I have never understood the push to include family in the treatment of an adult. It has been the thing in a lot of eating disorder programs for a long time, and when the patients are kids, that makes sense. But too often separation and individuation is a far larger problem and this won't be solved by bringing in the whole family.

As someone who was stymied at every turn in her effort to help her adult daughter during a manic episode and who even now can't engage in "help" for surviving siblings without incredible hassle, I frankly applaud this concept of family therapy. I know privacy rights are a thorny thing but common sense needs to enter into these therapeutic relationships too. Furthermore being completely excluded can make it easy for therapists to label other family members the "problem" when they really don't have a clue if this is the case or not.

I think it is an individual treatment plan that must be considered, and what I believe is doctors see patients respond to certain family members, and often when a doctor is stumped on how to treat a patient; the doctor sees the support system in place and whatever appears to work for a positive result in the patient is then used to further therapy.
I believe that adults cannot move forward with independent living skills if family is depended on too much for filling in the gaps for self-functioning. If the family/or support system can be observed as constructively furthering and promoting independence then that can be certainly helpful.
I have been in a situation where I was told not to participate and to give space to an adult child and also told to play more of a key role.
What conclusion I have had as a result is the above description, some people respond to family and some don't.
I also have a psychiatrist that has been instructed by myself that no one is allowed to discuss me with the doctor. Personally, I don't want anyone interfering with me, my life or my medications. If that husband in the article calls and feels better by talking to the doctor then he should get his own. The husband should be promoting charting or other ways the wife can become self-aware as a patient and if the husband wants to be involved, then it should be in a 2 person session with a shrink not on the phone playing God.

One more thing, I have a letter from my father's lawyer explaining that the fact that my family abused me is my fault because I am "stricken with bipolar disorder." The lawyer implies that any thing done to a person labeled as bipolar is justified because the person so labeled is thus utterly valueless and even physical abuse is sometimes necessary to "help" them. She mentions her brother who got "put away" in the 70's because he was bipolar. I wonder what happened to her brother.

Good thing I could prove I had never been so diagnosed, still do we really believe this evil sh*t?

Think about the woman whose husband calls a psychiatrist to blame his problems on her behavior. If she loses interest in sex, it's her bipolar, if the quality of the meals she prepares drops off a little, it's her bipolar. And if she doesn't get well and start "putting out" and getting dinner to the table on time, it's inpatient treatment for her. And Psychiatist forbid, what if the crazy b*tch gets manic and buys the baby a new pair of shoes when hubby wants a fishing pole?

Think about how any controlling abusive person should get their relative labeled bipolar first because then it's the one labeled bipolar who gets medicated.

What Torrey is actually preaching is that anyone ever labeled bipolar or schizophrenic should always be forced to take major tranquilizers to prevent these dangerous mental defectives from ever appearing normal, because it's when someone labeled bipolar or schizophrenic is allowed normal autonomy that they become dangerous. And then review this contract people labeled bipolar are being pressured to sign, that my father tried to bully me into signing all the while telling me I was present at an involunatry civil committment hearing but didn't remember it because of my disease:

http://www.manicdepressive.org/images/contract.pdf

What human would want to sign this contract?

Very troubling. There are a few problems with involving families in mental health care:

(1) From the patient's point of view, it can often seem that her doctors and her family are on one side, against the patient on the other. Psychiatry is alienating enough without losing your family support.

(2) The person in the psychiatrist's office is rarely the craziest person in the family.

(3) Privacy legislation is in place for good reason -- to protect patients. This ought to apply to mental patients too.

(4) Child abuse is a major indicator for later psychiatric diagnosis. In most cases, child abusers are family members. It is entirely inappropriate to have a child abuser have a say in his victim's later life choices.

(5) Psychiatry is already infantilizing. Bringing in family members to reinforce old (and often dysfunctional) family patterns is not therapeutic.

I have to agree with this being a troubling trend; most of us are in therapy because of our fucked-up families in the first place and trying to break cycles of some kind. It would be great if every family could solve things with the help of a therapist, but the reality has to be that such a move would cause more problems than it would solve.

Obviously, if the parents or family are an obstacle to the patients well being, then fuck bringing them in to the meetings or appointments.

But if the family is willing, and the patient is willing, then all kinds of good can come from having them involved in the treatment... and why turn down the help, even if it's from "mommy"? I've been diagnosed as manic depressive for nineteen years, and went untreated for sixteen, as well meaning as they've been I don't think my family can spell manic depressive. If any of them had picked up a book, or had the option of there being a place or person trained in manic depression where they could learn about the disease, I think the fights we've had which were started because of their lack of understanding of the disease, wouldn't have been so vicious or devestating to my recovery.

Instead of thinking of this kind of thing as someone forcing a mommy on you, why not look at it as something learned from AA? Why shouldn't the family of a manic depressive have the same option as the family of an alcoholic does in Al-Anon?

Anyway. For what it's worth I wrote about this back in January... A "Perfect World" Would Start With An Intervention: http://saltedlithium.wordpress.com/2007/01/12/start-with-intervention/

Man, thanks for posting this. I'm looking for volunteer work to fill some time, and applied for the Board of Directors at the state MHMR. Just got the letter back, it included a sentence about the work we do with those living with S and P mental illness, substance abuse and their families. Unpack that sentence, it's all about deviance. Mental illness is conflated with drug abuse. I'm mentally ill and I don't use drugs. But if I did it would be my fucking business. And the involvement of the family? I could not get my head around that til now. The work we do with the iatrogenic fucking nuclear family to advocate for the nuclear patriarchical family. Unbelievable.

One sentence, so benign, so unproblematized, so full of adversarial shit.

The real pisser is in its bastardization of the old school "family systems" therapy, which really was decent and non-adversarial. Family systems regards all family members as equal contributors to family dysfunction, each member has a role, and they are identified and resolved, including the role of SCAPEGOAT, the problem child, who is targeted for and takes on that script within the family. All the roles and bullshit that goes on by the members are seen as dysfunctional but well-meaning attempts to serve the interests of the family unit, and in therapy they learn how it's not working, and that there are better roles to take on. Whatever happened to this approach?

What really stinks here is

"Child abuse is a major indicator for later psychiatric diagnosis. In most cases, child abusers are family members. It is entirely inappropriate to have a child abuser have a say in his victim's later life choices."

Amen, absolutely. It's collusion with the parent culture par excellence, the society we live in that refuses to look at the sacrosanct authoritarian family paradigm. In the real world it boils down to continuing that cycle of abuse in the life of the patient, who are sacrificed for the sake of a complete fairy tale.

My mother has been medicating my PS brother with a 30 year old med in uneven doses w/o his knowledge since he was DX'd after being taken down by SWAT for heading to a mall with a loaded in sight gun.I had no idea as she did he had a gun pile. He had come home from the navy with classic signs. Put locks on doors shaded windows etc. I was 18 and till grandiose, full of 3-4 Hugely emotional DELUSIONS as they affect my life and best friend who died about 6 years into the mom's plan to play GOD and DR. No liver tests no therapy, no ability to tell VA dr's he sees frequently what is in his body. He goes over what we thought were mostly not real urinary or other common medical problems and often gets scripts. on his 30th day of commitment they found something to control the paranoia and bizarre OCD behavior.
he was able with her sneaking in meds and his service record secure , you can laugh, a postal job. He has become fanatically religios added to the idea that as we grew up and found accepting his almost constant grandiose intolerant narrow minded religious and politically torturous lectures THIS WAS WRONG. She is in deial. Says he never would have hurt anyone because he gave the gun over quick. Well the cops were not "those people out to get him. When she lost her 1st manipulated source for the meds she convinced a completely untrained DO to give her scripts, she takes them out of state and pays out of pocketation? SHE JUST KNOWS THIS IS THE BEST LIFE HE COULD HAVE HAD AND WOULD HAVE BEEN HOMELESS. That he stopped taking it the cops said he was trying to buy a gun and instead of giving him a chance at the hospital decided his sad, lonely and probably now shortened life. He thinks he ry looking, impossible to listen to w/o comment for long and has no friends, no joy no sorrow no independence, no bils to pay or TP to buy. Yes he has a million in the bank and is very CHEAP. She says trying it now he'll lose his job and that , seep and Church is all he has. Well we think the idea of him home with her all day is scary too. Not as scary as in all this time we've let it go on knowing one day he may not have her I JUST KNOW "plan and we will be responsible and I have an 8 yr old w/ autism that due to my brothers lack of social Skills we can't let him be around which caused controlling mom to ban us from all and worse. I finally told him one day when although it's not his fault once or twice a year I flip out on him thinking he'll hear. i feel better. This time I let out our corrosive family big secret, the truth I felt so guilty never pushing it and being embarrassed of behavior SHE not he or a qualified DR created. he said that I was silly, we are bad parents mom would never HA! (no boundaries) and besides he insisted it's illegal and refused to even go look where she keeps it or gets it filled. She told everyone WE were liars and bad parents and I'm so mixed up(lots of therapy for me but no other of the 6 very dysfunctional and one actually ill sibling . If I have to live hearing her calmly say she will feel no guilt at all if the long term effects that are showing cause him to predecease her. He deserved a chance and respect and she spoke of no shame and I know all the stigma and facts most don't Yet her actions have hurt so many and I've spoken with many NAMI people who worked hard to accept and take their meds who think it's something for the police. My mother is a felon with a deep need to save and be needed and her focus is on our son now and she uses my ill brother to torture us by mail with bizarre letters, religios books and often telling me how terrible I am. Although I consider the source to hear it and read it over and over and know it does not have to be this way, never should have and feel so conflicted. i'd be sending the little town's church lady who thinks we are lying to jail, a Dr would lose his license and I have no clue what my grown brother would do. He doesn't need money or his job. He needs good treatment and a quality of life if it's not too late .
Would you report your mother knowing she'd be charged w/ serious crimes to stop , A joke, the madness a change this cycle for you and your child?
Sorry just totally streesed out
Thanks for reading