The 3 R's: How to Engage the Family in Mental Illness Recovery
"Ben is so lucky to have you."
I hear that a lot, from healthcare providers who often don't even know the families of those they treat and from PAMIs (People Affected by Mental Illness) who usually add one of three things:
- their family has given up on them - and they grieve the loss
- their family has somehow made their recovery more difficult and they are glad to have broken free from them, or
- their family has been a major part of their desire to stabilize, and they are so grateful for the love and support.
One of the most validating things I heard at the NAMI National Convention was this, from the producer of a photo collection called 99Faces Project: that a UCLA psychiatrist was quoted as saying that the most important common link among those in successful recovery was this: someone who loved them anyway, and walked alongside them on the journey.
I plan to be that for my son, carefully balancing, as much as possible, the letting go with the support when needed. That is a tough balance to achieve, but the success is in the desire to do so. This is Ben's journey, not mine, but I do always want him to feel our love.
But this hasn't always been easy - it fact, I shed many tears of frustration and fear when I felt the most powerless. Right now it's pretty easy to be supportive. Ben is stable, working, loving, and seems happy in life. Last summer, during his re-hospitalization and refusal of treatment? Not so easy. Relapses are all too often reminders of the pain and grief that always seems to lurk, threatening to re-appear.
Still, I remain an MRG (Mother who Refuses to Give Up) - but what helped me to get here, with only limited control of this process, were the 3 R's of partnering with both Ben and the healthcare providers who are essential for support:
- Respect - for what the family has been through, and is going through - and the fact that each family member may be at a different stage of acceptance. Consider the symptoms they report and observe in their loved ones; listen when they share feelings of loss and grief; reassure them that their feelings, while painful, are normal.
- Resources - place a brochure in the hands of a family member who hopefully will read it; steer them to NAMI for support and education; let them know about HealthyPlace.com and other websites where they can also find information, support and community. Have good mental health books available for them to borrow - or a least a list of them.
- Realistic Hope - Every family needs hope, but not false promises. The more treatment options available when Ben was ill, the more we could continue to hope every time his response to one was less than effective. Realistic hope requires patience, though. One of the most effective things I was told by a provider when Ben was just starting to respond to treatment, but still so clearly different from what I'd hoped for him, was this: "I love my job because I like to see people get better. And I believe Ben will. Wait and see. But it will take time."
I spoke about these at the APA (American Psychiatric Association) earlier this year to a group of doctors at a session about the
"Therapeutic Alliance" and the part that a family can play in the process.
It's not always easy - and progress never comes as quickly as we'd like - but one thing I know for sure when it comes to these 3 R's:
An educated family is in a much better position to be a helpful part of recovery than a family in the darkness of blame, anger, and stigma.
Help them to stay in board with Respect, Resources, and Realistic Hope. These gifts were treasures to us as we struggled to provide the right balance between stepping in and letting go. A family given these gifts just may become the best ally for recovery - and hopefully will not - ever - have to give up on someone they love.
Kaye, R. (2012, July 12). The 3 R's: How to Engage the Family in Mental Illness Recovery, HealthyPlace. Retrieved on 2020, October 30 from https://www.healthyplace.com/blogs/mentalillnessinthefamily/2012/07/the-3-rs-how-to-engage-the-family-in-recovery
Author: Randye Kaye
I'm new to the site and I really don't know a lot yet about you Randye but I hope to learn more. My son has Bipolar, a mood disorder, and ADHD. He doesn't get along with really anyone. He and my husband (step dad) do not get along and I am always put in the middle. Neither of them seems to consider what I have to deal with. They both end up not talking to me; I am the bad guy and find myself sitting all alone. I feel so punished no matter what I do. My family and what friends I have told me to try this and try that, but every resource I have ever found for my son, it seems that he ambushes it every time. A big problem is that first my son is very gullible, and secondly he believes smoking pot is his cure regardless what we say or the Physiatrist has to says. He also refuses to go to a therapist to help maintain the other 50% of what the Physiatrist say that he cannot help him with. My son is at the point of not listen to what anyone says so yes, soon, I will have no choice but to give in to my husband and what the Physiatrist thinks too, and let Brian be homeless. Yes he acts seven at times and destroys the house if he can’t get his way; ending up doing what whatever he wants anyway. This is all taking a big toll on me and my health is getting bad. I feel I am the only one ever really trying to understand and work with my son. I have a full time job so it’s hard to run around and help a kid with no transportation, who wrecked a moped and a car. I’m not a doctor and I can only do so much. The place/homes that I have found are completely full for years, or they want an "ARM" in payment for about two week of treatment. Please let me know if I should let my son be homeless. I know I cannot continue to have him in my house, it is not healthly for me.
Dear Katherine - been there, understand that...have you reached out to NAMI for support? I hope so. You shouldn't have to go through this alone. There are options, but sometimes the best way to find out is via other families who have been there in your area. My heart and thoughts are with you. Education helped me a LOT.
If you read in "Ben Behind His Voices" you'll pretty much get the scoop - and see that we have so much in common. There IS hope - but yes there is such a maze to get through first. I did "make my son homeless" for awhile. SO hard to do. In our case, worth it. I got some sanity back, he got some responsibility back. Have you attended NAMI speaker meetings - or, better yet, Family-to-Family? Helped us so much. You are not alone. Believe me.
I have a son who is now twenty-two. His illness gets stronger very day and it has been very difficult to talk with others about my son. They don't want to be associated with it and they certainly do not understand him or what my family has been going through. I have looked for years to find someone, anyone who would help. You are correct in saying it is heart breaking, scary, destructive, and has almost put ME in a state of insanity and anger to where I don't want to deal or live anymore. I just want it to go away until my son's voice of reason and needing me sounds in my ears. I then become strong as an oak tree ready to try again to beat the bushes and find him help. I have tried to get in touch with Dr. Phil two different times, with no luck. Please dear God above, I need help. He is my child and I will never give up.
to follow up:Today (in the light of day) things do seem better. The way out of the mess, she is constructively engaged in working on (new apartment, to replace one being lost) This is due to behaviors roommates could not tolerate- I do not blame them. Neither does she, but she is naturally disappointed. Some hard lessons in how the larger world responds to the illness. Knowing this, I think can motivate her to do the best she can with her management of the illness. She is a "walking set of contradictions" strengths and needs (aren't we all?), and I would hate to see her do less well than she could because people don't hold her accountable.
Not as fun as a bunch of roses at graduation, but valuable.
I think maybe the "realistic hope" part is the most important part for me right now. To hear that you have hope, and you accept that progress is not a straight line so to speak, helps me a lot. I am just dealing with the fears brought up by thinking my daughter was doing better than she was, and now trying to figure the way out of the mess of relapse. I know it's hers to figure out. I also know that she relies on my support to do that. What I most want to figure out, is the fine line between support and enabling. Thank you for making it clear that you still have hope even in the times where it is really challenging to do so. And also for sharing the good parts. I often feel like those parts of this journey are less often shown than the hard parts. Both parts educate, but I feel like it helps to have a picture of hope from your stories.
Hi Nina - I'm so glad that my words were of some help to you. As you well know, acceptance and hope are not static emotions; we constantly work to keep them in balance. Hang in there (both of you), and keep balancing (and hoping) as best you can!