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mr1991
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Default Aug 10, 2020 at 09:39 PM
  #1
Hey there,

First of all, I've posted this question in another forum already, sadly without any replies, just in case anyone is on various forums. I know this is probably a loaded question and I hope I have chosen the right forum for this - but how can one persuade someone he's suffering from a mental illness?

In particular, this is about my dad. He's 59 and the only interests he can pursue are his job (interrim manager) and his hobby (horses; natural horsemanship) - other than that, he is unable to have a proper conversation and is generally disinterested/apathetic towards a majority of issues and topics. As soon as an argument, a request, or a conversation touches on him and problems he's got (perceived on my/his family's part), he shuts down and reacts emotionally, prohibiting any further enquiry, regardless of how diplomatically it is phrased. In group settings, he starts playing cards on his phone at some point.

I must add that two years ago, he's suffered from a stroke. This, however, is only a partial explanation for his behaviour; the inability to argue as well as a certain degree of apathy have been present before. Though it now appears as if the negative qualities have been amplified and the things he's likely unconsciously been struggling with come to the forefront. It was a predominantly left-sided stroke causing aphasia and partial paralysis of his right side; subsequent testing later on deemed him to be capable of addressing issues through a psychologist (i.e. mostly a software issue, not hardware). Since he is more emotional, my personal theory is that since the brain's left hemisphere is associated with logic, the stroke has taken the logical override ability that he previously had, thus now fully being exposed to all emotions. I emphasise, though, that that's my personal theory. Effectively, and dangerously, he now doesn't check his blood sugar levels (early-stage diabetes) nor his blood pressure whilst eating sugar on a daily basis (and lying that he doesn't). He briefly simply stopped taking all meds (none psychoactive) at one point but fortunately quickly realised that it was a stupid idea without medical supervision and natural substitutes. By now, he's recovered to ~80-90% but doesn't address the remaining issues (lack of sensation in his leg, watching his diet and replacing pills under supervision through diet, etc.)

History-wise, it's not as if there is no source of trauma. His parents were terribly abusive (pretty much everything safe for sexual abuse; I could write a book about that no-one would probably believe), his father probably a diagnosable narcissist, his best friend tragically died young from cancer. Both his parents are fortunately dead now. His late friend would likely have been the only person to be able to have got to him, whom he'd have listened to. In general, there's a whole slew of stuff that went on, particularly in early childhood but also in his adult years that he most certainly didn't process. His sister went through years of therapy and imho still hasn't properly digested things.

Further complicating matters is in my estimation his attitude; mental illness is something others have but not him. As mentioned in the first paragraph, he does natural horsemanship (we all do), and gave courses in it. As a brief excursion, natural horsemanship is the attempt to emulate horse language/behaviour; it is by now also used in therapy settings for its didactic and emotional effects on people. Google "horse-assissted therapy" or "horse-facilitated therapy" if you're interested. Anyway, in doing that, he's seen many people break down in sessions, placing him in some sort of "therapist" role (big quotation marks, this is never what he wanted but what sometimes happened), likely cementing the self-perception and deception that he's "fine" and in control of himself. Post-stroke, he's since given up teaching, though. Another issue he's got, trying to put blame on others and not really pursuing things rigidly (he wanted to make it his main business but didn't tackle it with his whole heart - he put the blame on me because I didn't create a business website when I was 15 - ignoring that I created a facebook page that got him customers but which he neglected, not pushing advertising/tending to social media to establish himself).

This self-perception was confirmed when we got him to talk to a therapist recently - more through my mum's threat that she'd leave him than anything else. The first session was him alone, though he phrased it like "my family thinks there's something wrong with me; I do have some problems in dealing with them so they are probably right." The therapist couldn't quite do anything with that, so the second session involved me and my mother; it appeared as though he tried to present himself in the best light possible, wasn't open and generally tried to maintain the image that "he was fine". Moreover, he treated the therapist like a service provider, not as an equal to explore and solve personal problems. It's not like it's money-related either; psychotherapy is covered by insurance. Through this presentation, the therapist said that it's like someone coming to a garage with a car for repairs and saying the car was fine - not quite anything he can do there. Or a polite way of saying why the bloody hell are you here to begin with if you don't want help?

Well, that's it in a "nutshell", if this length can be considered such. It's sort of a stalemate situation - he's becoming particularly angry and defensive if I say something to him; he's at various points said he sees his father in me or that I behave like him so anything I could say is null and void. He's sort of cowing to my mum because he's afraid of losing her; my sister has her own mental issues right now and he sees her as the "little girl"; if she says something, it's at my/our behest and not her own opinion. Perhaps I should elaborate on the living situation; my parents have a house and I live in a flat inside of it (separate access, fully appointed) with my girlfriend (fairly common in my country). My sister recently moved back in. We're both in our twenties. I've personally run out of ideas of how to crack him to finally see and address his problems. I know it isn't quite my place, but watching someone basically commit slow suicide (ignoring health problems associated with his stroke) isn't pleasant, either. He lets the house deteriorate, doesn't clean up after himself (didn't before, but it's extreme now), and doing most things is "too much" for him. He let's things slide, also important things he should address asap (e.g. tax or rather getting a tax consultant). He's got an extensive comfort zone he doesn't want to leave, and often sees things as "us vs him". The only thing I've come up with is sending his sister to talk to him, though she's failed in the past to get him into therapy (they also have a troubled relationship). He doesn't really have any close friends, either.

Therefore, any input on how to approach this would be quite welcome. Thank you very much in advance for your replies :-)
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Default Aug 11, 2020 at 10:37 AM
  #2
Hi mr1991. Welcome to Psych Central. I am sorry you face so many challenges with your dad.

I am also a partner to someone with mental health challenges that resists treatment, so I can empathize with your pain and frustration. What I say is based on my experience in the US. Check with people in your city and or country as to applicable laws and guidelines.

There is no magic tip for how to get someone who is resisting treatment to get it, even if it is obvious they are suffering from it. This being said, there are some indirect routes which may be a help. You hinted at one: use leverage to get the person to weigh the alternatives and possibly decide the lesser of two evils is better. In this case getting treatment rather than losing his wife or fouling relationships with children. This has to be done showing them the benefits of a course of treatment in maintaining their world.

If the house is not safe, local officials may come in and give them ultimatum to clean it up. Reporting them to authorities may have negative consequences.

Another way in US a person can be compelled to get treatment is if they are a threat to themselves or other by their action or inaction. This can be difficult to prove unless the person has reached a serious mental health crisis where they are no longer living in the reality that most people live in.

these may be of interest
How to Deal with Difficult Family Members

How to Deal with Difficult or Toxic People

How to Help Someone with Mental Illness Who Does Not Want Help

Feel free to message me or reply to this thread
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Default Aug 11, 2020 at 10:44 AM
  #3
It can be really hard to encourage someone to seek help when they're not intrinsically motivated to do so. If he doesn't see a benefit in it, he's not likely to pursue it. He may have his own biases about it or anxieties which also keep him from wanting to do it. The idea of the ultimatum that was given to him may have been the only thing that would get him in the door right now.

I would say there are a couple of good books that you can read - "When Someone You Love Has a Mental Illness" and "I'm Not Sick and I Don't Need Help." Both of these are available on Amazon.

I'd also suggest going to NAMI (National Alliance on Mental Illness) meetings. It's like the Al-Anon of mental health, for family and friends of those with mental illness. Often times you can learn a lot from other families who have dealt with similar challenges and frustrations.

Bottom line, you have to decide what limits you're going to set for yourself and what you want. It's very likely that he will not change and will refuse to get help as he doesn't see a benefit to it. You can try to educate him and challenge his resistance, but sometimes people have to come to that choice on their own. Therapy only works if you're engaged.

Sorry to hear it's been such a long struggle. Best of luck.
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Default Aug 11, 2020 at 12:30 PM
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Sounds like he needs a housekeeper / cook. You are living there - is there any way you can help him with some of the functions of daily living. He had a stroke and is getting older - he is declining, not getting younger, not adding more things to his agenda. He has provided you with a place to live - it should be in exchange for your assistance to him in his time of need. I understand the culture.
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Default Aug 14, 2020 at 04:15 AM
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My son was 23 years old and had a stroke. The scariest thing in my life. His was related to a heart defect. He is 98% recovered. When he gets wound up and flustered there is the occasional stutter. His short term memory is a little affected. How long ago was his stroke? IMO he needs more OT/PT/speech therapy before he begins regular therapy.

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Default Aug 16, 2020 at 06:43 PM
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Thanks for your replies; it took a while till this was permitted by the admins (first post) and I didn't know that there wouldn't be an email notification. My bad, should've checked more frequently. So, sorry I only got round to replying almost a week later.

I guess you confirmed what I kinda feared and perhaps knew. Should perhaps have clarified, the house is cleaned up (now), he's just not pulling his weight in maintaining the household. There's stuff that's accumulated over the years (his stroke was 2 years ago and his negative sides have been amplified); now he's completely negligent when it comes to cleaning up or in some ways even dressing properly. As well as refusal to undertake things that would penetrate his comfort zone - there are alternative means of addressing underlying health issues, e.g. through herbs from TCM I got from my girlfriend's dad who's from Asia which he refused to take because "they didn't taste good and he can't have sugar with it." So, effectively, it's upon the rest of us to tidy up. His work he can do alright, his speech is fine as long as he concentrates (interrim manager, currently lots of phone conferences, his speech is alright) - just a lack of movement.

The threat to themselves or others is a legal means that exists where I live as well, but he's far from that. Legally speaking at least; he doesn't threaten anyone nor does he become outright violent, he's thankfully got that self-control, Technically speaking, it's a slow suicide through eating the wrong stuff, not getting exercise and shutting out uncomfortable social matters as well as his past. Any argument ends in him sulking like a child, becoming an outright drama queen and leaving the room.

@unaluna As to lightening the load/helping day-to-day, I don't think it's a good idea - from care of children to the elderly, I've heard it said time and again "let them do what they can do, even if it takes ages." So, any physical exercise he's required to do I won't take from him, be it walking the dogs or tending to the horses. Did that from the start at the hospital, requiring him to talk form day 1 and not making anything easier for him. I think that's the problem I in particular have - our intervention got him this far, there must be something that's missed. I perceive this encouragement as an exchange for all he's done for him, which is a lot. Hence my refusal to give up. I feel like if I took over more things, he'd give in to sloth, as well as it souring relations even further with my mum who'd probably give him the boot at some point.

@sarahsweets I'm so sorry to hear about your son. His stroke was in 2018; problematically, given his, well, inactivity, getting him to do any therapy is near impossible. He had speech therapy as part of rehab and some time following it (also basically ever since day 1 in hospital through us); the speech therapist said he was fine and if you don't know him (or know certain signs) you wouldn't hear it. So, given this "sloth" I think psychotherapy would be preferable right now. Is there a particular reason you suggested this order?

@CANDC&quietlylost thanks for the links and book tips. I'll need to check whether services of the kind, i.e. are available in my country; I'd contemplated researching them out but figured most things are restricted our cancelled given the current virus situation. One of the reasons why I'm on this forum instead. The boundary advice is pretty good; I am I guess fortunate that I've got extended experience with my girlfriend who's got her own mental issues., so boundaries have been firmly drawn. Interestingly, she's had a breakthrough in realisation through an offhand comment I made and had made multiple times before. Probably an example of "right time, right place"; it's led her to move forward with her problems. So, in staying with leverage as pointed out by CANDC, I guess his sister might be the right one. Maybe such a "lucky punch" can be landed as well, even if unlikely. It's weird what leads people to realisations sometimes - which is why I feel there's something missing. Else, it's probably just being there and offering help if it's wanted.

Anyway, thanks again for all responses and advice :-)
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Default Aug 19, 2020 at 12:32 PM
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@mr1991 glad to help. Hope things work out for you and your family.

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Default Sep 04, 2020 at 07:00 AM
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Hi.
I feel for you. I am in a similar scenario, too. Get anybody involved that you can. Leverage the "maybe the family will stop complaining if you take some meds.". Depending on your country, a therapist maybe out of his league to help. It needs to be someone who understands the medical side (mental plus physical) that you are dealing with. Best wishes.
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Default Sep 15, 2020 at 08:44 PM
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