything in my life!

Dedication

This book is dedicated to all those people who are coping with mental illness, and I hope it will help them find hope, health, and wellness so they might rise to their potential and fully participate in life. This book is also dedicated to all the parents, other family members, and friends who are supporting their loved ones amidst their struggle with mental illness. I trust that it will give them new understanding of the symptoms with which their loved one is contending, and how to help.

Copyright Information ©

Stephen Luce Jr. 2022

All rights reserved. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, including photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the publisher, except in the case of brief quotations embodied in critical reviews and certain other non-commercial uses permitted by copyright law. For permission requests, write to the publisher.

Any person who commits any unauthorized act in relation to this publication may be liable to criminal prosecution and civil claims for damages.

Ordering Information

Quantity sales: Special discounts are available on quantity purchases by corporations, associations, and others. For details, contact the publisher at the address below.

Publisher’s Cataloging-in-Publication data

Luce Jr., Stephen

Pills, Skills, and Will

ISBN 9781647507428 (Paperback)

ISBN 9781647507411 (Hardback)

ISBN 9781647507435 (ePub e-book)

Library of Congress Control Number: 2021924589

www.austinmacauley.com/us

First Published 2022

Austin Macauley Publishers LLC

40 Wall Street, 33rd Floor, Suite 3302

New York, NY 10005

USA

[e-mail]

[phone]

Acknowledgment

I am forever indebted to my mom, Gwen, for giving me life, and for saving me from death through expensive medical care (without strings attached or ever making me feel like a burden)!

Waiver

I believe the concepts in this book can help you find relief from mental illness, but I am not a licensed mental health practitioner. Please seek treatment from a licensed practitioner, for example, a psychiatrist, in addition to reading this book. Also, if you are thinking about taking an overdose of pills (or have any other plan to harm yourself in any way), please call your doctor immediately (or go to the nearest hospital emergency room right away and tell them everything and ask for help). Just one moment of hopelessness can unnecessarily and unfortunately lead to a pretermitted life. Don’t worry, the locked psych ward won’t keep you there long! They need beds for the next person! Also, you can feel confident that the doctors and nurses there can help you – they are experts!

Preface

I have been in treatment for mental illness since 1995, and I would like to share with others how healing and happiness are attainable, even for the most disturbed patients. Since 1995, my doctors (and the residential treatment program at which I lived for about six months, called La Selva), cost a lot of money. My mom, Gwen, has worked very hard since 1995 to pay for this treatment, though since about 2012, I have been able to take this burden off her shoulders (through the full-time work I am blessed to have as an administrative assistant, what used to be called a secretary in the olden days)!

It occurred to me that many patients might benefit from a book that encapsulates the insights that have been taught to me by these (and other) highly sought-after mental health practitioners over these many years. My function might be somewhat like Diderot during the Enlightenment. At that time, there were many original thinkers like Voltaire who were writing great tracts of authorship which were being voraciously read in salons. But then there were other workers in the age, not original thinkers, but rather encyclopedists who devoted themselves to compiling and organizing the essays and articles being written by the original thinkers (in order that encyclopedias could be drafted to promulgate the information to a wider audience). Perhaps if I can summarize and distill the many aspects of mental health treatment I have been privileged to enjoy into a book, those helpful ideas can be distributed to a wider audience, virtually for free.

I chose to call the book Pills, Skills and Will because the mental and emotional recovery to which I am witness – my own – is being accomplished by the pills prescribed by my psychopharmacologist, by the psychological skills taught by the therapists, and by an increasing will and ability to love others, which is the spiritual aspect of my recovery.

So the basic premise of this book is that pills, skills, and will can be your three-pronged recovery plan. I don’t, however, recommend availing yourself of only one prong – you can’t expect psychiatric pills to fix everything. You can’t expect psychological skills to handle all your symptoms. And I don’t believe it is wise to reject pills and psychological skills and say that you are only going to avail yourself of spirituality or religion to achieve recovery. Folks (especially the seriously mentally ill) often need to watch out closely for hyper-religiosity.

Equally true is that it is not necessary to be nihilistic about the possibility that patients can recover from serious mental illness. It is my good fortune to have been treated by mental health practitioners who have high expectations for their patients. For example, psychologist J. Mark Pratt, Ph.D. works closely with his patients believing that they can find activities that feel good, are good for them, and are good for others. These are noble goals, whereas many other mental health professionals get so frustrated by inertia and lack of progress in treating the mentally ill, that such goals seem farfetched, almost like tilting at windmills. But Dr. Pratt truly believes they are all possible. In the movie, A Beautiful Mind, John Nash struggles with the idea of whether it is possible for a person to both act in his or her self-interest while also acting for the greater good. For we live in a world with limited supplies, even scarce resources, so it might seem at times that in providing for myself, I must take away from others. But Nash ultimately concludes that it is possible for one to both help himself and help others, and this is what Dr. Pratt is helping his patients concentrate on. Along the path to recovery, Dr. Pratt tells me what I need to hear, rather than sugar-coating platitudes that he thinks I want to hear. In this way he serves as an impartial counselor, arbiter, sponsor, and adviser helping me filter out untoward activities (and embrace useful pursuits) – not just a rubber stamp approver of whatever distorted or deluded goal I might be pursuing in the moment. I have been working with Dr. Pratt for about two decades, and this is where I learn many of the skills I need to live in Silicon Valley in 2021.

In addition, for most of the past two decades I have been treated by psychopharmacologist Reed J. Kaplan. M.D., former head of the locked psych ward at Stanford Hospital. In addition to prescribing the medications, Dr. Kaplan teaches me about how the meds help me, and tries to avoid unwanted side effects. I learn that the approximately 15 pills that I take each night have the welcome effect of lowering the volume of the internal dialogue in my head (that so often in the past disabled me). In addition to lowering the volume, the meds also slow down the pace of the internal thoughts so that I can regulate them better. In this way the committee in my head becomes less problematic. I can now read, write, listen, and speak better than before. Thank you, Dr. Kaplan!

I also have been on a faith journey during the more than 20 years that I have been treated by Drs. Kaplan and Pratt, and am blessed that they do not pathologize the spiritual component of my recovery. I think Dr. Kaplan and Dr. Pratt see my religious beliefs as a source of moral values, essential for making behavioral choices. Also, I think they realize these beliefs give me hope – both for help in this life, and beyond (in possible life after death). As I heard one Jewish rabbi once say, if she did not have hope that there will be justice in life after death, she would feel hopeless when she looks around and sees so much injustice during our life here-and-now! Dr. Reed J. Kaplan and I have discussed my religious views and agree they can help one become a more loving person – give one an increasing will to love others. So I have doctors that strongly focus on finding the right combination of meds to prescribe for me – and who strive to teach me psychological skills – but who also realize that spirituality/religion may be important to recovery too. This is what is meant by the title of this book Pills, Skills, and Will.

At this point of reading this book, I hope you can sense and discern that though I probably don’t know you personally, I view you as one of my brothers or sisters and very much hope that you will be able to rise to your potential and fully participate in life, and will otherwise be able to benefit from a treatment plan in which you feel respected and consulted. I am reminded of what Jim Stump used to say, No one cares much about what you have to say until they know how much you care. (Jim Stump used to work with the football players at Stanford University, to help them find spiritual/religious meaning in their busy lives alongside football, school, and social activities.) If you can’t already tell that I care about you, please continue reading – my hope is that you will know that I care.

I John 3:18 in the Holy Bible says, Dear children, let us not love with words or speech but with actions and in truth. It would seem, therefore, that the best way I could show you that I care about you is through actions, not by writing a book. But once again, my mom has spent so much money on my treatment, why not write a book to publicize what I am learning at almost no cost?

I don’t think any one book can cover all aspects of mental illness. My diagnosis is schizoaffective illness, which incorporates elements of both bipolar illness and schizophrenia. Thus my experience is with the symptoms of depression, mania, anxiety, delusions, hallucinations, lack of motivation and initiative, and other symptoms of these illnesses. Also, I am a dual diagnosis patient, with the co-morbid (simultaneous) illness of substance dependency (I suffered from alcoholism and illicit street drug addiction until 1995). This book therefore focuses on these illnesses, and not on the other myriad mental illnesses that exist. However, along the way I have learned a lot about these other illnesses from which I do not suffer, and their treatments. For example, DBT (or Dialectic Behavioral Therapy) is a phenomenal treatment originally used for borderline personality disorder. While I may not suffer from that disorder, I very much am interested in DBT (and greatly benefit from its concepts and suggestions). It is my hope that this book can help all people trying to find effective treatment for mental illness, even as it concentrates on finding relief from the symptoms of bipolar, schizoaffective, schizophrenia, and substance abuse.

Sincerely,

Stephen Luce Jr.

Palo Alto, California

2021

Symptoms

Anosognosia – "I Don’t

Need Medication"

To start off, let’s talk about pills, the medications that the scientists and doctors have found to treat mental illness for us. I was once asked to speak on a Rise Above Stigma panel, and we were given a list of questions to prepare for the panel discussion. The primary question we were asked to discuss was When did you realize/become convinced you have a mental illness? While I was sitting in psychologist Dr. J. Mark Pratt’s office, he and I realized the more crucial question for me is When did I realize/become convinced that I have a mental illness requiring medication(s)? It was a long journey for me from 1995 (when I had my first psychotic break from reality) until 2001, which is when I finally became convinced that I need medication to treat my mental illness.

I had started therapy in 1995, then started taking pills prescribed for me by the campus psychiatrist at Pepperdine University in 1996. Thereafter I went off the pills in 1997 since I did not like having to pay so much money for them, and since I had found a book that examined the question of the placebo effect of psychiatric medications, suggesting that psychiatric medications are effective only because of the placebo effect (i.e. anything you believe can become true for you). In addition, I think the meds were helping me so much that I no longer felt mentally ill.

In short, I succumbed to anosognosia – which is a term meaning the person does not know that she/he has an illness. This condition is quite common amongst patients with the illnesses of bipolar, schizoaffective, or schizophrenia. Thoughts can become so out of touch with reality that one cannot see that she is ill. The psychologist and author Kay Redfield Jamison poignantly and beautifully describes her own battle with anosognosia in her book An Unquiet Mind. For example, Dr. Jamison was treating bipolar patients at the UCLA bipolar clinic as a clinical psychologist while she was suffering from the same or similar symptoms as they, yet did not notice this. Another example was the party after Jamison’s dissertation was accepted and she became Doctor Jamison. The festivities were held for all new Ph.D.’s, and Jamison felt great. In fact, she felt really great! She was speaking easily, was the most interesting person at the party, flirting in all the right ways, and making all the right connections with all the best people at the party – or so she thought. Afterward, her friends told her that she had been a train wreck at the party, totally out of control, uncomfortable to be around, hyper and manic.

Jamison did not, however, immediately admit her anosognosia and accept that she has a mental illness requiring medication. Eventually she went on medications, but was not convinced. After a while, she decided to discontinue the medications, and this was followed by a suicide attempt, which she survived.

I too had a similar experience with anosognosia and medications. After discontinuing the meds in 1997, I went back to psychopharmacologist Dr. Reed J. Kaplan in the year 2000 and asked him to prescribe pills for me again. I was reaching out for help, and getting closer to accepting that I need the medications, but I still did not know for sure.

Then in 2001, I survived a suicide attempt and woke up in the locked psych ward on September 11, 2001 (9-11 day). As I watched the television screens, I realized that there is great evil in the world. Then later that morning – when some malicious malefactor called the hospital with a bomb threat and the entire hospital had to be evacuated, I again realized that there is much to be displeased about in this world. But then I looked at all the doctors, nurses, physician assistants, and other hospital workers giving their very best to serve the sick. I saw a glimpse of light in the darkness and held on to it, and decided to do whatever it would take – even committing to a medication regimen – to help me focus on the positives in the world around me, and to sense and discern positives in my heart and mind. I became convinced that, without taking the pills, all I saw were the negatives in life, and that had pushed me to the brink of suicide. But praise be to God – I was given the realization that it is an illness to believe that life is only full of negatives. Acceptance of illness then led to certainty that I need to take the pills. This realization did not come right away, but as I started to work with the Cognitive Behavioral Therapists in the hospital, and commenced a new medication routine while in the hospital, positive changes began to occur.

Getting back to Kay Redfield Jamison, after she survived her suicide attempt, she decided to go back on her meds, and to stay on them for good. She did, however, work with her doctor at some later point to reduce the dosage. Jamison said it was like taking scales off her eyes – by reducing the dosage she saw everything around her in high fidelity. She saw beauty and heard music, and felt more alive. So it is quite important to work with your doctor closely to find correct dosages at some point in the process. But at the beginning, please just trust your doctor while you team up with him or her to find the medication(s) that work for you, as you collaborate to determine the dosage(s) that are best for you (with the least unwanted side effects).

Symptoms

Delusions (Example of John Nash)

The goal of your doctor is to get rid of those awful mental illness symptoms, to keep you out of the hospital, and to help you see beauty in the world (and in yourself)