I learnt a new word this week. Anosognosia.

According to the National Alliance on Mental Illness, Anosognosia is the medical term for an individual experiencing acute mental illness who may be experiencing a “lack of insight” or “lack of awareness.” The word comes from the Greek meaning of to not know a disease. Essentially, especially with mental health, it means that someone is unaware of their own mental health condition or they can’t perceive their condition accurately.

And I was shook. And so I did some research.

As most of you know, I spend most of my days working with our most vulnerable and unfortunately mental unwellness is part of that role. However, up until recently, I never fully grasped the concept of someone not fully understanding their disorder. Now, I knew that people were sometimes too unwell to think clearly which would usually end with a hospitalization, but never considered the concept that for some people, they may actually not understand, or believe, that they have a mental illness. And that changes a lot of things.

It changes how quickly I get frustrated with that client who doesn’t seem to want to take their medication. It changes how I understand why someone is hesitant, or refuses, to seek ongoing treatment and the reasoning, although skewed, behind it. It changes how I understand reckless behaviors’ or bad decision making. And it made me think about how someone sees themselves, their ongoing barriers and my own, sometimes inaccurate, assessment of them. It changed how I interacted, how I understood and how I worked with those who I see as the most vulnerable.

Most important of all, it made me more empathetic. Empathic to how they saw themselves, to how they interacted in the world, and how to make them feel heard in a society that tells them they are wrong. And it was surprising to me that one word, a word I had never seen before, gave me so much insight (obviously with further exploration).

But it also taught me to be cautious as well. Cautious in my limited understanding of this word and how it impacts those who struggle with it. I was also cautioned to the following:

• It is not the same as denial. For some individuals, they have insight into their unwellness but are not quite ready to address it or begin to work on a recovery plan. That is different. It is not the same as not understanding that you have an illness and the ways in which it may be impacting your life.
• It is relative. Self-awareness, like most things, can vary over time which will allow a person to have insight into their unwellness that may shift back and forth.
• It makes it hard to update our own mental image of ourselves. People may get stuck with their old self-image before they had the disorder or started exhibiting symptoms. This can make them feel that those around them are either lying or making a mistake.
• It will make it harder to treat their health conditions. Unfortunately, this can lead to higher levels of homelessness and criminalization.

Regardless of whether you work in a field like I do, or have someone you know who is struggling, it is important to note that this is only one component. Only one factor that may be impacting someone struggling with severe mental illness and in slightly changing our perspectives (as I have) will help to consider a different aspect of the situation. Sometimes, that shift, may be enough. And understanding that sometimes it may not be as well.

“To empathize with someone’s experience, you must be willing to believe them as they see it and not how you imagine their experience to be.”

– Brene Brown