Healing is about community and family is, for many people, the most powerful community. Too often though in the name of treatment compliance the mental health system fractures the family into groups with competing interests.
Recovery is real. People do get better. They do find new and better life. It is really tragic though that so many people I know talk about recovering despite their families and not because of them or with them.
I remember the first time it was explained to me what a positive effect the medical model ultimately had on the functioning of families with a member who struggled with some form of “mental illness.” It, the argument went, decreased blaming and conflict among family drastically if it was understood properly. The loved ones behavior was the result of a biologically based brain disorder. It was not a matter of fault, not a matter of willful decision or deliberation. Their behavior was the result of factors beyond their control. It was the genetic cards they were dealt. And, so the reasoning went, who could blame someone who was largely the victim of forces beyond their control?
The model gave families hope. Treatment was available that made a difference. The core of that treatment was medication and if their loved ones would be compliant with the treatment and take their medication then there was every hope that their symptoms could be managed and life could go on. For families the task became to help their loved ones accept the reality of their disease and to be medication compliant. The disease was chronic but if their loved ones would accept their need to take the medication forever the effects of the disease could be managed and the effects on them and the overall life of the family minimized.
For too many people it hasnt been that simple.
The medical model has lead to a family increasingly torn by blaming and strife. It has lead to a life increasingly devoid of hope. For many the “cure” has been worse than the “disease.” Medication has not worked as advertised. It has not been the magic bullet promised. It has side effects that are disruptive and destroying of the quality of everyday life. For some people effects can be permanently life altering or even endanger life altogether. Some people have been helped, but for many the search for the “right medication” comes to define a life marked by less and less quality.
Families are told that their loved ones resistance to medication is a symptom of their illness. They dont realize how much they “need help.” . The net effect is that while people may or not be blamed for their “illness” they do become blamed (held accountable) for their failure to be compliant with treatment (take medication).
Love becomes trying to exercise power over someone because they “dont really know what they really need.” The result is further and further family conflict and battle. The family sees the conflict as evidence of the working of the disease and decides to push things harder and harder. The end result is a family broken.
The medical model sells the family short. To live with someone you care about having problems with mental health issues is a trauma for everyone. There are issues of loss and grief for everyone. Everyone is damaged. The medical model tells the family that treatment is what happens to their loved one when what is needed is the opportunity for healing for all. In the end it is unfair on all ends.
Families are a we. Anything that defines proper interaction as “us vs. them” in the end pose a very real risk of doing as much harm in the long run as the problem they attempt to solve.
Treatment compliance is defined as the same thing as recovery…. sadly so for many people. Some families do get past this. They realize that they are all in life together. They support the choices each other makes and support them learning the tools and knowledge to make good choices. The treat hope as a real thing. They know that everyone is more than the difficulties they struggle with and that families are defined not by the presence of pain and suffering, but how they deal with that pain and suffering.
They know that all have been traumatized in some way and that finding better life is about healing. They know that healing is not about what they make each other do, but in what they help enable each other to become able to do.
More and more there are voices saying that healing can be a together and not an apart. The Mother Bear Community Action Network in North Carolina ( http://www.motherbearcan.org/ ) is one resource I know the most about. They are a pioneer in developing resources that emphasize the development of family strengths and core competencies to enable the family to be part of the healing for all its members. There are places to turn for help.
Recovery is real. Even for families. We dont have to be a burden life has inflicted on each other. Even in the greatest of traumas and amidst the most painful injuries of life the family can be a source of healing and safety.
Hopeworks Community 
“Even in the greatest of traumas and amidst the most painful injuries of life the family can be a source of healing and safety.”
Larry, this is such a beautiful vision! Thank you for reminding us over and over again that Hope is Real, Hope Works and that families can rely on this and each other when they have support and access to education about all they ways can heal together.
You are a wonderful Papa Bear!
I like this piece. I agree that the medical model, while liberating in the sense that it takes the “blame” off the consumer also inhibits a true understanding of mental illness and inhibits development of a cohesive family dynamic, that is needed to truly support recovery. I believe that a family that is educated about a diagnosis is at an advantage. I have worked with families who have no interest in learning about diagnosis, medications, etc. and I have worked with those who do want to learn and it is the first group that are more successful in providing a supportive environment.
The problem, as explained in this piece so poignantly, is that this model creates the “us. versus them” scenario – the consumer is different or “sick’ and the family is not. Wow what a problem this is!!! I believe that we should not only work on family cohesiveness, post-diagnosis, but ALSO work on understanding family dynamics as something that evolved long before a breakdown or other devastating event has occurred.
In other words, what kind of unhealthy family characteristics have contributed to the origin of the illness? What is it about the relationship of the “identified patient” and the rest of the family that is significant and has ENABLED the consumer to become ill in the first place? Isn’t this important is a consumer is to leave a hospital and return to the family of origin?
A long time ago, people known has psychoanalysts believed that all human behavior was related to our psyche, that all mental illness developed from traumatic family experiences, many occurring during early years. These could theoretically be resolved through therapy. There were actually psychiatrists who just did “talk therapy” and not medication!! (I was lucky enough to have worked with one.) The times have changed.
I mention this because it is pertinent to the discussion of family. We need to think about mental illness as a family illness and not an “us versus them,” consumer versus others, type of syndrome.
I will sum up by saying this – I have worked for 13 years as a social worker and I am yet to meet someone diagnosed with major mental illness who did not come from a family with significant dysfunction. The illness doesn’t develop in a vacuum. Let’s recognize that.
I agree. that certainly sums up our situation. I am a single mom with
a 17 year old daughter. abusive dysfunctional parent with more rights than the child thanks to “joint custody” is what set her up and kept it going.
Now I have obtained a no contact order through the minors with disability act:
After five years, no thanks to Childrens “protective services”, or psychiatrists involved.
My daughter is old enough to make a written declaration, so she helped herself and the judge decided enough is enough.