Many people suffer with mental illness, whether it is a mild psychological disturbance, such as temporary depression that will resolve soon after onset, or a chronic condition such as bipolar disorder or schizophrenia. While the person themselves may have difficulties in coping with their situation, it can also cause stress within a family.
How that family member’s mental illness affects the family depends on many things; what kind of mental illness they have, the level of engagement with treatment they are having, how well the treatment is going, whether the person can afford such treatment, how cooperative with the process the family are, what other personal difficulties other members of the family may be encountering and how well the family dynamics work.
In cases where the person with the mental illness has delusions, hallucinations, paranoia, added personality disorders or violent and abusive outbursts may prove very difficult for other members of the family to cope with. Since families are bonded by emotional attachments, other members of the family tend to take person’s behaviour as a personal attack and alienated them from the family. This may leave the person with the mental illness adrift and alone to deal with their situation, which can lead to worsening of their illness and sometimes suicide.
It is highly stressful, however, for other members of the family in dealing with constantly challenging and disruptive behaviours. The continual exposure to the behaviour can lead them themselves to encounter anxiety, depression and, at times, fear for their safety, if the person has violent tendencies. They themselves can begin to feel alienated and not want to engage with the world.
When therapists look at how to help families coping with mental illness they have to wear many different hats. Not only do we look at the needs of each member of the family but we also look at the health of the family unit itself separately.
- When the family unit has been fractured by the presence of mental illness we must ask if that is repairable.
- Would the family benefit from the family working as a unit?
- Does the family need to maintain some distances and work in a different way from how it once might have been?
- If the family unit is to become healthier, how can that happen?
- What compromises do members of the family need to make?
- What actions can family members cope with and take?
When families come into family therapy it is important to remember that they are not there to make other members do what they want them to do. Resolution is generally built on compromises in life and working on making the family work today and not operating retribution for past disputes.
Family therapy is a safe place where each member can be heard and their options considered. There needs to be an attitude of mutual respect and an acknowledgement that the mental illness does affect the family. Sometimes some members of the family may need to recognise that they need to adopt new attitudes and behaviours to form new positions in order for the family to become healthy once again and cope with the member’s mental health issues.
Dr Tracie O’Keefe DCH, BHSc, ND is an individual family and couples therapist and Director of the Australian Health and Education Centre, Sydney.