Family Support

How can I give helpful support to my mentally ill daughter, brother, spouse, best friend?

In our practice, we frequently hear from family members of patients desperately hoping for some suggestions or guidelines to tell them what to do in cases of self-harm, addiction, lying, running away, or just plain apathy.  It can be a heart-wrenching dilemma: to give support without enabling dependency; to prevent harm without stifling initiative; to love when under suspicion.

We really wish we could give you some easy tips for solving your problem, but the reality is that mental illnesses are usually chronic conditions that require sufferers to learn management skills for a lifetime.  It’s a marathon, not a sprint, and, as a supporter and/or caregiver, you will also need to learn skills, and prepare yourself to be in it for the long haul.

Which is not to say that there won’t be progress.  With determination, people can learn the skills they need to manage any kind of disorder, and there are plenty of examples out there of successful, hard-working people who don’t let their mental illness drag them down.

So what can you, a loving but not healthcare-trained family member do?  Here are some tips:

  1. Your engagement really matters.  Even if you are not getting the feedback you are hoping for, your constant, positive presence in someone’s life is a great help.  Try to make regular check-ins and ask how things are going, even when it all looks good on the surface.  Resist the temptation to go from crisis to crisis, and take action only when something goes wrong.  Don’t expect a sudden epiphany or realization on the part of a mentally ill person that will let them “turn the corner” or have a sudden insight.  Just be there every day and be available to listen to what needs to be said.
  2. Try to stay at least a bit detached.  Don’t express anger or disappointment, just keep moving through what needs to be done at each moment in time.  Sometimes, relatives of a sick person get fed up with the constant failure to meet standards, and they try to “punish” or control behavior by negative feedback.  Punishment doesn’t work for a mentally ill person because control is exactly what they have a problem with.  Experience consistently shows that what works is to give positive feedback whenever possible and no feedback at all to negative behavior.
  3. Don’t support self-destructive behavior, whether controlled or not.  Your job is not ”rescuing “ your loved one from the consequences of their choices.  Especially when they are financially dependent on you, the temptation is strong to throw money at a problem, rather than letting someone work it out on their own.  You are not being “cruel” if you limit their access to money or transportation, you are only providing training wheels that hopefully may come off some day.
  4. Consider professional support.  Family-focused coaching can give you a much-needed perspective on what’s going on and how your engagement is working (or not).  When emotions are running high it’s hard to step back and look at the big picture.  A trained therapist can give you the space and coaching you need to work out the best way to move forward in your helping role.
  5. Seek family support yourself.  Talk with a friend, spouse or parent and get others involved in giving you the care you need too.  Even people who are not professionally trained can offer the same kind of support to you that you are giving to others.  Don’t try to go it alone!

A family member with special needs can be a real burden and it’s not easy to know how to help.  Educating yourself and reaching out for available resources can make the difference between being overwhelmed and being capable.  Below are some additional resources for family support.

More Information:

Family Resources

Punishment vs Negative Reward

Nancy