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Subtitled: How to Help Someone with Mental Illness Accept Treatment

10th Anniversary edition

Every once in a while, I do something a little impulsively that in retrospect, is so amazingly wonderful that I don't think any amount of planning could ever be quite so successful. Getting this book was one of those experiences.

Amador had an older brother diagnosed with schizophrenia. The story of Henry is told, on and off, throughout the book, and Amador's deep love and compassion for his brother is unquestionable. Amador also consistently attributes his development of LEAP (a communication approach intended to strengthen relationships, develop motivation and, where possible, insight, and promote adherence to treatment) to his brother -- not just his relationship with his brother, but that his brother led in this process. It's a compelling and beautiful story.

Also, the negotiation, communication and motivational strategies partake of a variety of approaches that I, personally, believe in (client centered, "doing what works", identifying action items that all parties can agree on, even when they have different reasons for doing so, etc.).

The exposition style of the book is intended to persuade, and pursues a spiraling, incremental and iterative approach to describing anosognosia as an important element of serious mental illness, and how to integrate an understanding of anosognosia with treatment, to ensure adherence. So if you're already mostly sold on the idea of anosognosia (captured well in the title of the book), and the components of LEAP, it can feel repetitive. If you blow through the details, it's _really_ going to feel repetitive -- and you won't get as much from this book as you otherwise might. Also, the book is clearly aimed at people who are dealing with a relative/loved one suffering from serious mental illness in the here-and-now, rather than people like me, who are suffering from pervasive curiosity and to whom treatment questions are more theoretical than urgent.

I'm really glad I read it. While it is not aimed at a general audience wondering about what public policy we should pursue with respect to serious mental illness and violence, say, there are elements of the book that can shed a lot of light on that debate. And Amador is a real pleasure to meet through the words on the page.

July 2025

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