Sally, if what you say is true, then your father should be permanently disbarred for deceiving the Court. You might want to check out MindFreedom's shield program. It doesn't have legal teeth but it makes your wishes absolutely clear.

Just wanted to say I agree that the "patient" has to want the family to be involved and give permission for that and/or the family might be seeking therapy as a unit to help with some dysfunction. I know there are instances when adult children need to be left to fly on their own or they will never learn. At the same time parents, siblings, or spouses may love and know the person suffering better than any therapist/doctor and have things to contribute without jeopardizing the therapeutic process. Furthermore at this point many of us know the mental health field is seriously compromised with its reliance on models and treatments that are flawed and some of these sufferers may need an advocate in the form of a family member. I think each case needs to be judged on its own merits and circumstances. It's very difficult to generalize. But I certainly am not going to write off family therapy as being unhealthy on the basis of a few anecdotes about controlling and dysfunctional family members.

"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."

Any therapist worth his salt won't be "labeling" anyone for his patients. Instead of problems and solutions, a good therapist will focus on thoughts and feelings and, when called for, challenge assumptions and foregone conclusions.

Speaking of which, the commenter is making the assumption that the family will have a more objective, more accurate idea of what's happening which is far from true.

Ultimately, any unwanted "help" forced upon a person will only lead to resentment and more issues. If you want to help me then talk to me and only me.

It's true that good therapists won't be labelling people unnecessarily but they do come to the process with certain preconceptions about family dynamics in general and if they never see the other members except as described by the patient they can subliminally make judgments that influence the patient and may not be constructive to recovery. Talk therapy can be as harmful as medication therapy in the wrong hands. But again I am not talking about forcing this on anyone who doesn't want a family member involved or whose interests are not being well monitored by the therapist. There is no doubt it is a sticky wicket. There are of course scores of parents who wish they had been called by college counseling services when their kids became suicidal and weren't and then the kids died (sometimes after being prescribed antidepressants unbeknownst to the parents). Who is really to say what the right thing was in these cases? The services were making a call about someone they really didn't know well or "love" in the way a family probably does. I'm not sure what I think the solution is in these circumstances. Probably avoid mental health services entirely if the truth be told. Sad but true. Until the paradigms in mental health treatment change drastically it's a scary place to be seeking recovery.

I find it irritating to hear concern about family members getting wrongly labeled as "the problem" by any therapist who sees an adult patient without knowing the rest of the family.

It seems a bit like what any overly controlling parent or family member would say when faced with the fear of knowing that their child or other family member(the identified patient)is discussing family issues.I see fear there.I'll tell you what else I've seen from personal experience: the identified patient is RARELY the problem,when it comes to family interference in treatment- no matter what the diagnosis.

Family problems and dynamics play an integral part in the development of mental illness. If a patient wants the family involved, then so be it. But many patients cannot get well when family won't stay out of their treatment decisions or therapy.In many cases,such as my own and many other that I have known, it becomes necessary for adults to leave their families or certain family members behind in order to become healthy.

People don't always exclude their parents from treatment decisions because of poor judgment due to a mental disorder;sometimes it is the best choice for the patient.If one is being pushed away from "helping" various people in the family, then maybe what is being done is not so helpful, and it's time to back off.

Really, why would it be so important to have to get in there and make sure that a mental health care provider knows who "the problem" is? That kind of thinking is a red flag right there.It's up to the patient and therapist together to identify and treat the problems. Even when there is concern and genuine caring on the part of family members, an adult has the right to accept help only from the people they want help from. This concern sounds more like a control issue that is often found in troubled families. The "patient" is almost always the scapegoat.

Yep... get in there and make sure they know who the problem really is...ugh! Thanks, I'll keep my family far,far,far away from my treatment.They can't even help themselves.

I wonder what readers think about me and my daughter.

In response to Francesca, what I say is true. I posted the style of the case and its case number. Phillip chose to edit them out and I'll trust his judgment. I'm a member of the mindfreedom shield. My father is elderly. It's his lawyer, who I also sued, as well as the lawyer appointed to represent me, who should be disbarred. The Court was not deceived. The judge, who didn't know me, signed the documents saying there had been a hearing as a favor to my father. The judge is a probate judge and in Alabama where this happened Probate Judges don't have to be lawyers. Of course there is a huge VA Psychiatric Hospital in the community where this happened and the judge does lots and lots of involuntary civil commitment hearings. I bet he's "doing favors" for lots of other lawyers. But there's a settlement agreement pending, held up as one of the defendants is in bankruptcy - so hopefully I'll have a settlement agreement soon.

As for the family counseling thing, I offered, and have the email to prove it, that if my family would go to the counselor of their choice for a year, I would go to the counselor of my choice for a year and at the end of the year we could all meet with the counselors. They refused. Voluntary family counseling that all members choose to participate in can be a very good thing. It's the forced kind I disapprove of.

There is a huge difference between voluntary family systems therapy with a therapist trained in family systems and a therapist with no family therapy training or qualifications violating boundaries to get opinions from family members. The first can work very well for certain issues and concerns, the second is just a bad idea.

The concern about family members being labeled the problem is uncomfortably reminiscent of the False Memory Syndrome Foundation's assualt on adult children's confidentiality in the past, fortunately they did not succeed in getting laws changed anywhere of which I am aware.

Stephany, I think you are an amazing mother and I think your daughter is lucky to have a strong and smart and loving advocate in you. I know it is incredibly hard on you and I pray that yours and your daughter's ordeal will be over soon.

If I had known what I found out later in my son's medical and therapeutic records, he might be alive today. Instead, because of hpaa and mental health privacy laws, I did not know what was going on and my son was killed by Zyprexa - of profound hyperglycemia. My son did not have the best judgment at the time, and also did not want me to know that he was sleeping most of every day, nor that he was having other, psychiatric symptoms.

At the last moment, too late, he went into a coma and died.

Surely when the information is a matter of life or death, there should be a requirement that a loving parent be told. But because of people with mental illness fighting so hard for their privacy and clinicians figuring hpaa and mental health privacy laws mean telling nothing, there is death on their hands.

I too am opposed to Hippa. What HIPPA means is that the only people guaranted information about a patient are the insurance providers.

Sorrowful,
I am so sorry for your tragic loss. I think it's incredibly painful to look back and think you could've done something to stop it if you had known.It's something that your son's doctors should've known, and they often do know and don't even tell the patients themselves the risks.

I became diabetic at the age of 24 after being on Risperdal for less than a year.I was the one who noticed symptoms and went to my doctor and said I thought I had it.I did, and they never told me the possibility that it was caused by the drug.They kept giving it to me anyway along with other atypicals and various other psych meds for years.

I eventually got some of my psych inpatient records from just a couple of months before I became diabetic. There was blood work results included in the records that showed abnormal glucose levels. It was never addressed. I was never told. They would've had to tell me, and they didn't.It might have been prevented if I had gone of the drug at that point.I no longer take any psych meds.

My own mother insists to this day that I should be taking the stuff, despite what it has done to my health, and despite the fact that my bipolar disorder was a misdiagnosis of PTSD.She doesn't like the PTSD diagnosis, because it makes her feel guilty.She takes her meds for bipolar disorder faithfully, and she's completely insane anyway. I don't think she even has it herself, but she'd rather swallow pills than try therapy.If she still had her say in my treatment, I'd be dead by now.If I listened to those doctors,Id be dead by now.Instead I'm healthier than I've ever been in my life, except for the diabetes which is greatly improved without the psych meds.

Patients and their families alike don't get told about the risks and side-effects of these drugs.Doctors often insist that the benefits outweigh the risks.For who? People often don't get to make an informed decision.Even when I found out what was going on with me, they still insisted I take the drugs(and for a condition I did not even have).

There is only so much you can do as a parent in a system that is grounded in coercion, force and misinformation.Fighting that is a full-time job. They have way too much power over the lives of psych patients.My heart goes out to you and all the parents who truly want to help their kids. It's a really messed up system that is hurting more people than it is helping.

Alison nails it, as usual:

"There is a huge difference between voluntary family systems therapy with a therapist trained in family systems and a therapist with no family therapy training or qualifications violating boundaries to get opinions from family members. The first can work very well for certain issues and concerns, the second is just a bad idea."

And judging from the email I received yesterday (mentioned on commments in previous thread) it's the bring-the-family-in-to- gang-up-on "noncompliant"-patient authoritarian dynamic we're seeing come into play. Promotes dependency, halters individuation, it's therapeutically unsupportable, and should be fought.

My comments are more strident than usual on these 2 threads, I'm more pissed than usual. Well, when I was a kid, the school made me and my abusive mom go to a psychologist together. It happened when the principal opened the building and found me sleeping in his secretary's office, bleeding, bruised, ribs cracked, the usual. So the school sent me and mom to a shrink, where we didn't talk about abuse at all. The doctor just spent the time asking my mom about her intent with me, our relationship, and did she want healing and did she love me? Yes, yes, yes, she faked, and I remember the first stirrings of hope in my stomach, like wings, something dead coming to life.

You can guess what happened when we got home. Another beating of course, for wasting her time, humiliating her, for dragging the authorities into our business, and so forth. We never went back, not til the next time social services sent a caseworker to the house. And there was a price to pay for those visits.

Now I know that this isn't exactly what we're talking about here, but that's the problem. Some of these families are abusive and injurious and very manipulative, and how do therapists know, how does anyone know who the parent will be at a given moment? Pulling my mom in without a thorough assessment of her first did me no good.

All this came up, and I couldn't see anything else. Stephany I hear you, your daughters best interest underpin your advocacy and it's something of a miracle. I wonder sometimes what you must think of our family-bashing, it's good to talk. (((Hugs)))

When my family did this to me, I was between my second and third years of law school. FYI law school lasts three years. I got out of the nuthouse on a Friday, started lawschool the following Monday, and with family members telling me and my relatives and for that matter my psychiatrist that I was incapable of reasoning and should not live independantly much less attend law school, I graduated. In my second year of law school I had been diagnosed with generalized anxiety disorder and prescribed effexor. I was terribly stressed out about law school and afraid my father would have me committed if I flunked out. And I was an older student, 40 at the time my family had me committed. So after I got out of the nuthouse, during my third year of lawschool, I had a the same psychiatrist see me. He decided we would try life without meds. My grades improved and I finished lawschool with A's and B's (okay and one C) my final year, up from C's and the occaisional B and the one D that got me to the phrink in the first place. Now the Georgia Bar has put my application to take the bar on hold pending the resolution of the lawsuit in Alabama, because as they told me, they have to take the signed order of a judge that there was a hearing in which I was found incompent over my word, and the lawsuit drags on due to the sleazy hospital declaring bankruptcy. I think family systems therapy went out when biomedical psychiatry came back in, the 60's and 70's being an oasis. The idea supported by NAMI is that the family has no role whatsoever in the illness of the "patient," except that of victim and all treatment should be aimed at keeping the patient from embarrrassing the family, hence, the family system's idea is completely gone. If behavior patterns travel from one generation to another, it's not behavior its genetic though no research bears this out. And bizarrely, no other "illness" is approached this way. Imagine if the relatives of a child with asthma, leukemia or diabetes decided that their only role was to give the child a pill and call the cops if he was reluctant to take it.

I'm pleased to see positive comments about family systems theory. The only mental health professional I've ever had that had the slightest clue as to what she was doing was a therapist with a PhD in Marriage and Family Therapy. She was not focused on pathology which was new for me. The psychologist, the psychiatrist, etc were focused on my DSM diagnoses which did nothing for me except make me feel even more pathological. In the psychiatrist's office I was a very ill person who needed drugs and treatment. Whereas, in the therapist's office I was viewed as an incredibly strong person who had made it through a hell of a lot. I had a couple of therapy sessions with my whole family that were very healing, the key being that this was done with my consent and my family's willingness (if it had been done against my wishes or had the therapist been hung up on my pathology the outcome would have been different).

Alison and flawedplan --Thanks for the kind words, and I am just stunned at everyone's stories here. I also appreciate how hard it is to write them down. I'm thankful to those who are sharing what I believe is instrumental in understanding how complex all of this is. ((hugs back at ya))

Re: parents helping kids being a full time job--yes it is, and I often said that my photo must be on dartboards in some of these places. I'm like gum on a shoe on a hot summer day. Interestingly I've also met many patients who talk to me and don't have any visitors. It's just a sad story all the way around. Basing psychiatric care on medications for recovery/or discharge is what has to be tossed out, and believe me I felt the scrutiny as a parent I was grilled, and I swear over the last 2 years they were trying to break my spirit down with my daughter's, and I wouldn't budge. I had a note taped to my fridge for a solid year that said, "Soldiers don't cry in front of the enemy". I had to act tough and cry later in the car. Same now. I also have had professionals take me aside and thank me for bringing in posterboards of photos and stuff. Anyone who is advocating for a loved one or friend--get the staff to know who they are also fighting for, because inside hospitals we often do not represent who we really are, [when sick or over-medicated]. Many people told me it was the photos that helped them to "get it".

Lots of painful and moving stories I must say. And yes, I was a "problem" but I believe for the therapist, not for my daughter. I had just too many questions about the treatments they were recommending (and I wish now I'd had a whole lot more). So I was a "problem" and they wanted my daughter to think so too. She didn't and then that made her a "problem" too. It's very insidious if you don't go along with the program and bow down to the professionals -- that's all I can say -- but of course there are family members out there who really are problems as many of you so painfully describe, so what can I say.

Sara, I am sure that I would be called a pain in the ass. Questioning authority is not an easy task. One parent told me "Sometimes you have to eat dirt." I've been kicked out of a private hospital's CEO's office, shoved out the doors of a mental health agency, and was read a riot act from a doctor that started like this:"I'm the doctor, and with 25 years experience"...blah blah blah. That guy even twisted documentation wording around when talking about my daughter [who had kicked me in the shin]had the balls to say "She tried to murder you." In front of a packed boardroom. My answer to that, "Last I heard leg-kicking wasn't murder."
I never backed down and I'm never gonna back down. Ever.

Stephany, I'm curious about you and your daughter, but can't find much, and I agree with Sara that the therapist can be worse than the family. In my case, my family wanted me permanently institutionalized, they still do, so even the best family therapsist couldn't have helped other than to advise me to stay away from them, which I do, and yet, a big problem with "family systems therapy" like any other kind of therapy is that it can lead to the idea that there is only one kind of functional family. If a family goes into therapy because they all want to change, it can work, if not, it can't, and a family willing to go into therapy to change is already healthy. Seeking therapy, i.e. being willing to change is a sign of mental health, not mental illness.

Sally I've droned on enough on this poor blog you can find a lot of my writing here and almost 500 pages of more rambles on my blog. Just click on my name.My current situation is that I am preventing long-term "care" [as a discharge plan]in the state mental hospital, because I oppose it, disagree with it, and already got her out of there once per the Governor due to unsafe living existence.If there is a need for long term care, I have yet to find an adequate place that I would feel comfortable with anyone I loved or myself residing in. Until medications stop being the protocol for care and discharge doctors will scratch their heads wondering why these places are over-booked, and why many never go home. If the current medication based paradigm was working, those places would be empty.

I remembered this thread when I saw the below anti HIPPA website. Hippa is a bad bad thing. It's odd that so many people agree on this. Here's a link to a good site about it:
http://www.patientprivacyrights.org/site/PageServer?pagename=First_Visit

"There is some point at which we must as a society grant free will even to our most-cherished and most-coddled family members, regardless of their condition."

Since reading this I have wanted clarification.What do you mean? Do you mean let them go regardless of condition, for instance if sick? let them go into the system? and then the system and the patient partner up and hope for a good outcome? I'm confused.

I can't speak for Philip, obviously, but when I read that sentence (which I truly agree with, by the way), I took it mean that patients ought to be empowered to make their own decisions. The right to decline treatment is a fundamental human right, along the lines of the right to free speech. Forced treatment raises very serious ethical and legal questions.

Just wanted to clarify that forced treatment can mean a number of things. At the horrible extreme, it means tying people down and injecting them with neuroleptics. But, aside from physical force, there are varying degrees of coercion inflicted by psychiatrists ("Do what I say and you can keep your voluntary status.") and also family members, however well-meaning.

Well meaning family member do not hold the needle. The injection or forced treatment. The doctor, nurses and system does. Try being a well meaning mother against that system and then meet me, because I walk alone in this shitty battle. Try being the mother who is sent down the elevator before the 5 member team shoots her daughter in the ass. Try going against mainstream protocol paradigm and get kicked out of several instituitions by FORCE. And calling the same mental health system for a "talk down" because they threw "you" OUT.
I am the one, and the only one I have seen post here to comment on the outrage of children in adult systems w/regard to Sara--and I hope Sara tells her story again for new readers.
This is shit. I am sorry Philip--but this has got to stop.
I am on medication. I am Bipolar. I am a mother. My daughter is in the system everyone hates.
Shut the fuck up and do something else, other than piss and moan on a blog that will make no changes. The person who can is YOU, the reader, the scorned, the ECT patient, the injected against your will, the mother who vomits from seeing YOU go through this. Someone has to speak up, and speak up or SHUT UP.
If I was everyone's mother, I would have cut you all loose, but since I am not, you need to cut yourself loose.

I apologize for posting such a rude rant in comment here.

"If the current medication based paradigm was working, those places would be empty."

Stephany, I think that pretty much sums it up.

Hey Lisa, you remember the health insurance parity discussions we have had here[who knows where]well I think I finally had a light bulb moment and "get" what you meant this whole time.
I posted about it on my blog, inspired by The Last Psychiatrist's post about it.