Having someone in the home with a mental illness can often cause conflict and chaos. Outbursts, not following the house rules, and refusing to communicate are all examples of how disruptive it can be to everyone involved.
Your loved one who is suffering and unable to live independently relies on you for many things. Because of that, there are some simple rules they should be able and willing to follow to make the home as comfortable as possible.
When problems do come up, it is a good idea to brainstorm solutions with the family before presenting them to your loved one. In the middle of a crisis, it isn’t fair or productive to include them in the discussion. They will most likely not be receptive and will pick up real quickly on anyone in the family who is wavering or even against the ideas being proposed.
Let’s walk through the steps to restore some peace and harmony to the home.
Step 1: Define the Problem
1. Pick the most pressing issue
You can only solve one problem at a time. I’m sure there are several issues you would like immediately solved but Rome wasn’t built in a day so they say. So, pick the most pressing issue to tackle first.
Let’s use, for example, your loved one getting so upset they punch a hole in your wall.
Sometimes you have to break the problem down into smaller pieces to get to the real issue.
A trigger causes a meltdown. The meltdown results in a confrontation. The confrontation ends up in something being broken (the hole in the wall), someone being hurt, or worse, the police being involved.
Obviously, no one wants the police called or any damage to property or humans. You could argue all day that your loved one should not become ‘that’ upset but rarely does that do any good. If you back it up to the beginning, it was the trigger that started the landslide. That’s a good place to begin.
2. Be specific
When we are frustrated, we start talking in absolutes. Things are always bad. He/she is never happy. H/she is uncontrollable. I’ve tried everything. All of these statements are emotionally based and most are not 100% accurate. In order to work on solving a problem, you need to be specific about what that is.
In the example above, the root cause can be traced back to the trigger. Let’s say for this instance that the trigger is not taking their medication on a consistent basis. That is a specific problem.
3. Is this the problem or a ‘feeling’ about a problem?
This can get tricky. We focus sometimes on how a problem or situation makes us ‘feel’ because there are some legitimate bad feelings floating around for everyone. However, problem-solving is not about feeling better (though that is a wonderful by-product). Problem-solving is to help our loved ones cope better in life, succeed and live in harmony with the rest of the home. Some people would focus on the feeling that the hole in the wall gives them instead of focusing on the resolution.
4. Getting the Family on the Same Page
With a family dynamic involved, it is crucial that everyone be on the same page. As an adult, your loved one, even with a mental illness, can sense tension and division among the ranks. Even if everyone doesn’t agree 100%, for the sake of solving a specific problem, the family has to present a united front.
Step 2: Problem-Solving with POW
1. Look at Past experience
You need to look at what has worked in the past. Using the same problem above – was their behavior better than they consistently took their medicine? Is there a pattern that can be followed when they do or don’t take their medicine? This can help provide the evidence when talking to them about taking it.
2. Find Options
As a family, you need to brainstorm ideas.
Set a reminder on a phone. Have someone hand deliver the medicine. Put it in a pill organizer so there is no confusion.
There are many things you could try. You should prepare a list to present. Be sure in this list to specify who will do what and when. There should be no misunderstandings.
3. Prepare for the What If’s
No matter how much time and thought you put into your plan of action, there are no guarantees it is going to work. You are dealing with another human being after all. You can’t force them to take medicine or anything else really. You need to discuss a backup plan.
(If it is impossible to reach a consensus or agreement from everyone in the family, then you may need to pick another problem. You have to be open to the opinions and ideas of others. As the process goes forward, everyone should have a chance to work on a problem that truly bothers them. Compromise will work well if everyone participates fairly with the same goal in mind.)
Step 3: Setting Limits
1. Limit Your Expectation
No one likes to go into a situation expecting to fail. We all want the best for our loved one and the rest of the family as well, but we have all learned the hard way that we can’t control another person, even when control is what they need and even crave the most.
The number one goal here is to maintain control over your home. That should be the one safe and comfortable place where everyone comes together. You cannot control what anyone does outside of the home, but you have the right to set basic rules from within. Keep in mind though, those small victories are still victories and this is a process.
2. Make Consequences
Almost everything in life we do has a consequence; either good or bad. The same goes for your loved one. Having a mental illness does not exempt your loved one from consequences out in the world, and it should not exempt them from those in the home. You do, however, need to be realistic about them. Do not state the consequences that you are not willing or unable to enforce.
3. Setting Limits for Your Loved One
The first thing you need to learn when presenting an issue and expectations or limits is to keep a controlled attitude. If they can get you to lose your cool, they have already won the first round. Nagging isn’t going to cut it either and the same goes for criticism. Just present facts in a firm but realistic tone and demeanor.
Pick a time when everyone involved in the discussion is calm. You don’t need a huge family meeting unless you believe that is required. You don’t want your loved one to feel ganged up on. You should pick one head of the family to talk with the loved one and discuss the problem.
Clearly communicate your expectations and any subsequent consequences. Understand that your loved one will test those limits (and thereby test your resolve). Don’t get into a battle or try to justify the rules. If everyone presents a united front and is willing to follow through, your loved one will be more likely to eventually comply. The flipside to that is if they decide the rules or aftermath is too much to accept, it will persuade them to work on becoming independent.
The Bottom Line
I understand it is easy for me to list out all the steps and then leave you to try and figure out all the details. It is often extremely difficult for all these variables to line up. Getting everyone on the same page is hard because everyone has a unique hot button.
Expecting your loved one to hear, understand and comply is usually the hardest task to accomplish. They are so caught up in their own inner turmoil that your rules are the last thing they are worried about.
I understand how challenging this is because I am literally going through the same thing right now. In fact, that is why I started the NAMI course, to begin with. I wanted help in being able to set limits and discuss expectations without commencing WWIII.
I can tell you that these steps have helped, but I can also admit there is no foolproof method. I don’t tell you that to discourage you, but actually the opposite. When you have done your best and things still fall apart, it’s ok. Or it will be ok. Or YOU are ok. Don’t give up on a peaceful home and never give up on your loved one. Both things can co-exist, just not always easy.
Hold your line and then maybe even hold your breath.
The time and energy you invest will pay off!