Dealing with Incongruity: Challenges to Recovery and Wellness

By Stephanie Chase Stallings, © 2008 www.MySchizophrenia.org

At a time in my life when I strongly desired to apply to a counseling master's degree program, I ordered some used therapy textbooks from the internet. Flipping through the one that seeks to define what a master therapist is, a relatively thin volume called Master Therapists: Exploring Expertise in Therapy and Counseling, I found a passage written by a so-determined "master therapist" about her intrinsic need for congruity, e.g. consistency between words and deeds, in her professional practice, i.e. in what she advises patients, and in her own personal life, i.e. in her beliefs, ethics, and behaviors.

The respondent, unidentified in the text, was quoted as saying the following passage:

"My integrity or my believability rests on what I do in my work and what I do in my personal life.... I don't go to work and come home and live a different life.... I fully require in my personal life and in my professional life a kind of absolute-- and in this sense, it's rigid -- absolute honesty....It's not that you're making a dedication to the client, it's that you're making a dedication to a congruent life.... It's a life in which the inside and the outside match. It's when what people think you are, it's who you are (39)."

That passage led me to consider: what have been the primary obstacles in my own path to recovery, from the flip side -- the patient side of the equation? The answer was apparent as the unsaid converse of this therapist's everyday inner and outer harmony: almost all of my major setbacks, negative feelings, stress, job losses, et al. stem from the conundrum of incongruity, i.e. the reality that people with mental illnesses are often required, in many realms of life, to present a healthy face -- a necessarily deceptive, if seemingly "normal", front -- especially and primarily when it comes to getting and keeping a job, which can be the best cornerstone and foundation of a sensible daily schedule that integrates psychosocial, cognitive, and behavioral therapy, in everyday on-the-job interactions, and a program one is compensated for, including health and other benefits, with all the added self-esteem of being self-sufficient, independent, and autonomous.

This double-existence -- all too often required of those with a mental illness -- touches on almost all important arenas of a healthy, fulfilling life, not the least of which is one's self-esteem, self-respect, mental peace, and as noted above, honesty and integrity as a person. Socially-imposed "incongruities in daily life", due mostly to the still-enduring stigma of mental illness, and people's ignorance about mental conditions, combined with sensationalist stories of the violently mentally ill, as presented all too often in the news media, leads those afflicted with any mental illness with quandries such as, "Should I inform my next door neighbor of my mental illness?", "Is it safe to tell this acquaintance/potential friend/potential significant other about my condition? Will they leave me if I do?", "Who, if any, co-workers or colleagues, can I safely tell about my illness?", "Can I ask the benefits coordinator at work about the specifics of mental health coverage plans, without word leaking out, and being discovered by my employers or bosses?", "Will my boss see something abnormal about me, or if he finds out about my illness, will he fire me?", et al.

Paradoxically, it is these very incongruities and their effects -- for example, fear of being terminated or discovered; not being your free and true, best self due to stigma, prejudice, and fear of judgment, etc. -- that become the defining aspects of living with mental illness. In fact, the perceptions of others -- colleagues, friends, family, caregivers, employers, doctors, and medical professionals -- forms, and informs, one's self-perception, and these perceptions work to shape our (speaking for the community of people with mental illness diagnoses) own perception of ourselves.