Dealing with Schizophrenia in a Small Town

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Reader’s Question

I just turned thirty and was officially diagnosed with Paranoid Schizophrenia six years ago. For a period of time I was able to function, but unfortunately I did lose control of reality and fell into a paranoid, delusional mess. During that time, I moved back in with my parents and began receiving excellent psychiatric care. While regaining many aspects of my life, I realized that an office environment created stress which would trigger negative thoughts and similar problems. Thus, both my psychiatrist and psychologist recommended I stop working so I could better focus on therapy. Luckily, I discovered that I learned perfectly well on my own. I am already certified in one area and I am working for certifications in other areas.

The biggest challenge I currently face is that my parents sold our home in a beautiful suburb and bought a larger home in a very small town. My parents were trying to put me in a less stressful environment. Unfortunately, we were not prepared for an environment in which people tend to be suspicious of “outsiders” — those who did not grow up there — people who tend to overstep boundaries of privacy, and people who really have too much time on their hands.

This creates a problem for me because the whole town is buzzing with why I do not work, why we moved there, how we earn money, why I do not speak with people in the town. It may be part of my delusion, but I really do not feel safe in this town. Currently, I just stay home and study and play music all day working towards my new career goal and lowering stress levels. My dad and I go together to a local gym because exercise is good for both of us but also because I am afraid to be alone at the gym with these town people. Outside of my home and the gym, I have no contact with the town.

So, my questions to you are the following:

  1. Do I have reason to not feel comfortable in this small town?
  2. Is there anything I can do to placate the town people without going into private details of my life which I feel only I am entitled to know?
  3. Is it a flaw of mine not being able to interact with the people in the town, meaning something I should work on?
  4. I’m currently the most isolated I’ve ever been, but I’m preoccupied; can this isolation still be bad in the long run?
  5. Have you heard of similar experiences?
  6. Can my opinion of the town be part of my paranoid, delusional disorder?

Psychologist’s Reply

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As you’ve discovered, the dynamics of big cities versus small towns are quite different. In the city, everyone is busy and there are so many people around that you can and do ignore the vast majority of them. Small towns operate on a much smaller scale and at a slower pace. This makes things more challenging for “outsiders” initially, but this obstacle doesn’t have to be permanent. Once people get to know you and your family, you may find that their warmth and acceptance is more welcome than you could have imagined.

Change is always difficult, and coming into a situation you were unprepared for makes it worse. So yes, I think you do have good reason to feel uncomfortable, but I don’t know about unsafe. Everyone in small towns has known each other forever, so when someone new comes along, it’s pretty exciting. You and your family are like the new ice cream flavor that everyone wants to try. It’s natural that they’re curious about you and, unless there have been negative incidents you didn’t mention, this interest doesn’t seem malicious. I’m afraid that your self-imposed isolation may have served to make you more mysterious and fascinating.

You do not owe anyone the private details of your life, but you can give generalities without going into specifics. For example, you can mention that you’ve found that working on your own is better for your career than being in an office. You can also tell people more about you as a person by sharing your likes and dislikes. You can talk about food, movies, books, music and other hobbies. The more information you can give them, the more likely it is that they will connect with you. You may even make friends which would help lower stress. Human beings are social creatures, and isolation is not good for anyone.

I come from a relatively small town and I know that “outsiders” from large cities sometimes do have trouble adjusting. I don’t think you’re unusual in that. There are even several television shows and movies exploring just this idea (for a recent example, try the remake of Footloose). However, unless they’re in the horror genre, I think most of them come from the perspective of a fish out of water versus someone in danger. I think your feeling of being unsafe comes mostly from your fear of the unknown and possibly from your disorder. Whatever it is, you will not know for sure unless you try getting out there and meeting people. As I said before, I think you’ll be pleasantly surprised.

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