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Ask the Mental Health Expert Archives 2001-2004

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Helping a Mental Relative

Q. I suspect that my adult brother has a mental illness. He is convinced of a conspiracy to ruin his life. He refers to character assassins, how they pull antics to ruin his social life, how he can prove this and sue for damages. He says he has a pain in his left side that was intentionally given to him by a hateful conspiracy, and on and on and on. How do I approach him and encourage him to seek help? I fear that I will become one of the "hate freaks" or "jealous-false-friends". I fear that he will no longer trust me. I certainly feel a strong responsibility for his well-being, but as a sister, what authority do I have? I am planning on talking with him about my concerns. Can you offer some advice?

A. This is a difficult situation for you and for your brother, and I'm afraid there may be no easy solutions. In the end, you don't have any authority in the matter of your brother's care, unless you are appointed his guardian. But, in the mean time, here are some ideas to consider. First, you might begin by getting together in an informal and relaxed setting where you can speak privately. You might then begin by asking very generally how he has been feeling lately, and see what he says. Depending on his answer, you might say something like, "You know, [his name], I've been a little concerned lately that you don't seem very happy. If that's true, I'd like you know I want to help." His answer may be quite defensive or dismissive, in which case, you may not be able to do very much. But if your brother opens up a bit and acknowledges that he's feeling like his life has been ruined, etc., then you might be able to suggest some options for him.

It might help to normalize his experience a bit, if you can do so honestly. For example, saying something like, "You know, when I feel really rotten about life, I find it helpful to talk with someone I trust. What about you? Have you thought about doing that?" Again, depending on his answer, you might be in a position to suggest getting some counseling. It is sometimes useful to take a slightly paradoxical approach with folks who externalize blame--i.e., who see the whole world as being against them. For example, you might say something like, "You know, you're right--the world CAN be a pretty cruel place. There are a lot of bad actors out there. Maybe it would be helpful to get somebody on your side, for once, and have that person around to help you strategize."

If you can actually get a couple of names of good mental health counselors, that would be the next step. You could check with your family physician if he is in the same area as your brother--or you can try calling 1-800-638-8799 for referrals. You might also be able to get some good advice and support from your local chapter of the National Alliance for the Mentally Ill (800-950-6264). I hope you are able to help your brother help himself--that's really the best you can do.

April 2001

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