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May 20, 1983

The Surprise Party

Author Affiliations

Washington, DC

JAMA. 1983;249(19):2632. doi:10.1001/jama.1983.03330430018008

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In understanding the experience of the mentally ill individual, we should recognize the courage they often exhibit even while engaging in superficial ordinary human interactions. Unless we appreciate this, their responses of isolation and withdrawal because of interpersonal terror will seem inexplicable. Two clinical examples help to clarify this point.

An alcoholic woman began talking about her son, who had been psychotic since childhood, and I wondered if there would ever be any end to her grief. Alcohol had destroyed her liver, but it had not washed away the grief. She mentioned with a slight smile that finally she was beginning to accept the many losses her son's illness represented.

"We had him home from the hospital Sunday, and Mary, the friend I told you about who also has a schizophrenic son, brought him over. The two boys have known each other since they were kids and there they were,