Saturday, April 21, 2012

Setting up and maintaining boundaries with family members who won't get the help they need

"Insanity does not run in my family. Rather it strolls through, takes its time, and gets to know everyone personally." -author unknown
One of the things my therapist said the other day was that I am learning a lot about boundaries, and how to keep them and maintain them for myself with others. For my mother, with example. It is a process, when you have grown up in a dysfunctional family where alcoholism and mental illness, and, obviously, chaos, were rampant to become an adult who has stability in your life. It is a long, arduous process. I am still in it. It is an interesting process, and one through which I have learned and grown, only to fall back into old patterns and have to learn and grow some more again. This came to mind tonight because I spent some time with my mom, and my brother and sister who are my closest family members. I have another brother and sister by my dad's second marriage, but they are much younger than me (one is still a child) and I didn't ever live with them or see them much, so we don't know each other the way I know my brother and sister who I grew up with.

It's hard to explain this, but I felt responsible for my brother and sister (the two I'm speaking of) since they were born. I never wanted them to go through the problems in life that I went through. Ever. That was my main goal. I didn't want them to go through any mental or physical abuse, or chaos, or loneliness or depression. I wanted them healthy, happy, functional. I used to tell my therapist, Barbara, when I was a teenager, "If I could take them away to the woods and raise them apart from our parents I know I would be able to protect them and keep them safe and treat them well in a way my parents never will". It sounds a little arrogant for a teenager to think that she has that ability, I guess, but I was speaking as their older sister who always felt responsible for them, and who often was given responsibility to take care of them. I wanted to protect them. And I was unable to protect them. I now know that many of the things I wanted to protect them from happened to them anyway. They have both gone through Bipolar Disorder and alcohol issues. I never wanted that for them. I wanted to protect them from that very thing. And I couldn't. So they had to go through it themselves; they still do.

This is really hard for me to come to terms with. I struggle constantly with my desire to save the world and my knowledge that my inability to manage my own life fully effectively is pretty good evidence that I do not possess the ability to save the world. I struggle with my inability to save my brother and sister. If I could, I would just live their lives for them and go through it all for them. What good what that do though? They would not have to take the responsibility to grow through their own difficulties, and I would crumble under the pressure. So I do things like offer to take my brother to Twelve Step meetings, which he never wants to go to, or to take him to work, or to make a resume for him, or things like that. But I try not to lecture as much now as I used to, to him. I know now that - as is evident from his behavior - he does not really seem to want or believe that he needs mental health treatment. Even though he was suicidal and was forced into a psychiatric hospital a few months ago. He does not seem to want treatment. He went off his medications and stopped going to see a doctor (again). He never went to live in the halfway house he was supposed to live in so he could stay sober. He doesn't seem to want to stay sober or know how to. Yet, he also, adamantly, does NOT want my advice. So should I continue to shove my advice down his throat like I have often done so many times over the years? It's ineffective. It makes him angry, resentful, and silent so he ignores me. It doesn't change him or make him take initiative. It makes me tired and stressed out more than I can afford to be. It doesn't work for anybody.

People have to live their own lives. For those of you who have family members with mental illnesses and substance abuse problems, one of the things I have learned over the years dealing with this (my mother has been mentally ill my entire life), is that people have to learn to live their own lives. You cannot live their lives for them. I cannot go to the mental health center, or get a new job or attend AA meetings for my brother. I think that's what he should do to save his life and benefit himself. I think it would bring him into recovery, which offers fulfillment, hope, and happiness. But I can't be my brother. I am me. He is him. He must want the fulfillment, the hope, and the happiness enough to reach out for help, go to the community mental health center (he does not have health insurance), get back on medication again, go to AA meetings, get sober and stay that way as long as possible, go to Vocational Rehabilitation and get help finding a job....these are things that I know would benefit him. But I am not him. He has the right, and the ability to make his own choices. They are not always going to be choices I agree with. But I do not have the right to take his choices away. I also do not have the arrogance to think that I know exactly what my brother should do with his life and he would be perfectly happy if he just did what I said. I am human too, and I don't know what goes through his mind. I want to know, I want to understand, but I rarely know how he's really doing or feeling because he never wants to tell me. So he will have to find his own way.

My brother is 31 and my sister is turning 30 in a few days. When I was 30 I almost shot myself in the head. I then got forced under the Baker Act into a hospital for five months. I then got better, and got into serious recovery, which is why I now am where I am today with a much, much, much improved life. I can't tell you how much I want that much improved life for my brother and sister. I want them to be happy. I went them to recover. I want them to get help. But they may never choose to do so. That is a fact I must accept. I can't force them to get treatment. I can't do it, and it wouldn't work if I could do it. I don't have the financial resources to perform an "intervention" on my brother and send him to an expensive rehab, and even if I did, it probably wouldn't work because he doesn't want to deal with his problems.

He is dealing with them in his own way. The way he knows how. And I know that there were years of my life when I survived by the skin of my teeth, getting by any way that I knew how, which was often horribly self destructive, painful, and brought me near my death. But I did what I had to do to survive. And eventually, I hit a crisis, I got forced into treatment, and I got better. Not everyone gets better. I don't want to think that my brother or sister will never get better, but they have to define what better is for them. I can't define  their reality for them. If they don't think they have problems, it is not my job to point their problems out. If they don't think there is anything they can do about their problems, all I can do is point them to the resources that exist and offer to give a ride there, but I can't force them to go. You can lead a horse to water, but you cannot make it drink.

Sometimes I wonder if there is a god, why that god would have put my family in so much pain. Why do there have to be five people in my immediate family who either have a diagnosed serious mental illness or an obvious alcoholism problem? Why? Five people. Not one person. Not no person. Five people. Five people struggling to stay afloat. As my dad would say "it's every man for himself". I take on the burden of these other people's problems too often, internally, worry about them all the time until I'm physically and mentally more sick myself, and it solves nothing. I have to stop doing this. It's no good for me to do this. And it doesn't help them that I do this. I have to remember to let go.

Sometimes, all you can do for a homeless mentally ill person is tell them where the nearest shelter is and point them towards the bus that can take them there. Giving them a dollar really for food isn't effective in solving their problems, but getting them to the real resources that can help will have long term benefits. I was homeless myself three times, so I don't give out money to homeless people often because I know that this is no solution to their problems. They need much more help than a dollar can provide and they need to go to the places that have that help available. There are community mental health centers throughout the United States where you can go without health insurance and get mental health assistance. It's very frustrating when you tell your brother and your sister to go to the local community mental health center that you go to, for years, and for them to then never go. It's even more frustrating when they go once and never go back, choosing to go off all their meds and suffer instead. But what can we do? All we can do for our families who have mental illnesses is give them support and be a listening ear, and offer to help them. We can intervene in a crisis, but every day is not a crisis where we can intervene. So we have limits.

I understand the frustrations of family members who want to help their loved ones who have mental illness and don't want help. I  go through this too. But I also remember that there were years when I didn't know I needed help, or didn't know what kind of help I needed, and I was still a person during those years, with feelings, and thoughts, and wants and desires and skills and abilities, and value. My brother and sister, even if they never get the help I think they need, are still human beings with feelings, thoughts, wants, desires, skills, abilities, and value. A lot of value. Who I respect.

Tonight when I spent time with my mom, brother, and sister, I valued that time. We laughed, joked around, sang, talked, played with mom's dog, and had a nice time. I must cherish these times because they don't always come often, and when they do they are important.

If you have a family member with a mental illness or substance abuse problem who won't get help, you may not be able to save them, but what you can do is continue to respect them as people, continue to talk to them, laugh with them, joke with them, listen to them, support them, give them resources, and wait for them to get  help on their own. You  can also be a good example of taking care of yourself, which is vitally important. And showing this by example might be more effective than any number of lectures. And sometimes, that is all you can do. But that is something. Cherish the good times. They are still people.


  1. I've been known to straddle a blurry line with boundaries within family in the past, no longer. You can have true innocent purpose, trying to assimilate, to understand, to to too much. Someone winds up feeling like the peacock in the fox den, you, them, whomever. And I have always guessed(rightly) that you cannot protect anyone by trying to anticipate their problems. ~Mary

  2. Nice post Jen. I agree with you, love and respect your brother and sister, but don't try to live their lives for them. You are a great sister. I'm so glad that you are a part of their lives and visa versa. You really have lived and learned. You sound sensible and mature. I know it's not easy to step back and watch your siblings struggle and fall and have trouble getting up again, but they absolutely have to learn for themselves to reach out for help. I had trouble with that and sometimes I still do.

    We all want to seem so self-sufficient, but there are times in our lives when we just aren't. This goes doubly for the mentally ill and addicted. The best thing you can do for your brother and sister is to take care of yourself, as you said, so that you can be there for them when they really need you and not fall apart because you've beaten yourself down with worry. A little bit of worry is natural and understandable, but a lot of worry, especially when you're feeling helpless about doing something about it, is real poison.

    Good for you valuing the good moments with your family. I'm working on doing the same, you know, stopping and just appreciating that, for the time being, all is quite right in the your world. Love is precious.

    Kate : )

  3. Loved this post Jen! I struggle with this. I've learned this lesson several times in my lifetime and still always manage to forget it when a loved one is in need. I'm glad you are setting these boundaries--it's a healthy way to live your life and quite possibly could strengthen your family relationships. Reading your posts gives me hope for myself Jen, thank you for that.


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