Archives for September, 2011
In my last post, I wrote about how to handle the feeling that no matter what you do, it's never good enough. But now I want you to consider whether your reactions to your partner and their illness have shaped their behaviors into something you don't like? A classic example of this is someone who has borderline personality disorder. Often, as children, people with BPD were not validated when they had legitimate concerns. As a result, they learned to perform more and more extreme behaviors until they got the attention they needed. Now, as adults, people with untreated BPD have tendencies to resort to self harm or actual suicide attempts when upset because they don't think they will get attention any other way. Your partner may not have BPD, but they still may be doing something to get your attention that absolutely grates on you. But is this behavior the only way your partner can get your attention? Are you responding to them when they do what you ask as well?
My client sat across from me, her arms crossed tight over her chest, tears spilling over and down her face. "It doesn't matter what I do...it's never good enough! I try my best, do what people ask, put my own needs aside...and it's never good enough. At work, at home, with my partner, with my kids...I'm tired of never being good enough." This client was telling the truth about her effort level, and struggling with the demands of work, family and a relationship with a partner with mental illness that was not going well. This is a common problem among people who seek counseling services: how to balance the expectations they have of themselves with the needs and expectations of partners who need extra effort from them. When things become unbalanced, that's when the feelings of "I'm not good enough" come into play.
Today is my parents' 47th anniversary. They say rain on your wedding day is good luck, and, according to my parents, it poured on their special day. They have been very fortunate to not have to struggle with the challenges of having a partner with a mental illness. Marriage is tough enough without the extra considerations, accommodations, and adaptations one needs to make in order to navigate the choppy waters of an illness. But I believe--mental illness or not--there are some basics that are necessary for any relationship to survive. So today I will share with you what I have learned from my parents as some of the basic ingredients of having a relationship that can stand the test of time, no matter what challenges are thrown your way.
Articulating the inner experience of having a mental illness is hard. Like the saying goes, unless you've walked a mile in the other person's shoes, there is no way of really knowing what it is like to have bipolar disorder (or any other illness, physical or mental.) Previously, I've highlighted the voices of people with depression and adult ADHD. Today, the folks with the bipolar disorders get their moment in the spotlight. Here's a sample of what people with bipolar disorder would like their partners to know:
Getting a partner who is showing symptoms of schizophrenia to accept help can be difficult, if not impossible. Quite frequently, the person doesn't believe anything is wrong with them, despite plain evidence to the contrary. It can be a frustrating and frightening time for partners and loved ones of the ill person. Add in the fact that 15-25% of those with schizophrenia ultimately commit suicide, and the stakes to get good treatment now suddenly rise even higher. As the caring partner of someone with schizophrenia, what can you do?
For the past five years, the American Psychological Association (APA) has conducted an annual survey of Americans, called Stress in America. In the survey, they ask what are the leading causes of our stress, how stress affects our lives, and what we do to manage stress. The highlights of the 2010 survey results will probably not surprise you: Adults seem to understand the importance of healthy behaviors like managing their stress levels, eating right, getting enough sleep and exercise, but they report experiencing challenges practicing these healthy behaviors. They report being too busy as a primary barrier preventing them from better managing their stress, and a lack of motivation, energy and time as the chief reasons for not being more physically active. In 2009 and again this year, lacking willpower was cited as a barrier to adopting healthy behaviors when lifestyle changes were recommended by a health care provider. Yet the majority believes willpower can be learned as well as improved, if they only had more energy and confidence. Survey findings have consistently shown that the majority of Americans are living with moderate (4 – 7 on a scale of 1 to 10, where 1 means you have little or no stress and 10 means you have a great deal of stress) or high (8 – 10 on a scale of 1 to 10) levels of stress, and while they understand that this is not healthy, they’re stymied in their efforts to make changes. Two-fifths of adults reported overeating or eating unhealthy foods because of stress in the past month. More than four in 10 said they had lain awake at night in the past month. The most common physical symptoms of stress reported were irritability (45 percent), fatigue (41 percent) and lack of energy or motivation (38 percent). Nearly one-third of adults exercise less than once per week. Those who exercise once a week or less say they don’t do it because they are not motivated (44 percent), are too tired (33 percent), are too busy (28 percent) or don’t like to (26 percent), among other reasons. If you and your partner can relate to the above findings, what can you do?
When your partner is not feeling well, it's natural to become reactive, doing whatever it takes to get through the current crisis of the moment, and hoping this is the last time. Taking a more proactive approach to managing the symptoms of your partner's illness, however, is more effective and empowering, both for you and your partner as individuals, and for your relationship as a whole. Working together to identify a "What Works" list that can be referenced when the illness appears eliminates confusion, frustration, and the feeling of helplessness. This technique works no matter what illness your partner has. Both of you should work together to create this list, and agree that when the illness appears, both of you will reference this list in order to figure out how to stop the cycle.
Getting help for a mental illness is hard. I was told in my graduate program that the average number of counseling sessions a client attends is one. It's not necessarily because of the clinician--although that does have an influence--but because sitting across from a stranger, and being expected to reveal the depths of your pain, suffering, and trauma is hard. Really hard. It takes a tremendous amount of courage, and I always make sure I acknowledge that verbally when I meet clients for the first time. How to build rapport and maintain ethical boundaries is something that most counseling and psychology programs spend a good deal of time on when clinicians are in school. But not everyone has what it takes to be a good therapist or psychiatrist. And some people are--unfortunately--downright unethical. If your partner has had a negative treatment experience, whether it was just because they didn't "click" with the clinician, or because something more serious happened, what can do you to ensure your partner gets the treatment they need?
For most people, there's no place like home. Familiar surroundings, your own bed, your own food in the fridge, and maybe pets or other comforting objects all make life run a little smoother. For people with mental illness, having the optimal environment for healing can make a significant difference in how quickly they recover. If they are living in a stressful environment, it can make getting better a big challenge--not only do they have to deal with their symptoms, but they have to manage household stressors as well. As the partner of someone with a mental illness, you can play a large role in creating a place of safety and stability for your partner.
Today is Part 2 of my interview with Bridget C. Cantrell, PhD, expert on military PTSD and author of several books about military life (read part 1 here). More information about Dr. Cantrell and her work can be found on her website, Hearts Toward Home. 3) Many soldiers who come home from military service are afraid to seek mental health services at their VA, or to get mental health services at all. How can concerned partners encourage their soldiers to seek help? Yes, this is very true that the stigmas of seeking help for the service member can interfere. However, with that being said, the help is available and things are changing to encourage our troops to reach out to address the issues they are experiencing. It is important for them to know that it is to be expected to have some challenges with sleep, irritability, relationships, etc. The military have providers on the bases, and there are organizations that provide services for our service members and their families. There are also community and veteran service organizations that have programs to explore. So one needs to be creative and determined to seek out what works best for them to get the help they need to move forward.