Losing Dad, Paranoid Schizophrenia: A Family’s Search for Hope (10th Anniversary Edition)

Book Title: Losing Dad, Paranoid Schizophrenia: A Family’s Search for Hope (10^th Anniversary Edition)

Author: Amanda LaPera

Publication Details: Adamo Press, 2023, 325 pp., $19.95 paperback

Amanda LaPera’s memoir, Losing Dad tells the devastating story of a family in the aftermath of a beloved father’s sudden onset of schizophrenia at the age of 53. The diagnosis is not immediately identified by professionals nor by his family and is never recognized by the patient himself. Anosognosia and the patient’s lack of acceptance of any treatment are at the crux of this book. “If my family had understood anosognosia and the positive and negative symptoms of schizophrenia, our story could have turned out very differently” (p. 104). At multiple points in the book the author notes the hurdles of addressing mental illness when the patient refuses treatment.

Throughout this book, Amanda LaPera struggles to make sense of what happened to her father, Joseph. She is an English teacher and the author of several books including the sequel entitled, Finding Dad.¹ She ultimately becomes an advocate for families with a family member suffering from severe mental illness. She has previously served on the Board of Directors for the National Alliance for Mental Illness, Orange County Affiliate.

Following 3 months of erratic behavior as well as a suicide attempt, Joseph is diagnosed with schizophrenia. However, physicians and psychologists do not seem to be able to help the patient or family even after the diagnosis is made. The patient proceeds to spend his life savings, abandon and strand his wife 3,000 miles from their home, become homeless, exhibit extreme paranoia, travel the world as a “prophet of God,” and ultimately disappear for 9 years.

No one in the family has experience with severe mental illness, and the author describes how overwhelming and confusing it is. The poor understanding of Joseph’s condition unfortunately contributes to a significant lack of communication among family members, especially in the early stages of the illness when each family member copes on their own. Thus wife, parents, and three children do not share concerns with one another, which interferes with a coordinated response. The author posits that they were trying to spare each other pain and were happy “to maintain a façade of normality” (p. 103). At times family members ask, “Why doesn’t he just snap out of it?” (p. 103). Six years into the illness, the author admits having “a moment of realization” and that she “had mistakenly believed he could conquer the mental illness on his own” (p. 231).

Joseph is particularly good at masking mental health problems given his previous success in life. Nine months after his diagnosis, a psychologist allegedly told his wife, “I don’t know what you are worried about. Nothing is wrong with your husband. He’s an intelligent man.” When a significant other meets the dad, he is quoted as saying, “He rambled on about religion too much. Other than that, he seemed normal” (p. 229). The family members had decades of time with Joseph when he was a rational, loving, and wonderful son, husband, and father. Thus, it is hard for them to accept that he is need of significant help. When they do ask for help, they learn how complicated getting treatment is.

Another theme of the book is the difficulty of “ambiguous loss,”² which is when family members live with unresolved grief due to uncertainty about the loved one’s status. This is especially hard on the family as the author states, “To watch a loved one fade away is worse than death” (p. 301). Not knowing if Joseph is dead or alive is agonizing for the author. This book sheds light on the tragic experience of a family with the onset of severe mental illness. It is painful but important to read about the consequences of the illness and the lack of support for families, especially those families who do not initially understand the gravity of the illness.

In addition to the personalized account, the afterword addresses legal issues arising from similar cases. Frustration with the legal protections of patients’ rights to refuse treatment are apparent throughout the book. Soon after the onset of Joseph’s mental illness in 1996, laws were passed in 1999 in New York and 2002 in California to set up assisted outpatient treatment (AOT) for certain patients. AOT “is a community-based, court-ordered, mental health treatment program for a subset of individuals with serious mental illness who have a history of difficulty adhering to treatment and staying well while living in the community.”² Initially debated in the legal community, there appears to be research in support of AOT programs benefitting society albeit with gaps in the literature.³