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About Mental Health

Dear Carolyn: Any advice on how to deal with my single, middle-aged, mentally ill sibling who will be attending family holiday dinners? Sibling is difficult to get along with, is out of touch with reality, and — even though aware of mental illness — won’t do anything about it. Sibling can’t be excluded because it would upset elderly parents. However, sibling drives my spouse and kids crazy. It takes a lot of restraint not to engage with sibling in an angry way. What should be a lovely family celebration will be strained at best.

Between a Rock and Hard Place

What a sad situation, I’m sorry.
It might just be one of those things you endure because the alternatives are worse. However, I do have one resource and one . . . not a suggestion, really, but a thought.
The resource is NAMI’s “Family to Family,” which aims to improve “the coping and problem-solving abilities of the people closest to an individual living with a mental health condition.” It’s also free. It’s a 12-week course so it’s not for this round of holidays, but it can get you ready for the next one.
The thought is for now, and it’s actually a twist on a strategy for dementia caregivers, “meeting people where they are,” meaning, you don’t point out that Uncle Billy isn’t actually here, or that it’s 2015, not 1965. You don’t correct, correct, correct. Instead you go along. “So what does Uncle Billy have to say?”
There’s a relaxed beauty to this that I believe applies, with a few tweaks and more (or less) respect for reality where warranted, in many other situations as well — like dealing with a crabby store clerk or an intrusive neighbor or a difficult relative with or without mental illness.
That’s because its essence is this: not winning. It’s about letting go of the expectation, or even hope, that you’re going to have the conversation you want, and giving yourself over to whatever conversation the other person is able to have.
It’s also about letting go of what you need from the exchange long enough to look for, perceive and satisfy, to the extent you can, what the other person needs, just because . . . or because it actually improves your chances of getting what you need. It’s about having a lowest-possible-friction exchange above all else, to help both of you feel more comfortable than you’ve managed to feel in the past. You can decide from there whether anything is possible beyond that, but you can also decide just to quit while you’re even marginally ahead.
So, what would it take to meet your sibling where s/he is? If your sib says black is white and up is down, can you roll with that for the duration of one dinner? If you can’t actually agree that black is white, can you at least choose not to correct your sibling, but instead riff on it — “So if black is white, then what does that mean for gray?”
Meanness is harder to roll with, but “I’m sorry you feel that way” can withstand heavy use.
Again, it’s a thought — the kind of thought that generally isn’t entertained unless all other avenues have been tried to no avail, but it sounds as if that’s where you happen to be.
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