We want our loved ones to go to therapy, rehab, take their medication or do their follow-up. But many times with those who struggle with behavioral health, whether mental illness, addiction, or both, don’t always want to comply with treatment. What’s more, teens doing drugs want even less to do with healthcare because they have “all-natural” solutions to the pain they are enduring. Never mind that they move to unnatural remedies.
The point is, they don’t want to listen to you. And you may not have the relationship now to get them to accept treatment or take medication. Not because you don’t love them enough. You do. It’s just that the relationship needs to change. Because it’s not just their recovery, it’s yours, too.
So here are some tips on improving your relationship which is what can eventually help them make the decision to accept help, take their meds, or go into recovery.
1. Maintain Composure
Has resorting to yelling or lecturing ever worked? When you talk with your loved one, keep your cool. Don’t engage in the emotional chaos. Learn deep breathing or whatever it takes. But once you try this way, you will see the difference and you’ll feel the shift.
Arguing shames your loved one. You might not see it that way but that’s how they feel. They will say things to trigger you because they know your weak spots. It’s not them, it’s their disease that is so cunning. After all, it has your loved one wrapped in its embrace. And what you want is that it has less of a hold on them. That’s reason enough to learn to maintain evenness. Participating in the vortex of emotion won’t help you reach your goals.
2. Eye on the goal
Keep your focus on what it is you want. So if your goal is to get your child into treatment, remember that goal when you see them on the sofa after an all-night manic episode that has left you tired and drained. Or an all-nighter drinking. What you want cannot be achieved if you accuse, shame, scream, have a tantrum. It will simply fuel more behavior you don’t like or they’ll be more refusal to get any kind of treatment.
So if you want them to go to family therapy, frame it that you are going because you need it and the therapist requested that family members attend a session. “I have been struggling with the right thing to do and I saw that I needed some help so I am seeing a therapist to help me work all this out. He requested that some family members attend to help me work through some of my issues. Would you come to one session at least to help me out?” And if they do go, it’s vital that you listen and not get in a heated exchange or start making accusations. Get it out of your system prior to the session to make sure you listen more. Your goal isn’t to be right, it’s to help your loved one, right? Keep that in mind.
3. Use “I feel” words
“I feel so terrible for the way I screamed at you. I’m losing it and can’t seem to get a grip on my own emotions and I owe you an apology.” They may have yelled at you. They might have done something to elicit that response but it’s never a good idea to blame and yell back. It’s unproductive and disrespectful. Take responsibility for the part you have played because we are not entirely innocent. We think it’s all their doing when in fact we have contributed to their feelings of low self-worth. How we speak to our loved ones with behavioral health challenges is not always respectful or thoughtful. There is so little they can control and if they struggle with thoughts of suicide, nothing makes a person feel so vulnerable. And it’s not like they asked to live like that. Besides that, it takes enormous courage to survive your own brain telling you that you should die.
Situations can escalate because we throw a log on the fire in terms of passionate responses that simply don’t help you reach that goal. So let your loved one know how you feel and how it’s affecting your own responses. We don’t want to use “I feel awful because of you.” That’s not helpful. And if you want results, that won’t get you there. By taking responsibility you are modeling that behavior.
Be vulnerable and they will start to as well. We want to improve relations not fracture it further.
4. Be empathetic
That means trying to understand and look at things from the point of view of the person suffering. Who wants to live with addiction, depression, bipolar, or thoughts of suicide? Why are they taking drugs? Probably because they are using it to cope with something else. What is that something else? My son’s ‘something else’ was depression and thoughts of suicide.
It takes love, patience, time, and so much more. This is hard for you. But imagine how hard it is for them. They have no idea what kind of future they’ll have. Imagine how difficult that is for them to grasp. You must come from a place of empathy and understanding instead of punitive and dismissive. That’s not to say there is not punishment or consequences. But if you are thinking that punitive measures like taking away car keys or trying to get someone to stop doing drugs with testing, you are not going to succeed. You, your family has to shift and look at this from a different angle.
Sample question: “Son, can I ask you a question. Why is it that you started using drugs? Was it to numb something that hurt? I promise I’ll shut up and listen to you. I may not be able to fix it but I’d like to know.” Then do not refute what they say, share studies or anything you feel is a logical next step. Meeting them where they are means just that. Be patient. Let things marinate. If you listen and they feel heard, they will share more, they will think more.
5. Be a good listener
This is so underrated. We all want to be heard. And when we talk over our loved one because we’ve “heard what they have to say a million times” we are not respecting what they have to say. If they have said it a million times it’s because they feel they have not been heard. So listen, really listen. Don’t be formulating your answer while they are talking.
And when they are done, reflect back on what you heard, “I hear you saying you are afraid to go to a psychiatrist because he’ll put you on meds that make you a zombie and rob you of your creativity. Do I have that right?” Wait for their answer. Allow them to correct you. Accept that this is their fear and be understanding. Then you can say, “I tell you what. Let’s ask the psychiatrist that very question. Can you do that? Before anything is handed to you as a prescription, bring the questions and any fears of what you may be thinking to the appointment. I’d like the answers, too. So if we can agree to that and that you’ll at least hear the doctor out, would you be willing to go? I will back you up. I don’t want it to rob you of your gifts and personality either. That’s not what I want for you.”
6. Get educated
If you are going to have any empathy you need to understand your loved one’s illness. One of the best things I did for myself was to attend a support group for Narcotics Anonymous and one for those with mental illness. I did ask permission to attend the open groups but I learned more at those two events than I have ever in my life. I attended lectures, read papers, and books. Because it’s hard to have empathy if you don’t know what’s happening to them or what it might feel like from the point of view of other people suffering.
7. Find support for you
So you wonder why our loved ones won’t get support when you refuse to get it for yourself. Be a role model. Understand that you are not handling this right. Who would know how to handle this stuff? We need help, right? So go get it.
If there is one thing parents resist when I tell them it’s this. They think it couldn’t be them. Surely there is some secret formula and that can’t be it. But it is. And when you do seek support, let them know you are seeking help for yourself. Be a role model for seeking help. Besides that, it’s where you get names of the best practitioners, leads on the best rehabs, and more. You get resources, support, and someone to call in a crisis when no one else in your friend circle understands. A group, a therapist– either one works.
8. Pledging your unconditional love
This is complicated. In the case of a spouse who doesn’t find help for decades despite your changing yourself, you may have to make the decision to leave. It is a choice although a really hard one.
But if it’s your child, you do need to let them know that as much as you want them to get well, you love them even if they don’t.
9. Establish boundaries
For the most part, you want to stick to boundaries once you set them but not be so rigid that you can’t see when you might need to shift. For example, when my son was alive, prior to his suicide, we pledged not to give him cash. Because he used it to buy drugs, not gas.
However, he did ask for help. Only it wasn’t in the way I had pictured. It was messy and emotional and argumentative. But he spent two hours on the phone. That alone was a cry for help. Another mom told me her son asked for help by showing her his arm with track marks. A cry for help rarely is, “Hey mom I need help.” I was thinking my son needed to own his own addiction recovery and didn’t recognize signs of suicide. So in that case, I needed to ignore the boundary of “rescuing him” and instead go get him and take him to a mental health facility.
It’s really hard to get a perspective in emotional chaos. And that’s where a group comes in. They can share scenarios with you and help you gain perspective. But boundaries are important. You don’t want to be a doormat or to pay your loved one’s bills when what they really need is to suffer the consequences of not paying them. This fine shifting line is the hardest to manage.
None of this is “one size fits all” and will shift based on relationship and level of illness and given the personality of your loved one. But these are general guidelines to changing your relationship and to working on yourself in hopes that it will influence change in those we love.
- For those of you with loved ones who refuse to take their medication although they need it, I’ve read it and highly recommend the book, “I’m not sick. I don’t need help.” The author is a psychiatrist who had a brother with schizophrenia. It maps out the conversations and what needs to change so that your loved one who lives with a mental health condition is more likely to remain stable on medication they need.
- For those with a loved one with an addiction, substance misuse, or behavior addiction which is often co-occurring with a mental health issue, I have read and recommend “Beyond Addiction” based on the CRAFT model for families (Community Reinforcement and Family Training). This is your best shot at changing the environment to be more likely to encourage a loved one to find recovery. What is CRAFT?
This resource can help you change your relationship and it’s only 11 pages.