The Family as an Agent in Recovery | The Retreat at Sheppard Pratt

The Family as an Agent in Recovery

November 29, 2011 —

Holly Slapinski, LCSW-C
Family Therapist
As we anticipate the upcoming holiday season, our thoughts frequently turn to spending time with the families in which we were raised throughout our childhood. While many of us remember specific times with fondness when we lived with these families, we might also often remember incidents of pain, sadness, or worse. How does it happen that families have such an impact on us, and how might they best assist when we are experiencing an acute or long term mental illness?

Of all the organizations that human beings have created, the family remains the most powerful on our health and well-being. Its fundamental purpose, after all, is to create adults capable of surviving all the challenges presented in modern life. This starts, of course, with providing for our physical needs, the most basic being food, clothing, shelter, and health. No infant could physically survive without care for its basic needs. Most adults who become parents are aware that a child needs proper nutrition, sleep, diaper hygiene, protection from the elements, and immunizations. When the million and one questions arise, from what to do if my infant is constipated to where can I find reputable day care, they research their sphere of resources to find the answers. Well-baby literature, pediatricians, friends who also are parents, and Mom all are valuable points of reference.

Yet preparing a new human being to survive in today’s world goes way beyond physical care. Nurturing, defined as “promoting the development of,” is critically important for a child to learn the emotional and behavioral skills that will ensure true survival. Self esteem, initiative, and autonomy are just a few of these many skills. Unfortunately, when that child also struggles with a mental illness, there are fewer resources either available or accessible for the family to question about how they might help that family member attain a feeling of well-being.

The first step in learning how to support a family member struggling with mental illness is knowing where and how to find valid information and guidance. Unlike questions about physical nurturance, however, we usually cannot find the useful answers within our personal sphere of contacts. Additionally, the social stigma that continues to persist regarding mental illness may hinder our comfort to seek insight from those with whom we have personal relationships. There still exists much misinformation, distorted ideas, and just plain ignorance about the nature of mental illness. Not the least of these distorted opinions includes viewing the individual as weak or flawed. For parents, the corollary is that if the child is flawed, then I must have failed as a parent. So the conspiracy of silence continues and serves to maintain these erroneous points of view.

A huge contributor to these erroneous views may lie in the nature of mental illness itself. Unlike physical illness, which we can observe in concrete manifestations in clearly identifiable parts of our bodies, the foundation of mental illness lies in the neurochemical processes which are hidden from obvious view. Even the way we diagnosis mental illness is through the observation of behaviors, rather than evaluating the composition of one’s blood, scanning the brain, or other diagnostic processes of the body commonly used to diagnose physical illness. Therefore there lies little ability to substantiate the presence of illness through the physical evidence upon which our society has come to view as the only valid diagnostic criteria.
Adding on to the lack of physical diagnostic evidence, the truth is that mental illness affects a person’s behavior, rather than the functioning of a specific body part. When one’s behavior is impaired it naturally follows that one’s relationships with others, most closely with one’s family, will be specifically impaired as well. Relationships with family tend to be more impaired than those with other people who exist outside one’s “immediate circle”, simply because the intimacy of family relationships represents a great deal more about one’s view of self. For example, if my boss isn’t satisfied with my work, I can minimize that boss’s ability to recognize its validity, or even decide to get a new boss by finding other employment. But if my father isn’t satisfied with something I have done, I am more likely to generalize that dissatisfaction to mean that I myself am an unworthy person because I get disapproval from someone who gave me life and has been my point of reference since I was born. This is pretty heavy stuff!

In addition to behavioral impairment directly caused by the neurochemical imbalance which underlies mental illness, the person struggling has also learned behaviors which have enabled them to compensate, cope, and otherwise maintain themselves in relationships. People who interact with them on a regular basis have come to expect certain behavior, and will respond interactively according to their familiarity in something of a dance. In this way, each responds to the other in a way that maintains the compensatory behavior. An illustration of this is the young adult recently diagnosed with bipolar disorder. We know that the illness has contributed to his history of erratic, perhaps explosive reactions. Yet balancing the biochemistry in a way that allows the person to experience less abrupt neurological changes does little to teach them more functional thoughts or actions. The family is accustomed to the person behaving in a certain way and will continue to treat that person according to their habit. Therefore, families also immensely benefit from learning other responses which will support behavior change in their loved one.

Resources to provide specific direction for your family are available in every community. While information on any specific topic can be easily found online, personal interaction with others is usually the most effective way to learn how to apply that information to your unique family. Medical professionals, especially those in the field of psychiatry and behavioral health, usually can direct you to local support groups or other resources. Most municipalities, as well as health insurance companies, have information and referral services for families. The National Alliance on Mental Illness, or NAMI, conducts an excellent 12 week program without cost to educate and support families of those with serious mental illness-further information can be found at www.nami.org. It’s important to remember that mental illness does affect the entire family. Very often a skilled Family Therapist can prove invaluable in helping the entire family to recover and design new, more functional ways of interacting amongst themselves.

Your holiday season doesn’t have to be a replay of all your worst childhood memories. Now please, pass that pumpkin pie!