"I am Not Sick, I Don't Need Help!"
How to Help Someone with Mental Illness Accept Treatment

AARON T. BECK, M.D.
University Professor of Psychiatry,
University of Pennsylvania , Department of Psychiatry
At last we have a volume for those individuals most closely associated with the mentally ill. In a very readable fashion, Dr. Amador addresses the nature of the patients' unawareness of their illness and their need for treatment. He also clearly outlines the relevant research and gives clear prescriptions to help families and therapists deal with the patients' obviousness to their condition. I strongly recommend this to families and therapists of seriously mentally ill patient s.


E. FULLER TORREY, M.D.
Professor of Psychiatry, Uniformed Services University of the Health Sciences ,
Director of the Stanley Foundation Research Programs on Schizophrenia and Manic-Depression;
Author of Surviving Schizophrenia.
This is the first book to address the elephantine question running roughshod over families of individuals with schizophrenia and bipolar disorder: Why won't the sick person take his/her medicine? Amador, a psychologist who has a brother with schizophrenia, has pioneered research on poor insight into illness, a.k.a. anosognosia, for the past decade and is an acknowledged authority on it. He blends clinical vignettes skillfully with his erudition, and the resulting mix is both edible and edifying. Most important, Amador provides families and mental health professionals with a concrete, step-by-step plan to improve awareness of illness. This book fills a tremendous void in the literature on schizophrenia and bipolar disorder.


JONATHAN STANLEY, JD
Assistant Director, Treatment Advocacy Center,
and a Consumer diagnosed with Bipolar Disorder
Looking back, the strangest part was not the omnipresent government agents, the agonizing radiation weapons, or even my own super hero-like capabilities. What frightens me most is that my manic depression gave me an immovable certainty that it was the world around me that was convulsing but that my perception and judgment of it were unaltered. Thinking of this time leaves me frustrated and embarrassed as well as apprehensive that it might come again.
I read Dr. Amador’s book and felt better. First, he concretely and understandably establishes that most denials of treatment are but manifestations of the illness and that it is the illness that is the enemy. Dr. Amador then presents a powerful game plan for penetrating, or at least circumventing, sickness induced lack of insight that will maximize the cooperation with treatment of those affected. When I first became ill, I wish this book had been in the hands of someone who cared about me.


CONNIE LIEBER
President and founder of the
National Alliance for Research on Schizophrenia and Depression,
(NARSAD).
From start to finish, I deeply appreciated the opportunity to read this book. I think it is a remarkable service which should be available to millions of people. Reflecting Dr. Amador's own profound empathy and insight, the book is a guide to the shocked, bewildered and too often hopeless close relative. It is no mere compendium of generalizations. It is a practical, step-by-step program for achieving understanding and even expressing love in a situation where that love is difficult to convey. His is a remarkable achievement and a great public service. Many lives of patients and their loved ones could be enhanced, often immeasurably if copies of this book were given to the families of every patient who begins to show signs of psychosis. As people use this book, it will mark the beginning of a sound remediation and even rehabilitation.

HERBERT PARDES, M.D.
President, New York-Presbyterian, The University Hospital of Columbia and Cornell,
past Director of the National Institute of Mental Health
This is a wonderful book bringing together the personal experiences of a psychologist and a lay person who have relatives with serious mental illness. Dr. Amador's research and clinical experience makes this book a rich source of information and practical advice. It is one of the salutary characteristics of our culture that people who experience pain convert that pain into something productive. People who are victimized by, stressed by, and dismayed by serious mental illness will find this book enormously helpful. It contains information about new research and concrete advice that will be of enormous help to both the families of the seriously mentally ill and to the mental health professionals who care for them.


FREDERIC J. FRESE III, Ph.D.
Summit County Recovery Project, and a
Consumer diagnosed with Schizophrenia
There are several publications that address best practices for clinicians treating persons with schizophrenia. These are written from the perspective of the practitioner. There are a few books written from the perspective of the consumer or of the family member, but these do not incorporate the values of clinical insights, particularly those reflecting recent research findings.
The great value of I’m Not Sick, I Don’t Need Help, is that it incorporates both the consumer’s perspective and that of the clinician. It finds common ground, pointing out where the consumer and his/her clinician can work together in partnership. It is practical, easy to read, and hopeful. I highly recommend it to anyone interested in helping those who, like myself, live with the condition we call schizophrenia.


MICHAEL B. FIRST, M.D.
Editor, Diagnostic and Statistical Manual for Mental Disorders, Fourth Editon (DSM-IV), American Psychiatric Press
I am Not Sick, I Don’t Need Help is essential reading material for family members battling with their mentally ill loved ones about the need for treatment. Dr.Amador provides an insightful, compassionate, and practical guide for handling the frustration and guilt that inevitably arises when dealing with a sick individual who, by virtue of their illness, is completely unaware of the need for treatment.
What makes this book especially poignant is Dr. Amador's inclusion of his own personal account of his lifelong struggle with his own brother who suffers from schizophrenia, as well as his detailed presentations of patient cases. He does an exceptional job summarizing the compelling science behind anosognosia, clarifying that the loved one's lack of insight is not a product of a psychological defense mechanism, but is a result of the very brain dysfunction that underlies the illness. Finally, the inclusion of practical tips on how to interact with loved ones or how to proceed with civil commitment, if necessary, make this book especially useful.


MICHAEL FLAUM, M.D.
Director of Mental Health, State of Iowa
Of the myriad of problems presented by serious mental illness Dr. Amador has focused on the single most critical factor. Breakthroughs in treatment will not be effective unless we deal with medication noncompliance and the related issue of poor insight into illness. Dr. Amador takes this issue on in “I am Not Sick I Don’t Need Help” and deals with it head-on, providing vital information and practical advice for both families and therapists of patients with schizophrenia and bipolar disorder. This book will be immensely helpful to anyone dealing with the problems of medication noncompliance and poor insight.


ROBERTO GIL, M.D.
Director, Schizophrenia Research Unit at Columbia University and the New York State Psychiatric Institute.
It is uncommon to find books that bring together the latest findings in psychiatry research with relevant and practical clinical advice. Even less common are those that do so in a readable and engaging fashion, for both familes and mental health professional. Dr. Amador accomplishes all of the above in I am Not Sick I Don’t Need Help!


DOLORES MALASPINA, M.D.
Professor of Psychiatry, Columbia University College of Physicians and Surgeons;
Director, Clinical Neurobiology in Medical Genetics .
This is a well-written and must-read practical guide for those facing serious mental illness in a loved one, friend, or colleague. Delusions and psychotic thinking are quite beyond our everyday experiences, so it is not surprising that most people are at a loss about how to approach and obtain help for someone with serious mental illness. Those with psychosis may not even recognize that their own behavior and function is disturbed, let alone that they need treatment. If only the ailment were a stomachache rather than a malady in the part of the brain that distinguishes normal from abnormal!


RICHARD KEEFE, PH.D.
Professor of Psychology in Psychiatry, Duke University Medical Center;
Author of Understanding Schizophrenia.
For so many, it is very difficult to accept the notion that people like Ted Kaczynski or Anna-Lisa Johanson's mother have medical illnesses. It is easier to somehow cordon them off in our minds, just like they have been walled off from society through the centuries, as somehow less human than the rest of us. In this book, Dr. Amador breaks through these walls with personal courage and brilliant science. Lack of insight in people with schizophrenia and bipolar disorder is the major cause of many of the worst aspects of their illness, and may be the most recalcitrant since it is difficult to treat someone who thinks that nothing is wrong. Dr. Amador has spent the better part of two decades conducting research on this topic and has been the world's most influential scientist in this important area of work. In this book, he prescribes detailed interventions to help families and therapists deal with lack of insight and the many difficulties it causes people with major mental illness. Yet Amador is not an academic preaching from an ivory tower. His poignant personal experiences with people with schizophrenia, including his brother and close friend, are laced throughout this thoughtful, moving, and indispensable book. I am Not Sick is an essential guide to anyone who knows, loves or treats someone with schizophrenia or bipolar disorder.