I like to share this quote with family members who love someone with a mental health condition:
“Ask not what disease the person has, but what person the disease has.” —Sir William Osler
Remember: you did not cause the illness, you cannot control the outcome of the illness, and you cannot cure the illness.
Here are suggestions for how you can make space for the illness that is visiting your family.
Relate to the person, not the illness.
When interacting, relate to your loved one’s personhood. Remember that this is a person who has thoughts and feelings separate from their illness. Avoid generalizing about “people like you.” Don’t give them a negative label when talking to them. You wouldn’t like being labeled schizophrenic, or someone with a brain disorder. Neither do they like it. Remember, they are more than their diagnosis.
Focus on now.
Ask them, “What do you want for your own life this next week?” Symptoms of mental illness can be overwhelming for your loved one. Stay in the present with this to minimize stress for all.
Listen and accept that their feelings and thoughts are real to them.
Act as a mirror when your loved one expresses feelings such as pain, anxiety, anger, and fear. Bear witness to their current pain, rather than try to fix it or talk them out of their feelings. Use empathetic language, such as, “It sounds like you are in a lot of pain. I see you are suffering.”
Don’t try to talk them out of their voices. They are actually hearing them, even if it is a delusion. Say things like: “I can imagine how those voices must scare you.” “How hard that must be for you.” “Your voices are distressing for you.” “You have survived the voices in the past. You have managed to lessen the voices in the past with meds. You can lessen the impact of the voices with meds.”
Acknowledge their strengths.
Find opportunities to acknowledge their strengths to your loved one. They may need lavish amounts of praise. Use five positives for every negative. Wait for them to say something positive and then reinforce it with your own comments. Examples: “We enjoyed your comments at our family dinner tonight.” “That is a really interesting idea.” “I can see you making efforts to take care of yourself.” “Thanks for helping last night.”
Remind your loved one that feelings change.
Dispel apprehension they may have when experiencing depression or thoughts of suicide. Acknowledge their feelings first, and then say: “I understand you feel hopeless today. Tomorrow you may feel differently.” “Feelings aren’t facts — feelings can deceive you and convince you of things that are not real.” “Excuse yourself rather than accuse yourself.” “Feelings change rapidly.” “There is no right or wrong in the everyday trivialities of life.”
Put them on an equal playing field with you.
Example: “Why don’t you be the family photographer and take pictures of our family group? Afterwards, you can send photos to everyone in the family. Everyone will appreciate this.” Give yourself a small task to do that and model doing an activity for your relative. This can make them feel as if they are a partner with you, rather than one being superior and the other inferior. It is always important to put them on an equal playing field with you.
Tell them the truth, but focus on positive outcomes.
It’s important to tell the truth, but remember how valuable praise can be. Example: “When you don’t shower, people really don’t want to be close to you. When you take a shower, people enjoy being with you.” “You have felt persecuted by the FBI in the past and taking your meds seems to lessen this feeling of persecution for you.” “When you are on your meds, you don’t feel people are staring at you or talking about you.” “Your angry outbursts scare me and others.” “Taking your meds helps you feel less stress.” “Taking your meds can protect your brain from further stress and further brain damage.”
Nurture belief in their future.
Remind your loved one that there is hope of recovery. Examples: “When you are feeling better, we will. . . .” “When you are able to hold down a part-time job, you can….” “Remember that feelings change rapidly; you won’t always feel as negative as you feel today.” “Try to replace an insecure thought with a secure thought.” “Thinking a calm thought can help make you feel calm.”
Try to stay calm and focused. Don’t threaten, don’t shout, and don’t bait your relative into an argument. Look you loved one calmly in the eye and state what you can do and what you cannot do to help them. Repeat this several times. Be very specific and clear.
Learn from the past.
Remember: the best predictor of future violence is past violence. Most people with brain disorders are not violent. If you sense they may be, open the door and encourage them to leave the premises. Give them space and distance from you. Sometimes, locking them up is the best thing to make them safe, even though they feel you don’t love them and that you are controlling them.
Take care of yourself.
Keep yourself safe, as you are their advocate! Remember to honor yourself and give yourself credit for all you are doing to improve the conditions of your loved one’s life. You have a right to have your own life, no matter what is going on with your relative. You also have a right to take care of yourself. Without you modeling for them how to be kind to yourself, they cannot know they have the same basic right to be kind to themselves.
About the Author: Sharon Dunas is the co-President of NAMI Westside LA’s board of directors. More about Sharon.