Unconditional love; conditional participation

When I was walking around trees, following deer tracks, listening to the music of red-wing blackbirds, I realized that I love my family members unconditionally. It does not matter to my loving them that they are unwell. Where the conditional aspects of our relationships come in are around their behaviors when they are unwell. When they are hurtful, dangerous to me, unkind, disrespectful, scary – these are behaviors I don’t let into my life from anyone, and that means, not from them either. I am willing to have them in my life when they are able to behave in ways that I want to be a part of. The strings are, “As long as you are able to be around me, on my terms, we’re good.” I am not closing any doors. I am merely defining the parameters for participating in my life. And my (currently) estranged family members seem to be aware of this. I consider their estrangement from me as a way that they are protecting me from their unwellness. What are your thoughts?

About GASF

We had the opportunity to connect with a blogger who has a great deal of wisdom and insights (The Bipolar Manifesto http://www.yourbipolarfriend.com/index.php/general/effectively-managing-a-bipolar-relationship/ ).  In the course of our discussion, GASF (the Founder) answered some very thoughtful questions about us.  Here is a partial transcript:

Our model of operation in all programs is that mental illness is a chronic illness and can be managed effectively.  It is “typical” whether or not people talk about it.  WE not only talk about it, we actively look to promote recovery for the whole family and maintenance so that acute episodes can be taken in stride and the chronic nature of mental illness accepted and managed.

What drew me to creating this organization was when my adult child was diagnosed with a mental illness and there were no services available for us as a family.  I had been an in-home therapist with families with children with behavioral issues and I worked for an agency that provided general services for the parents and friends so that they could network, find support, and improve their family systems.  I had an idea that the model would extend to services for adults.  “Nay, nay.”  Being a fee-for-service clinician with a lot of professional and personal experience, I was appalled and sought to right this wrong.  So, I brought my considerable experience to the forefront and after several different attempts to get something going, founded Grow A Strong Family.

One questions that often comes up is, “Are your programs evidence-based?”  They are evidence-informed.  The only evidence-based referral I make is to NAMI’s Family-to-family program since I think it is an excellent introduction into this new world.  Otherwise, there is not anything “out there” that is specific to this population.  Integrating evidence-based and evidence-informed material from other sources (like the substance abuse and education fields), I bring it out in ways that enable our population to grow.

“Parent 1 and Parent 2 have a mentally ill child (when I say child, assume any age including adult). Parent 1 insists on an approach with boundaries, almost teetering totally into tough-love but not necessarily. Parent 2 insists on compassion to the point of enabling, often stemming from guilt and fear of being a bad parent or failing their child”.  GASF response to this scenario: In typically developing families, parents often have different parenting styles.  So, why not when a child is atypically developing due to a mental illness?  Our underlying philosophy is that each parent is entitled to have a relationship with the child(ren) independent of the other parent so long as there is no abuse.  They do not have to like or agree with the other’s way of handling things however they may not undermine or otherwise negate the other parent’s contribution to the growth and development of the child. They do need to have an agreement about safety, however.  A general rule of thumb is that whichever parent is more bothered by a behavior gets to deal with the behavior.  When both parents must come to a place of agreement, such as whether an adult child moves back home, they come up with a plan that works for them before extending the invitation to the child.

In situation 2, ” Compassionate, loving parent is being manipulated and gamed by mentally ill child. Parent is unable to separate the difference between an acute bout of unwellness and someone who is toxic and potentially destructive to their life and health.”  Our role as family life education coaches is to offer alternative views of the behaviors that the parent is experiencing.  We ask more questions than make statements so that they can determine for themselves that the behavior is toxic.  We have many resources that we offer these parents including the powerful module from the “Replanting lives” workbook on “Finding the person in the illness.”  This brings the parent in touch with the best of their child and they can then note (for themselves) how their child has changed and the cost to them as a parent of acting in ways that are self-destructive and unhelpful to their child.  There are also rich discussions of the difficulty of identifying symptom from personality/behavior and we help them tease that out through offering developmental and mental health information.  Again, our approach is to bring the parent to an aha moment so that they can make informed decisions about how they want to move forward vis a vis their child.

” Does your material and services require participation by both family and the mentally ill person together? Can it quietly benefit a person who is basically trying to survive a destructive mentally ill loved one?”  Our materials and services are designed for the family members so participation by the family is necessary.  If they want to include their loved one with mental illness, they are welcome to do so, however it would be as part of a private coaching session.  The presentations are not designed for the sensibilities of the individuals with mental illnesses so much as the focus is on the family as a whole and its needs in particular.  Our model is designed to encourage positive outcomes so whomever participates brings their acquired knowledge and skills to the family system. In that way, there is both active and passive changes.  As in 12 step programs, even if only one member of the family participates and makes changes, the whole family becomes impacted by that.  Same thing here.  Very often, we get one family member at presentations and they report that they share what they are learning with their families.  In coaching, we are likely to get the primary caretaker and if there is a spouse or significant other, they attend also.  Our services are available to the whole family, however, and we are open to problem-solve accordingly.

Grow a Strong Family is about building resilience in families that have been sideswiped by a difficult family illness that won’t typically resolve itself with previous strategies.  They can grow and become strong, however, and a healthy model for all of their family members, including their loved one with mental illness.  When there is a recovery model, everyone benefits.

“Do you feel it is ever appropriate for a person to eject a mentally ill person from their life for good? Family member or not?”  On the surface, no.  We are not in favor of shunning any family member, especially when they are mentally ill.  We can see where there are times when a limit must be set for safety purposes and that may look like ejection.  However, all individuals have choices, even individuals with serious mental illness. In our experience, more family members are rejected by their loved ones with mental illness than the other way around. We can’t even begin to count how many parents are estranged from their adult children with mental illness because they set down safety limits and their children did not want to agree to them. These parents mourn for the loss of their child and the loss of their opportunity to participate in their child’s recovery.  Of course, their children do not necessarily want to participate in their own recovery, never mind with familial support.

Recovery: What does it mean?

 

From our Sept 2017 Newsletter!

The certified pet therapy pair went to the annual awards ceremony at the Bedford VA’s Veteran Community Care Program in Lowell.  Max visits with the veterans every week, performing a series of tricks, and providing nurturing and support to those who need a furry friend with a wet nose.  The ceremony was conducted by the veterans and they shared stories of their recoveries, their appreciation for one another, their service to the community there and the greater community of which they are a part of.  Their model of recovery is based on the SAMHSA (2015) working definition:

“recovery as a process of change through which individuals improve their health and wellness, live self-directed lives, and strive to reach their full potential. Recovery is built on access to evidence-based clinical treatment and recovery support services for all populations. Learn more about SAMHSA’s Working Definition of Recovery — 2012.”

It is useful for family members to understand this focus on recovery because it includes management of the symptoms and offer hope, relief, and a call for strategies including setting appropriate limits.

The full discussion on this working definition can be found here:  https://www.samhsa.gov/recovery

Spring Seminars through Bedford Recreation

WHO CARES FOR THE CAREGIVER?
Learning how to actively schedule self-care is a vital skill when nurturing and supporting loved ones with mental illnesses. Give yourself the gift of an evening to acquire some skills that do not require huge amounts of time or commitments that you may not be able to fulfill. You might even have fun while remembering how to have fun!
Monday, March 13, 7:00-8:30pm (min 5/max 25) Fee: $25

HOW TO MANAGE THE HOLIDAYS AND FAMILY CELEBRATIONS WITH LOVED ONES WITH MENTAL ILLNESSES
Throughout the year, there are special times that families gather together and for some families, these can be quite stressful. In the spring, there are religious celebrations as well as Mother’s Day & Father’s Day, graduations, and weddings. This seminar offers effective strategies for moving through these potentially difficult times with our loved ones with mental illnesses or behavioral health issues. (min5/max25)
Monday, March 27, 7:00-8:30pm Fee: $25

HOW TO PARENT CHILDREN WITH BEHAVIORAL HEALTH ISSUES
Parenting is a challenge under the BEST of circumstances. Add a child with behavioral health issues and, well, it is MORE of a challenge! Learn how to step out of the fight of medical/mental health compliance. Examine some strategies to increase your effectiveness in establishing and setting limits. Consider how to have more fun as a parent! This introduction offers a framework for managing the challenges facing parents who are confronted with atypically developing children. (min5/max25)
Monday, April 3, 7:00-8:30pm Fee: $25

Please register through Bedford Recreation: https://apm.activecommunities.com/bedfordma

How To Seminars

Grow A Strong Family Presents: How To Seminars

Grief: Learning to Move Forward: As Lu (2016) points out, “When a loved one is struck with a serious mental illness, family members experience the loss of the individual they once knew, and are left to cope with learning how to live with a person who is physically present, but psychologically and emotionally different.”  When a loved one has a mental health diagnosis, typical transitions, hopes, expectations, and dreams require a re-write.  Family members experience a sense of loss, sadness, disappointment, discouragement.  The relationship has changed.  Roles are revised.  Triggers abound which cycle through the lifespan and the grief seems to know no end.   

Join us as we discuss this painful component of loving someone with a mental health diagnosis.

Monday, February 6, 7:00-8:30 PM 12 Mudge Way Bedford MA Room 152.  Registration required through www.bedfordrecreation.org or 781-275-1392.  Fee: $25

 Talk to loved ones more effectively Talk Text Email Tweet Message:  Communication can vary on many dimensions.   It can be direct or indirect, formal or informal, clear or blurred, etc. Trying to have a conversation with someone who holds onto her distorted thoughts in spite of overwhelming evidence is challenging, frustrating, and can lead to angry outbursts that hurt both of you.  There are proven tools that can effectively enable you to get your point across without fighting.  Learn the basics.  Practice in “real time.”  This is an introduction to better communication.    Learn how to “get out of the fight!”

Wed, Feb 8, 7-8:30pm, Concord Carlisle High School; Code FL101.  Registration required through www.ace.colonial.net or 978-318-1432.  Fee: $25

Monday, February 27, 7:00-8:30pm, 12 Mudge Way, Bedford MA Room 152.  Registration required through www.bedfordrecreation.org or 781-275-1393.  Fee: $25

Avoiding Power Struggles is for those of us who are tired of fighting with our loved ones who have mental health or behavioral health diagnoses over… anything!  Why do they hook us into fighting?  Why do we go there with them??? How can we step out of the battle?  How can we be more effective??

Learn what purpose power struggles may serve.  Pick up three strategies for avoiding the power struggles. 

Monday. January 30, 7:00 -8:30 Pm.  12 Mudge Way, Bedford MA Room 152.  Registration required through www.bedfordrecreation.org or 781-275-1393.  Fee: $25

Monday, March 6, 7-8:30 PM Concord Carlisle High School; Code FL102.  Registration required through www.ace.colonial.net or 978-318-1432.  Fee: $25

Who cares for the caregiver?  Learning how to actively schedule self-care is a vital skill when nurturing and supporting loved ones with mental illnesses.  Give yourself the gift of an evening to acquire some skills that don’t require huge amounts of time or commitments that you may not be able to fulfill.  You might even have fun while remembering how to have fun!

Monday, March 13, 7:00-8:30 PM 12 Mudge Way Bedford MA Room 152.  Registration required through www.bedfordrecreation.org or 781-275-1392.  Fee: $25

Tuesday, March 14, 7-8:30 PM.  Concord Carlisle High School; Code FL103.  Registration required through www.ace.colonial.net or 978-318-1432.  Fee: $25

Are you grieving the loss of a child who is still alive?

This is a too frequent occurrence in our families. In addition to the onset of mental illness, sometimes our children create stories about themselves. Then, they systematically eliminate anyone who challenges their version of events.

In trying to understand, I have uncovered a sad phenomenon of so many parents rejected by their adult children. In the short run, the “why” seems to obsess us. Then, we have to grapple with the “what” and the “how” we are going to move forward anyway. We learn that we cannot hang our hearts on their returns. We need to work through the`shame and self-blame and move to peace and joy, appreciation and gratitude for what we have, for what we’ve had, and for what we can have.

I have found that mindfulness practice is really helpful for me. I also have incorporated the exercises from the book, “Done with the crying” by Sheri McGregor (a fabulous resource and guide for parents grieving the loss of their alive child).

If this is something that you grapple with, what helps you?

About the losses

I have been doing a great deal of research into the kinds of losses that families experience when a loved one has a diagnosis of a mental illness.  This is such an un-talked about phenomenon that is deeply experienced by the caregivers and the families that it is astounding to me.  I have uncovered what feels like a wealth of information from allied fields, like dementias, war, disasters, etc that it saddens me that so little is brought forth for something that affects so many.

Blandon (2016) has written a series of 3 articles that describe “dementia grief.” The series summarizes much of what I have found in both the research and my own lived experience. For example, she mentions “Disenfranchised grief refers to grief that is not publicly acknowledged and sanctioned. This can occur in a variety of situations in which there is significant loss of some sort but not the opportunity to talk about it openly because of stigma or lack of understanding and sympathy from others. Disenfranchised grief can occur in the parents of adult children with mental illness, criminality, alcoholism, or other substance abuse.”  Makes sense considering that when a loved one has these descriptions to capture their experiences, there is little acknowledgement or recognition of the loss involved.  Losses of their beloved as a partner, friend, child, with all of the roles and components of relationships that were once fulfilled.

She goes on with the working definition of ambiguous loss: “Ambiguous loss refers to a significant loss that is lacking in clarity, finality, and does not have a normal sense of closure.” “There are two types of ambiguous loss. In the first, the individual is physically absent but remains psychologically present. This has been described as “Leaving without saying goodbye”. Examples include prisoners of war or disaster victims who are missing. “In the second type of ambiguous loss, the individual remains physically present, but is psychologically absent – this is described as, “The goodbye without leaving”. This type of ambiguous loss occurs in a variety of conditions, It is very difficult to grieve someone who may no longer be psychologically present as a spouse, a parent, a companion or other intimate, but who remains very much a physical presence with ever-increasing needs for care that must be met. The very ambiguity of the relationship makes it challenging for the family member to acknowledge the loss, to grieve, and move forward. Ambiguous loss – a loss that resists resolution and complicates the grieving process – is the result.”

Three strategies are offered: join with others with shared experience (like support groups, this closed group, etc); create a grief ritual; and, mindfulness.

So, with this in mind, we developed a “How To” seminar which explores this in greater depth and offers caregivers and families the space, tools, and strategies to “move forward” through the losses.  In addition, the closed FaceBook discussion group (Grow a Strong Family Inc. Together) is a venue for support, acknowledgment, and encouragement.  Of course, coaching can really get into this with a customized menu of services and strategies.

The full article series can be found here: https://www.dementia.org/dementia-grief-characteristics

Transition Time

As I pulled on long pants for the first time in 3 months, I realized that the summer is really winding down. Already, the mornings are darker and the sun sets earlier. The day is warm while it is sandwiched between cooler temperatures. Geese are gathering. Acorns are falling. Hurricanes are forecast! Everything is in transition. It is at times like this that I pause, take stock, and prepare for the busy time just ahead.

We have conducted our first survey and the results are in. We are making plans accordingly! So far, we will be offering the “How To” seminars in a 5 part series through the community education departments of Lexington MA beginning September 22 from 7-9pm ; Bedford MA beginning October 17 from 7-8:30 pm; and, Concord MA beginning October 19 from 10-11:30. Feel free to reserve your spot and ensure that you will be able to attend! This series offers strategies, support, and conversation about what the friends and caregivers of loved ones with mental illnesses need. In addition to more effective communication, avoiding power struggles, and developing a community, we have added managing the grief, and improving family “self” care. These last two are a wonderful addition to our repertoire of services.

For registration information, follow these links: http://www.lexingtoncommunityed.org/classes.php?department=MIND+%26+BODY
http://www.bedfordma.gov/sites/bedfordma/files/file/file/fall_2016_brochure_aug_24_edit.pdf
https://ace.colonial.net/ccace/course_detail.php?action=results&id=32328

We are offering a FREE evening talk, “Coping with the cycles of grief” for Central NAMI Middlesex on Monday, September 19 at the Edinburg Center in Lexington. Socializing from 7-7:30; talk is from 7:30-8:30.

The coaching practice has also been revamped. As expected, with the development of new programs, new skills have been acquired. We are very excited to be able to offer them in the customized format that the coaching service provides.

In our experience, the summer tends to offer families a relief from the grind of the structured school year. Even when families have adult children, we are all so conditioned by the school year that we tend to respond accordingly! With this in mind, consider how your family tends to operate in the coming months and plan for it. We are especially effective when we have the ability to manage difficult circumstances without the drama of a crisis.

Consider giving yourself and your family the gift of thoughtful preparation through participating in our coaching sessions or the seminars or even through participating in our Facebook group.

OH! I forgot to mention that we will be offering a closed group through our Facebook page (https://www.facebook.com/growastrongfamily/ )! It is in the planning stage right now and will be rolled out and open for membership by the end of the month! Visit us and like us and when the group is launched, you will know!

Max and I are ready, willing, and able to engage in our pet therapy service. Let us know who, what, when, and where, and we can make it happen! A visit at your house, ours, a walk, whatever will work.

We look forward to connecting with you in the near future!