By Jeff Shair, Mental Health Advocate

My brother Paul was diagnosed with schizophrenia, like myself. Yet because Paul was 10 years older than me, the illness was viewed quite differently when his symptoms first appeared.

That was back in the early 1960’s. In those days, some psychiatrists believed that the disease was caused by the individual having a weak will. For instance, when my parents took me to Paul’s psychiatrist at 9-years-old, a time during which I was struggling emotionally, they asked the doctor in front of me “Will Jeff get sick like Paul?” The doctor replied by saying, “Jeff is too strong to get sick.”

Nevertheless, I did develop schizophrenia and was diagnosed with the serious mental illness at the age of 17. At the onset of Paul’s disorder there was no knowledge that schizophrenia was linked to a specific gene and that it could materialize through a heredity component. Furthermore, there was little hope for the person with the mental illness, and recovery was considered to be out of the question.

As a child I looked up to Paul. I wanted to be with him as much as possible. When I was 6 years-old, I was very excited when Paul introduced me to sports. He taught me all the ins and outs of baseball, football, and basketball. We would watch all of the Philadelphia hometown games together of the Phillies, Eagles, and Warriors (The Warriors were the Philadelphia NBA team before the 76ers.) As a result, I became very knowledgeable about all the major sports and others were impressed by all that I knew about them, especially since I was a very young boy. But most of all, it was a topic that I could share with my brother on equal footing, and a connection that enhanced our relationship. I also enjoyed watching TV programs with Paul and I appreciated when he would prepare meals for me when my mother and father weren’t home. However, things began to change when I was about 9 and Paul was 19.

One of the main reasons I was having difficulty at that point was because Paul began to transition from a caring older brother to a distant person who seemed more like a stranger than a family member. My brother would spend most of the day in his locked bedroom. What was very upsetting to me was my brother started to discourage me from having friends over to the house because it left him with no option to come downstairs when I had company.

Paul was very self-conscious, particularly about his hair. He would obsess about how he looked. Consequently, my brother would spend hours in front of the mirror putting on his hairpiece and combing it until he thought it was just right. I believed Paul saw a distorted image of himself when he saw his reflection and thought he was ugly when in fact he was fairly good-looking. He was like a teenage girl with body image issues who is convinced she is overweight when she looks in the mirror, yet in reality, she is quite thin. I could never understand why none of the well-known psychiatrists who Paul saw in therapy over the years were unable to get Paul past the fixation on his hair and help him make improvements on his underlying condition of schizophrenia.

There were two very traumatic experiences that took place when I was 10-years-old that were both related to Paul’s treatment. In one, I was handed a bulky questionnaire over 30 pages long asking me how I felt about the other members of my immediate family and how I got along with them. So I had to write extensively about my feelings toward my mom, dad, and Paul, and the questions were very personal and intrusive, especially for a young kid. Moreover, I couldn’t share any of my answers with my parents or Paul. My mom, dad, and Paul had to fill out the huge form independently, as well. Paul’s psychiatrist gave us this assignment.

Most of the questionnaire was filled out at home and the rest of it was completed in a conference room. I felt ashamed about answering any questions in a way that could be perceived as me having any negative feelings toward Paul or my parents. Many years later I found out this exercise was for the purpose of research for family therapy, which originated in that year,1962.

Soon after that troubling event I was faced with another harrowing incident. Paul had his first nervous breakdown and now was in a mental hospital. One afternoon after school my parents picked me up and we went to the mental hospital to visit my brother. Eagerly I looked forward to that day as I hadn’t seen Paul in quite a while. In those days, patients were able to have much longer hospital stays than today. When we went up to the receptionist she told my parents that I wasn’t allowed to go up to Paul’s unit because I was too young. I was devastated that I couldn’t see my brother! Then my mother and father went up on the elevator and they told me to wait for them until they came backed down after the visit. I vividly remember crying in the lobby while I was doing my homework, upset that I couldn’t see Paul and thinking this place is more like a jail than a hospital.

A couple of years earlier, Paul was demonstrating some bizarre behavior. For example, my brother was enrolled in evening classes at a local college. However, as noted previously, Paul was very self-conscious and as a result would often skip going to school. Unfortunately, like some of his other devious schemes at the time, he involved me in his plans.

Paul didn’t want my parents to know that he wasn’t going to his evening classes and he didn’t want to leave the house, either. So he would go down into our furnished basement and hide behind the built-in bar down there. Then, Paul would command me to shut off the light to the basement and persuade my mother or father not to go down there by having me making up some excuse. I hated when my brother put me in these very awkward situations and that he seemed insensitive to how they affected me.

Sadly, Paul died in 1981 from a massive heart attack. He was only 39 years of age. Despite the hardships that I had to endure from Paul’s behavior, I loved my brother very much.

If you are concerned about someone who may be displaying signs and symptoms of mental health challenges, please encourage the person to seek help. Many people with behavioral health challenges live full, rewarding and productive lives, and manage their illness with professional assistance and self-help strategies. Please visit our Healthy Minds Philly resource section for crisis, treatment and support information.