Tips-Moving Beyond Anosognosia:Talking With A Mentally Ill Family Member| Psychotherapy Crash Course
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- Опубліковано 3 сер 2024
- #Trauma #Anosognosia #Family
#traumainformed #schizophrenia
Living with someone who has a severe (untreated or poorly treated) mental illness can be very difficult. It can also be very traumatic.
One of the reasons why this can be difficult is because a psychotic episode with delusions are hard to get through. In fact, if a family member does not believe they are ill or that they need help (i.e., known as anosognosia), they can struggle through life for years without getting proper help and possibly making life harder on their loved ones.
Research suggests that anosognosia is to blame for a large percentage of people living on the streets, engaging in violent acts, and being arrested (Treatment Advocacy Center, 2020).
Common sense concepts, accurate beliefs, and concrete proof are no longer existent in the world of someone with anosognosia (including active deulsions). This disconnect from reality often leads to arguments, false accusations, or separation.
In this video, I will be discussing ways that you can support and communicate with someone in your family who has delusional beliefs and may be suffering from anosognosia.
Discussed in the video:
-Respond only to emotion
-Offer help humbly
-Use safety parameters to create safety
-Listen attentively
-Encourage them if you are the target
-Watch how defensive they are - work around this
-Pay attention to their fear response
-Bring in the law (if applicable and needed)
-Don't argue
-Don't defend yourself
-Don't try to "trap them
-Avoid technical language
-Don't defend yourself 100% of the time
_Stay calm, balanced
-Bring in a neutral party
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Article that may shed light on this topic:
-What happened when I denied my symptoms: www.nami.org/Blogs/NAMI-Blog/...
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keywords:
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Have you come to a brick wall with someone in your family?
Thank you Dr. Hill. I struggle with this. My mom is diagnosed with schizophrenia and has delusions and hallucinations. I do not have the skills to remain calm. I get worked up and cry. It’s so challenging for me.
Hi Jessica,
thank you. And I'm sorry to hear this. I don’t blame you for struggling with this. No one wants to see their mother struggle with this. It's very tough.
That's a lot of people, that is pretty much everybody. I also get reactive. I have also been a target of delusions. It's pretty common especially in the community I live in it seems to be maybe because of last pandemics. Substances only make mental illness worse.
This is such great advice. But it’s hard when my mom presents “evidence” and me saying anything but agreeing sets her off.
This is so helpful Tamara--thank you! With my brother, when I have tried to "reason" with him, at times it escalates into what to HIM, looks like an argument and that just makes it worse. And at times, HE will bring up my education and say things like "Well, what do YOU think? YOU are the one with the degree!" I would just by instinct and ethics minimize that because though I DO have my degrees I have not yet pursued licensure. I also told him that even IF I were licensed, I wouldn't put myself in or allow others close to me to put me in that role because we don't counsel or diagnose friends or family. That helped.
I like the fact that you provide very concrete helpful hints as to what I should say or not say should he be delusional when we next speak.
Lori
Thank you Lori! I am glad this video is helpful.
You are right that reasoning with individuals like this often makes things worse. Sometimes I feel like statements such as "Well, what do you think?" is a mind-game played to see if they can get you to air your thoughts. I had a patient/client like this once and she figured she was smarter than me, even in her psychosis, and she used these kind of "hooks" to get me to tell her what I'm thinking It's almost like a way to "get ahead" of the person who is questioning their sanity. It's quite disturbing but having delusional thought patterns is very separate from intelligence.
Thank you Tamara for putting this together for those of us who are struggling to support a loved one with this condition. I am grateful to have stumbled upon your channel!
Thank you, Tamara. Excellent description go psychosis.I walked a fine line with my mother up until the day she died. She was delusional, yet I always loved her. Now I'm dealing with a high school class mate that I never interacted with way back then. He's stalking me; I believe he's a covert narcissist and I've been wondering if I should be honest and point out my observations - this video absolutely has given me the answer to follow!
Beautiful clinician and beautiful information. Bless you therapist Tamara!
Thank you 💖 Appreciate that. Blessings to you.
wow its been a long time, im happy to see you back
Thank you Joe!
Great advice. Thank you very much Doc.
Glad it was helpful!
It is interesting to see professionals adopting what peer supporters have been doing for the past 100 years or more.
You mentioned that if you're the target of the delusions to side step it or let them know younarent within arguments. I would love more details and maybe examples of what that could look like. ❤
So far, from all the research I have done to try and help a loved one, I haven't found the answer, in theory all these tips are good but when it comes to stubborn individuals who don't want help because they don't think they are sick or need the help, it's Impossible to get through them without telling them straight out they have mental issues and they need to be medicated. The answer I get is " you take them, not sick, I'm just not stupid anymore". How do you deal with that? Anyone out there can please tell me, because so far all the videos I watched get me no where . The Leap method doesn't work for everyone, empathizing and agreeing they aren't sick is not going to go nowhere. They need help, medications here and now!
you need to understand that some people have a tricky symptom called anosognasia which makes it impossible for the person who is sick to understand they are sick. .. watch a vid on youtube called 'im not sick i dont need help'
Thanks for the advice. My friend is very symptomatic of Borderline personality disorder (and I showed a bazillion texts to my therapist to confirm that I'm not just making leaps to such a difficult condition). I have a hard time trying to get through to my friend and this video is helping me to understand why. My therapist suggested a no contact policy, which seems harsh, but she's about as receptive as a brick wall. It's amazing to me because she nearly earned a PhD in childhood developmental psychology. Wild how someone can have that level of education and yet absolutely no insight.
I think for the time being, I'm going to give my friend space. When I'm emotionally ready to engage again, I will use these tips.
I'm sorry Christina. That's tough. I agree with your therapist. Sometimes, as you already know, we have to go "no-contact" to save our sanity. It also allows us time to process who the person is and why they are in our life. With no-contact you are able to gain a more objective view of the situation. Your emotions become less involved and you can make proper decisions from there.
As far as education goes, A LOT of people in the field of psychology have struggled themselves. Sometimes, depending on the intensity of the struggle, this can be helpful. There are other times, like in the case of your friend, where the person should not be in the field at all. Education and mental illness are so different and many people who are mentally ill can get through school and obtain the credentials needed to have power in society. That is scary indeed. The best thing you can do is go no-contact for a short period of time (or long-term) and see if this might wake your friend up.
Take care
@@TherapistTamaraHill Thanks for replying! That's kind of you. I like what you said about education being beneficial to some because I'm currently trying to learn a lot about mental health to strengthen insight into my own mental illnesses. It has been really helpful so far! I guess that's why I struggled to see why she could be so educated and yet so oblivious to her condition. I'm finding knowledge to be power!
I don't know the prognosis for people with Cluster B personality disorders, but I hope that she accepts psychiatric care before things get really bad (in her case, losing custody of her child would be the thing to worry about right now 😬). I've given her as many nudges as I can towards psychiatric care and I can only hope she internalizes that advice eventually.
If/when I do resume contact with her, I think I'll try to get her to talk about literally anything other than her current situation (boyfriend left her five months ago and that "abandonment" has done a number on her). I don't want to stop being her friend, but I think I need to draw a boundary around the topic of her boyfriend/the "abandonment" and tell her I'll only speak with her on ANY other topic. To be clear, the boyfriend is one of the most reasonable and hospitable people I've ever met and is being incredibly accommodating with her, but nothing is good enough outside of him getting back with her.
Sorry, I don't mean to go into my personal life too much, I'm just relieved to know that it doesn't make me a bad friend to give her space and try not to validate her unrealistic feelings.
My sister (27) has a developmental disability. But because of how my parents treated her when she was younger, she denies that something is wrong with her. She denies that it's hard for her to read or write, or communicate and express herself. Because of this, it was so hard to get her any help. Now, she's really struggling to find friends. Even her friends threatened her to seek for help or else they'll stop being friends. She tried to seek help but it was useless because she still doesn't admit it. I feel bad for her constantly and I don't know what to do.
My mother completely dissapeared me aftrr trying to confront her on her delusions
This was fantastic Tamara🙌. Thank you. My mother in law has schizoaffective disorder and is always defensive. How do we hospitalize someone who is a good talker?🥺
Thank you. I'm glad to hear this @truth4utoda.
This is a good question and a question I have heard so many times in the 12 years I have been counseling families going through this. I often suggest that families make arrangements with loved ones prior to them getting sick, if possible. For example, if a loved one had a psychotic break and is doing better and functioning better, this is the time to discuss a living will (a document that provides staff with an understanding of who is in charge of getting the person help) or have your name down on the medical record as an authorized person.
Another way to look at all of this is that if your loved one gets into the company of an experienced clinician (which is often the case in hospitals) that clinician will be able to detect psychosis or symptoms that are dysfunctional so to speak. In other words, the ways in which sentences are constructed, body language, eye contact, stammering and stuttering, repeating things, etc. Most individuals don't get through when they should not.
@@TherapistTamaraHill my husband and I married 5 months ago and in month 3 he had a break down. He went to inpatient facility and refuses to give me consent to speak with doctors. He’s been out almost two months and feels he doesn’t need medicine or therapy. In fact he hasn’t had therapy since he’s been out. He sites he doesn’t like psychiatrist approach but doesn’t do anything else. He’s in a rut - not productive on his own unless you tell him what to do. His lack of doing anything angers me and I’m starting to resent it. How would you advise?
I’ve already done everything wrong 😭 How can I possibly earn my mom’s trust again?
I'm sorry. I understand how you could feel this way.
I would start by showing love and compassion and then slowly building up to a place of trust. Trust is built one step at a time and with every single encounter with the person.
I hope this gets worked out for you.
you can , never give up trying x
By the way, you always look pretty girl!
Thank you!! I don't look like this on the weekend though. LOL 😳😂
Should I be alarmed if the family member talks to the delusion 99% of the time, and seems to become more engaged talking to the voices? She even gets annoyed when I disturb the conversation. She refuses any form of treatment, and has isolated herself for almost two years. She has an extreme case of anosognosia. I wish I could find a therapist like you. I feel so lost.
the harest question to tryr and side step is the direct onne that says > 'you don't believe me do you?' ?< how do you respond to that .. it catches me like a rabbit in headlights
That is a very hard question. I would always answer "I believe you are experiencing reality this way. I understand this is something that is real for you. I want to understand that. I'm trying." Sometimes this triggers the response of "so you think it's just in my head?" You could reply by saying "no, I think you are seeing things the way you see them like everyone else. It's just that I can't fully understand but I am trying."
Someone who is unwell and doesn't have the realistic foundation that those of us who are healthy have, needs us to not comply per se with their skewed view, but rather help them understand you believe they are experiencing things that they can't fully understand themselves.
So so hard. It takes practice and assertiveness to try this.
Sister is bipolar and also anosognosia.. I try to help her as much as I can but all she wants to do is come home. She lives in a group home and doesn’t think she could be bipolar. Is it a loss cause? I read that anosognosia could be caused my brain damage, is that treatable?
I'm so sorry. This is tough to say the least. I'm sure you struggle with guilt and want to give in sometimes but the best choice is to ensure she gets help. Proper help. Anosognosia is a neurological condition and research is mixed on whether or not it can be "treated." Sometimes a traumatic brain injury can also cause this and that can be healed with the right approach and treatment course.
So I have a new therapist I’ve been in therapy consistently for 6 years, I’ve voluntarily went to the crisis center a few times & have asked for mental health help, I’ve had recently a 5yr relationship that ended tragically, & was betrayed. I’m still grieving but I ask for help but my therapist believes this is what he is looking out for, & I respectfully disagree but how do I address to my therapist like what you said be in the middle. My diagnoses currently are ptsd, GAD, bipolar 1 l
how do you let ppl know you care about them as a friend online, no matter how much i say it, they feel noone cares about them still
That's a tough one. You can only say what you mean and that's it. If they choose not to hear your or can't hear you then there is nothing more you can do. Even if you call them or write them, they may still not believe you. If you mean what you say and say what you mean then the ball is in their court.
thank you both
But what if what there asking you to do something you can’t?
My son asks for $30,000. It’s hard to not say I don’t have it. He says he will pay me back in a month.