“If you can’t get rid of the family skeleton, you may as well make it dance” George Bernard Shaw
When it comes to healing from emotional distress, support from others and within the community is vital for successful recovery. Despite all the talk in the media about mental health, sadly people can find themselves without support or understanding. Lack of support can inhibit and delay the healing journey.
Families need accurate information on what can help a person in distress. “In the field of mental health people need to be as informed as possible as some day, without much warning, we can find ourselves, a relative or a friend coming in contact with the current system … Giving someone a Psychiatric diagnosis is an immensely powerful act which has profound implications for their identity, relationships, place in the community, employment, health and future.” ~ clinical Psychologist Lucy Johnstone . Dr Johnstone highlights that the process of recovery has to start with the most accurate description of what is going on for the person. Listening non-judgmentally with empathy is something to aim for, hard as that might be. Find out what is going on in the person’s life. It can sometimes be more convenient to slap on labels and blame genetics than address issues and struggles within the individual and their family or within society itself.
We have been conditioned in the biomedical view, which benefits the pharmaceutical industry but doesn’t necessarily help the person to heal to the best of their potential. It is possible to get people through recovery and back to being a productive member of their community. This could mean paid work but there are also ways a person can voluntarily contribute to their community and this requires some recognition. It is not always possible if the person is on high doses of strong tranquilizers which can affect their ability to get motivated and function e.g. in a work environment. While no one should stop or change prescribed drugs without expert advice, long term exposure to these drugs can cause brain damage which I will write about in other blogs.
Critical Psychiatrist Dr Philip Thomas in his book Psychiatry in Context explains that it can be hard to measure non-specific factors that aid recovery e.g. trusting human relationships . He points out that it is necessary to engage with people in emotional distress within the social and cultural contexts of the communities they come from. It may be possible to find out from communities what helps people in that community regain a sense of well being, so that people can be productive and have purpose and meaning in their lives.
Forces in society that damage family relationships
“Sometimes you got to accept the fact that certain things will never go back to how they used to be”
I recently re-watched the great classic movie One Flew Over the Cuckoo’s Nest and wish I had seen this movie at 18. While it is now over 40 years old and has cult status, there is a lot to be learned from this awesome movie. I do believe that mainstream Psychiatry is a powerful and controlling group that has the potential to cause a lot of damage to family relationships inter-generationally. As my father had an emotional crisis when I was about three years old, a lot of what I was led to believe about “mental illness” for the first few decades of my life is based on fiction and not fact. I had been indoctrinated from an early age into my families and societies way of viewing and dealing with mental health issues.
When I had my own crisis and direct experience a decade ago, instead of using an Open Dialogue approach to engage with me , family members were questioned and this information was then used as “collateral”. This made it feel like everyone was working against me instead of with me. The terminology is something I became aware of when I got my notes under Freedom of Information! Reading such notes can be very traumatic and I do not recommend it unless you have a good support person to go through this process with you. I was left with Post Traumatic Stress, feeling fearful, unsafe and hyper vigilant. While the feelings are starting to ease, this has lasted almost a decade so far! When I went through Regression therapy with Ivor Browne, it turns out the Post Traumatic experience I carry is very much intertwined with memories of my father been locked away on several occasions throughout my childhood.
In my experience, starting with how the person can be forced into an “Acute Unit” without use of a mental health advocate or Open Dialogue, I found the overall approach taken by the system to be highly traumatic and damaging. It destroys trust between family members. Sometimes the family is already struggling with past issues, trauma and dysfunction and this adds another layer of damage to the situation. What is needed is family therapy.
If friends/relatives spy and gossip about the person in distress, this is very unhelpful. If the person becomes aware of this, it can lead to a breakdown of trust and relationships. When trust is gone sometimes it’s gone for good! Sadly I am not talking about “paranoia” but evidence based fact. But a certain amount of paranoia can easily become a survival mechanism. While some people have been occasionally good to me financially to help me through the destruction caused e.g. loss of career, on an emotional level I went from feeling I was part of a family to feeling very much alienated and disconnected from them. I am still close to some cousins in my extended family and have started to build back some trust with relatives in the previous generation. People that have been very good to me, especially in my younger days. But as I’ve said the approach of Psychiatry can cause lots of damage.
We are advised to talk about our mental health struggles but in general we also need to be careful when doing so and to protect ourselves e.g. career wise. Some people in our communities are not so understanding about struggles with emotional distress. At the same time there are good people, therapists and organisations out there e.g. Samaritans (116 123).
R D Laing
Sometimes the dysfunction within families can trigger mental health issues. Scottish Psychiatrist R D Laing did studies on this using game theory (based on the work of mathematician John Nash) .
Family members may not be the best people to try to re-engage the person or motivate them. Occupational therapists and other support people should be involved. If I had a family member or friend with mental health issues I would acknowledge any true progress they are making and wouldn’t compare them to others. Everyone’s journey is unique.
Impact of mental health struggles of a parent on their children
“it is essential to try to open up the hidden area and collusion going on within the family” Ivor Browne
When a parent experiences mental health difficulties this also will affect the family unit and children, including the stability of the environment the person grows up in. Family therapy may be needed to help families through difficult times.
If the parent is / was on medication, the sedative nature of the drugs can impact on the parents ability to function and motivate themselves e.g. work, cook meals, get the children out to school or engage with their children. Watching a parent experience depression, mania or ‘psychosis’ can affect the child.
By being aware of inter generational trauma and what can be done to support each generation, it is possible to help families to function better. My goal would be that the next generation in my family will have an accurate picture of what mainstream Psychiatry is about and a more accurate picture of what Manic Depression is and what can trigger it. This would help them of avoid pitfalls of what has become an inter-generational trap. They need to be armed with the correct knowledge that will protect them, so that they do not become a victim of what I see as a damaging system.
As the oldest of four siblings, I grew up in an environment where my father was on up to 14 pills a day and given Electric shock treatment which had a huge impact on him, his relationship with my mother, my childhood and family life. I was unaware of the risks of getting involved with the Psychiatric industry and allowed myself to be referred by my GP for help with severe anxiety / panic. While I’m not discouraging people from getting psychological help when they need it, allowing myself to be referred to a Psychiatrist and into the public system was a big mistake that has cost me dearly on many levels.
Mainstream Psychiatrists are medical doctors that mainly prescribe drugs and get people onto cocktails of drugs. Only a relatively small percentage of them are trained therapists. Despite all their power and control in society e.g. in the courts, they can’t help a person in distress without the correct skill set! When I eventually got to see Prof Ivor Browne, who is a Psychiatrist and trained therapist, while I’m not trying to say he is perfect, the difference between seeing him and the other amateurs was huge. Even when I read back on my notes now from being in the system between mid 2008 and early 2012, the “help” I received was inadequate on many levels. With the exception of the help I received from Orla the Occupational therapist. More investment is needed in Occupational therapy.
In my blog on Genetics I explore the fact that some people can’t process drugs like anti-depressants and there is a genetic aspect to that. I have a 1st cousin that took a similar SSRI to the one I did (Citalopram & Escitalopram respectively). We both ended up with the same diagnosis. So I would recommend that people related to me, particularly on my paternal side, to steer away from these mind altering psychotropic drugs and to find alternative ways of managing their distress.
Strategies to enable family and friends to help someone through mania and/or Psychosis
While I don’t agree with all the information in this link some of it may be helpful. How to avoid a manic episode .
Start with the most accurate description of what may have triggered the Psychosis (loss of touch with so called reality) and anything that may be fueling it e.g. Severe lack of sleep, drugs (prescribed or street), alcohol. Address any of these issues appropriately.
An Open Dialogue approach is needed, if possible, which has been known to have very good recovery rates. See separate blog.
Address the stigma within families from the start. Not all families are supportive of each other. R D Laing believed that ‘psychosis’ and ‘Schizophrenia’ is incubated within family environments. Sometimes there may be other causes e.g. Drug use, including prescribed psychoactive substances.
Minor or major tranquilizers are not a “cure”. Short term they can help a person who is in mania and/or psychosis to relax and get some sleep. Depending on the person and the drug, as each person reacts differently to each drug. For example, I found 5 mg of Olanzapine used short term to be helpful.
Relevant courses, including online ones, can provide knowledge but are sometimes funded by or influenced by the pharma world e.g. Free online courses on FutureLearn.
Charities like Grow and Shine provide some support
Support is also needed for kids whose parents experience mental health difficulties eg play therapy and counseling, to reduce inter generational trauma 
Work on a sense of Self. Both the person in distress and their supporters can do this. There is a good book called Selfhood with exercises by Dr Terry Lynch .
Coming off medication should be an option for most people but that requires specialised, expert advice and close monitoring. It would need to be done slowly under the supervision of someone who has the expertise. Usually a GP or other doctor but the question is do they have the most accurate information and knowledge ? [8, 9]
If a person hears voices there are organisations out there that can help e.g. Hearing Voices Network and Intervoice [10, 11]
When the person is in a good place learn about WRAP (Wellness Recovery Action Plan) and help them develop a WRAP plan . There are some organisations in Ireland that provide training in WRAP e.g. Suicide or Survive.
Social stigma and discrimination
Research by the Mental Health Foundation (Pull Yourself Together report) found that 56% of people suffering from mental distress had experienced discrimination by family and 51% said they had experienced discrimination by friends. Many of the respondents reported that relatives and friends had distanced themselves, sometimes to the extent that people felt ostracised and socially isolated. Many people also reported being on the receiving end of name calling, labelling, and unhelpful instructions such as “Pull yourself together”. 
If you don’t feel accepted or feel unwanted, stigmatised or excluded, healing from emotional health issues can be seriously affected. Your sense of belonging within your family of origin can diminish or become non-existent.
Many of us have persevered in the face of discrimination and social stigma. We have witnessed the death of our old self and the “reemergence of a new self out of the ashes of the old” . This can be quite a painful process. You experience a sense of loss. Sometimes it can be hard to let go of what was to embrace the new reality. But this is sometimes a necessary part of the healing process, including stepping away from relationships that increase distress. Either temporarily or more long term. Life is short. Sometimes we really only appreciate people when they have passed away. As someone who lost a close friend recently in tragic circumstances, we need to learn to appreciate people more while they are still around and to be as supportive as possible.
 A Straight Talking Introduction to Psychiatric Diagnosis by Lucy Johnstone
My review of this book ~
 Psychiatry in Context : Experience, Meaning & Communities by Dr Philip Thomas 2015
My review of this book ~ www.goodreads.com/user/show/46943899-anne
 R D Laing used work of Nash and Game theory to study human relationships (18 & 25 mins)
 How to Avoid a Manic Episode ~ www.bpso.org/nomania.htm
 A collection of resources on Open Dialogue practices ~ http://willhall.net/opendialogue/
 The Efficacy of Play Therapy With Children: A Meta-Analytic Review of Treatment Outcomes
 Psychiatric Drug Withdrawal A Guide for Prescribers, Therapists, Patients and their Families by Dr Peter Breggin, 2012 ~
 Information on Psychoactive drugs and drug withdrawal ~ www.comingoff.com
 Hearing Voices Network ~ www.hearing-voices.org
 Intervoice (International Hearing Voices Projects) ~ www.intervoiceonline.org
 WRAP (Wellness Recovery Action Plan) ~ www.mentalhealthrecovery.com
 Pull Yourself Together! A survey on the stigma and discrimination faced by people who experience mental distress ~ by the Mental Health Foundation (2000) ~
Other information that may be useful
* The 7 Habits of Highly Effective Families by Stephen Covey ~
* Soteria ~ a network of people in the UK promoting the development of drug-free and minimum medication therapeutic environments for people experiencing ‘psychosis’ or extreme states ~ www.soterianetwork.org.uk
* “Phil Fennell, Professor of Law at Cardiff University, looks at mental health legislation in Britain and elsewhere, and draws lessons for reform of Ireland’s Mental Health Act 2001. Phil was speaking at an Amnesty International Ireland conference on mental health law reform in March 2013″ ~ www.youtube.com/watch?v=rDvah16UtaU
* Life After Suicide BBC Documentary 2014 “Documentary. Angela Samata explores why some people take their own lives and how those who love them come to terms with the loss” ~
* Antidepressant-associated mania and psychosis resulting in psychiatric admissions. Yale study (2001) ~ www.ncbi.nlm.nih.gov/pubmed/11235925
* New study concludes Psychiatric drug treatments haven’t resulted in an improvement in the long-term outcome of patients with “mood disorders”:
* “Understanding Psychosis and Schizophrenia” (revised version) ~
* The Writings of Ivor Browne: Steps Along the Road, the Evolution of a Slow Learner ~ www.amazon.co.uk/Writings-Ivor-Browne-Evolution-Learner/dp/1855942194
Some of the papers in this book covers family and family therapy “it is essential to try to open up the hidden area and collusion going on within the family where it is often seen as necessary to hold the patient in his or her sick and painful state as scapegoat and guardian of the secret” pg. 239
* Ivor Browne interview with Pat Kenny from 2013 ~ www.rte.ie/radio1/podcast/podcast_patkenny.xml
* Most people labelled as having Depression have suffered grief that hasn’t been resolved ~
* Music and Madness, Prof Ivor Browne, 2008 ~
* Sanity, Madness and the Family by R D Laing ~
Family therapy “is a type of psychological counseling (psychotherapy) that helps family members improve communication and resolve conflicts” www.mayoclinic.org
“Family systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin”
Pharmacogenetics “is the study of inherited genetic differences in drug metabolic pathways which can affect individual responses to drugs, both in terms of therapeutic effect as well as adverse effects” (Wikipedia)
Play therapy “a form of counseling or psychotherapy in which play is used as a means of helping children express or communicate their feelings”.
For more information see www.playtherapy.ie