Allan Schwartz, LCSW, Ph.D. was in private practice for more than thirty years. He is a Licensed Clinical Social Worker in the states ...Read More
You were sitting in the cafeteria with co workers having lunch when one of them said, “I wish I could get sick.” That was followed with a chorus of others who fully agreed and said, “Yeah, a mental health day.” All of them made their reasons clear, they wanted some time off from work so they could lie in bed or go to the movies.
For the sake of clarification, this is not the same as Munchausen Syndrome, a serious mental illness, in which someone deliberately gets sick or injured. It is not even the same as having a hypochondria, defined as being preoccupied with fears of having an illness.
Those workers stating that they need a day off and a bad cold would help them get that day, are really saying they need to get away from daily stresses. They want a day to “catch their breath.”
However, isn’t it possible that a few of these people have deeper, underlying reasons for this? I believe the answer is “Yes.”
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I even heard one psychotherapist say he wished he had a psychosis just like his patients in the hospital. Why would an otherwise healthy person wish they had a mental illness? There is nothing romantic about it. In point of fact, suffering from schizophrenia is awful, as many of those patients have told me. So, why would a healthy person want such a thing?
Here are a few guesses about this, all based on observations of people in psychotherapy. These reasons embrace both wanting a physical as well as mental illness.
1. From what I learned in working with patients in the psychotherapy office, there are parents who range from those who are over protective and keep their children home from the very first sneeze, to those who send their kids to school regardless of how sick they are because they are neglectful. I believe it is agreed that neither extreme is helpful to children.
2. In the case of children who are kept home for minor reasons, there is a risk of the child learning that illness, even minor ones, is a way to stay home and be nurtured. Unwittingly, the parent is reinforcing the notion that it’s good to stay home, sleep late, play with toys and watch television. The child then grows up and transfers this type of behavior to work. After all, for this individual, staying home feels a lot better than going to work.
3. Parents who send their children to school sick are not necessarily neglectful. Some of them believe it’s not good to cater to children. They want their kids to take responsibility even when they are ill.
Of course, there are those who are neglectful and do not care.
4. Some people who want to have an illness and stay at home, may have a deep seated need for attention, above and beyond what they believe they can get at work.
5. Then, there are those who need an excuse to avoid daily responsibilities, whether at work or at home. Any type of illness, from depression to fever becomes a rationalization for doing nothing except, perhaps, as a way to get lots of sympathy.
6. For those who are depressed and extremely anxious, there is a lack of energy to get up and out of bed and into the outside world. Sadly, this can look appealing to someone who wishes they had an excuse to stay at the computer playing video games.
7. Low self esteem and self doubt can be so anxiety provoking that there is a strong need to practice avoidance.
8. For the psychotherapist who wished he could be like his psychiatric patients, there is an expressed desire to get away from the exhausting and stressful work and to be nurtured, just like his patients. He then did admit that he would never want the type of awful problems that come with schizophrenia, such as hearing voices and experiencing other types of frightening hallucinations.
9. Finally, there was the patient with schizophrenia who was in the hospital after suffering another decompensation, and who told me she keeps going off her medication because she is fearful of being mentally healthy. Handling bills and the chores of daily life felt like too much for her. On medication, she was aware of the obligations she had. Off the medication, she did not have to deal with reality. This was a woman who did not have a loving and caring family who would help her adjust to life as a healthy person. If, at the time, she had that family support, she might have made it.
What are your comments, questions and experiences with this type of problem?
Allan N. Schwartz, PhD.