Un-Supportive Family

[Retired]

When a person is afflicted with a mental disorder and the immediate family cannot accept that someone in their family could "have such a thing", what is that person to do to gain the family's support.

When members of the family refuse to read literature describing the disorder, or refuse to accompany the afflicted person to the doctor, how can the family be persuaded to come around?

When the family is embarrassed by the person with the affliction or tell the person to "snap out of it" how can they be made to understand?

 

[David Baxter PhD]

Some of this depends on the age of the patient - but I think the therapist or physician can play an important role in informing/educating the family, provided the family is willing to listen. I have certainly advocated for clients with family members in the past, to help them understand that sometimes it isn't just "bad behavior", "stubbornness", or "drama".

 

[Retired]

provided the family is willing to listen

This appears to be the underlying factor in the situations we see in providing support services, and the unwillingness to listen transcends all ages.

It is seen when one parent, often the Dad who resists the Mom's suggestion their young child needs professional intervention, as well as an adult whose spouse and frequently his/her children seem to be in denial.

How does one advise people in such a situation in order to support their efforts to get proper help without splitting the family?

 

[David Baxter PhD]

I don't know of any general rule to tell you how to proceed, Steve. What I generally do is evaluate the individuals I have to deal with and devise a strategy for trying to enlist their cooperation without having them feel threatened.

When it's a case of separated parents and co-parenting, sometimes a very gentle hint along the lines of "I'm sure you both want to do what is in the best interests of your child" will do the trick -- if they are back and forth to court, or even if there is the hanging threat of that, even a suggestion that could be used by the adversarial partner that they might be cited for NOT cooperating in something that is in the child's best interests can snap them to attention pretty quickly.

 

[Retired]

If I may divert the discussion into a slightly different direction, but with the same premise in mind, what are helpful strategies in overcoming denial, which to me, seems to be at the root of these situations? Or is there another dynamic at work here?

 

[David Baxter PhD]

Sometimes it's denial: "A member of my family couldn't possibly have something like this!"

Sometimes it's fear: "I don't want this to be true so I refuse to let it be true."

In these cases, trying to let the family know about treatment options, etc., that there are many things that can be done so the individual can lead a "normal life" may help.

Sometimes it's financial: "How are we going to be able to afford all the treatment, etc., that s/he'll need?" -- in this case, talking to them about sources of financiual assistance, disability, even insurance coverage can help.

Sometimes, it's about power struggles: "She thinks this is a problem and I hate/am angry with her so I'll refuse to accept this" -- in this case, see above.

 

[ThatLady]

I run into many of the same issues when dealing with families of hospice patients. There is often a family member who decides (through denial) that the rest of the family has decided to "kill grandma". Although that's anything but the truth, this family member is determined to stand by their position. They can't let go without feeling they haven't done everything possible to keep "grandma" alive, even if it's not in "grandma's" best interests.

The only thing I've ever found useful is to try to promote rational discussion of the real quality of life issues that "grandma" is facing. Constant pain, frustration, loss of dignity and self-responsibility, and all the other things that go along with being at the end of life. Many of these, I think, are also felt by those with disabilities, including mental illness. Sometimes, if the dissenting individual can be made to see the fallacy in their thinking, they will come around. However, there is always the chance that they won't. In that case, that person must be left to his/her own devices while the rest of the family "takes care of business".

One can lead a horse to water, but one cannot make the horse drink.

 

[Philos]

Denial is an extremely powerful coping strategy, it is also very destructive.

When a parent in a family has a mental illness which they have denied, and a child in the family starts to develop a similar illness, there can be a powerful reaction against this child's presentation. In my case the reaction was complete denial. I was the child.

This denial set back my diagnosis and treatment by 20 years, and left me in confusion and unhappiness for a very long time. Even when I had a diagnosis by a consultant psychiatrist (depression and anxiety/panic disorder) the denial continued. In fact the denial continued until my father's death, so it was complete, and from his point of view successful. The power of his character was so great that other members of the family, my mother and brother, were convinced that there was no mental illness in our family. I later discovered that my father's condition had been so bad that the GP would ration his tranquilisers to only two or three on each visit, he would no longer give my father a normal prescription. I discovered that my father had a huge hoard of various tranquilisers secreted in his desk.

IMHO, denial is only effective if it is rigidly maintained, by taboos over conversation, no go areas etc. This makes it very difficult to break, and the more terrified the orchestrator of the denial is, the more strongly they will deny.

I once tried an experiment. I spoke to my mother about going to my doctor about a physical problem. She was interested and sympathetic. I then mentioned the psychiatrist and she blanked off, like someone in a sci fi movie. I then returned to talking about the physical illness and she was immediately interested again. It was amazing to see. For her, the physical illness was something to be concerned about, but visiting the psychiatrist was silly nonsense (I suppose). But it goes deeper than that, for nonsense can be mentioned, it doesn't have to be completely blanked off.

I believe that denial is one of the biggest barriers to dealing with mental illness, wherever we find it: in the sufferer themselves, in family and sadly in society as a whole.

Philos.