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On Accepting a Diagnosis: Instructions for Loved Ones


I am a praise-seeker.  I am an assurance-seeker.  I am an attention-seeker.  Though I prefer to remain on the sidelines in any crowd larger than myself and my dog, I constantly seek these things – praise, assurance, and attention – from my loved ones. Especially from my father.

This is not a post about a tyrannical, unloving, Draconian-style father.  I happen to love my dad dearly.  He is loving, charming, intelligent, and hilarious.  He never imposed unfair rules, he never demanded the impossible, and he never withheld affection as a form of punishment.  He and my mother gave me a childhood rich with opportunity and happiness.

I don’t really know why I become needy around my father, why I need his praise and assurance and attention.  I think it may be because I believe my best characteristics (my sense of humor and my pragmatism, among others) were learned from him. Or it may be because my dad traveled a great deal when I was a child; when he was home, I wanted to show him the best side of me.

While my father has always praised and reassured me, he has never been able to accept my diagnoses of OCD and depression.  To be fair, this makes sense.  My dad was raised in the “Rust Belt” of America, the son of hard-working, blue-collar, Depression-era, Eastern European-American parents.  If you’re not familiar with Eastern European culture, let me give you a crash course based on my experiences with my parents and grandparents.  Eastern Europeans and their American descendants are tough.  They are stubborn.  They are determined.  Their work ethic is as strong as their belief that rest and relaxation are for the weak.  (My mother, also of Eastern European descent, once hung a sign in her house that sums up everything you need to know about this culture: “We have all eternity in which to rest; now, let us work.”)

Above all, people from this tough-as-nails culture believe mental illness is an effete person’s problem.  Mental illness is easily treated with nothing more than a nose-to-the-grindstone, can-do attitude. Being depressed is self-indulgent.  Obsessive Compulsive Disorder is perfectionism, and really, what’s wrong with that if it ultimately produces a clean house or a good school record?  You’re unhappy? Eat a pierogi and get back to work, for heaven’s sake.

So I understand why my father is reluctant to accept that I have something real which requires medication and the occasional light touch.  A few days ago, I wrote about my experience with OCD.  I was proud of the piece and e-mailed it to my parents.  My mom was, as she always is, bubbling over with support and accolades and said I was the best writer since Shakespeare.  (She is not necessarily my most helpful proofreader.)  My dad wrote me back with this:

How can a woman with such a raucous sense of humor, one who loves her husband and children so much, and loves going head to head with her brother and her father not just enjoy life?  When you are having an OCD moment remember, don’t sweat the small stuff and it’s all small stuff.

See, my dad is not a despot.  What he wrote wasn’t cruel.  He did not overtly tell me to “suck it up”  (though that message is still subtly there).  He did, however, minimize OCD down to nothing more than a little personality quirk by telling me how to handle “an OCD moment”.

My dad loves me.  He just doesn’t understand OCD and doesn’t accept that it is real and, at times, debilitating.  He believes his “buck up, camper” speeches are truly supportive; he doesn’t realize these speeches can be trivializing (and therefore, hurtful).  I’d like to give my dad this simple instruction sheet:

Dear Loved One,

You have been given this set of instructions because I have (insert mental health diagnosis here).  I know you may not agree with or understand this diagnosis and that is okay.  I agree with and understand the diagnosis and that is all that matters.  I am working to improve my mental health everyday and I need your help.  When I talk about my diagnosis, here is what you need to do: 

  • Listen without comment or (what you think are) helpful suggestions.  Just listen.  
  • Listen some more.  
  • When it’s your turn to talk, tell me simply that you are here for me and you are proud of me.  
  • Even if you think this diagnosis is complete nonsense, tell me you are here for me and you are proud of me.  
  • Again, I don’t need helpful suggestions for how to fix this problem.  Just tell me you are here for me and you are proud of me.  
  • If you’re not proud of me, that’s okay.  I’m not asking you to be disingenuous.  Just tell me you’re here for me. 
  • Listen some more.  
  • Listen some more and then give me a hug.  

That’s it.  In return, I promise that I will forever appreciate your willingness to support and love me.  

I adore my father.  I see the best parts of myself in him.  I think he sees the best parts of himself in me.  It’s difficult for anyone to look at a loved one and accept her complicated parts, her weird parts, her frustrating parts.  But if there’s one person who can do something difficult (and do it well), it’s my hard-nosed Polack of a dad.

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On Accepting a Diagnosis: Instructions for Loved Ones

Kelley Smith

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APA Reference
Smith, K. (2014). On Accepting a Diagnosis: Instructions for Loved Ones. Psych Central. Retrieved on February 21, 2019, from


Last updated: 12 Oct 2014
Last reviewed: By John M. Grohol, Psy.D. on 12 Oct 2014
Published on All rights reserved.