there have been some studies looking at individuals with bipolar disorders as well as skwiz schizophrenia. 40-60 percent have systems of lacking awareness. what this means is basically there is damage to certain pathways of the brain responsible for self reflection and self awareness. this has been shown in neurology for individuals after they have had strokes with particular areas of the brain that have been damaged, has also been shown for individuals with dementia and in my clinical experience and my personal experience with my family member, it's very clearly an issue in mental health as well. the dilemma is that if there are individuals who are biologically unable to self reflect and have an awareness of their illness, they oftentimes very frequently will not want to engage with treatment and do not see themselves as needing treatment. and this is beyond psychological denial, kind of realizing deep down that there is an issue but not wanting to accept it. it's also beyond simple stubbornness. it's a natural inability to realize that there may be something wrong. one particularly pert