Family Culture and Mental Illness

On any given week (Yes, I am proud to be so dedicated to my healing that I see a therapist weekly =), my therapist or I mention my family culture and how it contributed/contributes to my MI. We discuss how engrained, maladaptive patterns  continue unchecked amongst the family unit (this includes me, by the way) and how these patterns helped/help create/continue the issues I am still working to unlearn in my own life.

Now, before anyone accuses me of throwing my family under the bus (again, as a side note, 9 times out of 10, when I refer to “my family”, I am referring to a family unit that includes extended family…aunts, uncles, cousins…because when I was young, I had weekly, if not daily interactions with my extended family), I feel I need to go into a little deeper explanation about the Biosocial Theory of BPD, which is the accepted seed of cause of BPD among BPD specialists.

According to Marsha M. Linehan, Professor of Psychology at the University of Washington and Director of Behavioral Research & Therapy Clinics (BRTC) at the University of Washington and founder of Behavioral Tech, LLC, “the main tenet of the biosocial theory is that the core disorder in BPD is emotion dysregulation. Emotional dysregulation is viewed as a joint outcome of biological disposition (nature), environmental context (nurture), and the transaction between the two during development” (Linehan 2). In my words, Linehan’s use of “biological disposition” means a baby was born emotionally sensitive, vulnerable to emotional stimuli even before social factors could influence the baby’s cognitive reactions to emotional stimuli…the “nature” in the long fight over “nature versus nurture”. Now comes the tricky part about throwing families under the bus…

Linehan’s use of “environmental context” can also be referred to as “environmental factors”, or the influence of social interactions and dynamics among a baby’s/child’s social unit, which is typically a family unit. It is at this point in researching BPD that we encounter the dreaded, yet so true terminology, “invalidating environment”. This is where I must tread carefully! =)

In Skills Training Manual for Treating Borderline Personality Disorder, Linehan explains that an invalidating environment “…is particularily damaging for the child who begins life with high emotional vulnerability” (3). See where the nature and nurture begins to interact? Ok, on we go…

Another personal favorite resource that I talk about in my blog posts is Schema Therapy, developed by Dr. Jeffrey E. Young of the Cognitive Therapy Center of New York. In Schema Therapy: A Practitioner’s Guide, Young, et. al use the term “environmental factors” the way Linehan uses “invalidating environment”, breaking such factors into four groups:

1. The family environment is unsafe and unstable.

2. The family environment is depriving.

3. The family environment is harshly punitive and rejecting.

4. The family environment is subjugating.

I would love to share the descriptions of each of the above headings, but the information is too great, and I’d rather you not fall asleep trying to read my post. However, I do want to point out that when reading the heading, understand them in broad, not always literal terms. For example, heading #1 talks about an unsafe and unstable environment. For some people with BPD, this description is very black and white; they grew up experiencing physical, sexual, or verbal abuse, which speaks very plainly to an unsafe and unstable environment. However, in the broader approach, some people with BPD experienced the state of being unsafe and unstable through a parent/caretaker who was emotionally unreliable or inconsistent. As Young, et. al describes it, “Instead of feeling secure, the attachment to the parent (or caretaker) often feels unstable or terrifying.” Again…understand where the nature and nurture to interact to make an existing situation more difficult?

“So Redhead, what is the point to all of this? Do you hate your family and blame them for your MI? Are you playing the victim “card”?!”

Heck no…and yes. =) Leniency from the court, please?

For many years, I was the victim of an invalidating family (remember…extended family is included. See my post Trying To Be What They Weren’t For Me to understand what extended meant to my MI life =) because at such a young age, how could I have been anything but a victim? Then, as I grew older and more cognizant of my issues, I chose to be the victim, blaming those who hurt me for “making” me MI. However, when I found the right doctor who provided the right therapy, I realized that while I started off with no choice as to the illness I developed, I did have the power to take control over my life and do the hard work of healing. And that healing includes understanding that as much as people invalidated and hurt me, I suffer from the same engrained, maladaptive patterns that flourished/flourish in my family unit. I realized I was a part of the problem, too.

See what I did there? You liked that, huh? I made it about me and my flaws because that is what my healing has to be about. I can acknowledge what has happened to me, but once I became aware of my ability to take charge and take the steps necessary for healing, I was accountable from that point forward.

So, did I connect my dots? I sure hope so. I write to help process and understand my life while trying to help others know that their struggles do not separate them, but make them a part of a large community of people who seek to rise above and heal. It is not easy…it will never completely go away…but a rich and meaningful life can be ours.

Linehan, Marsha M. Sills Training Manual for Training Borderline Personality Disorder. New York: The Guilford Press, 1993. Print.

Young, Jeffrey E, et al. Schema Therapy: A Practitioner’s Guide. New York: The Guilford Press, 2003. Print.

AFSP

The American Foundation for Suicide Prevention (AFSP) is the nation’s leading organization bringing together people across communities and backgrounds to understand and prevent suicide, and to help heal the pain it causes. Individuals, families, and communities who have been personally touched by suicide are the moving force behind everything we do.

  • We strive for a world that is free of suicide.
  • We support research, because understanding the causes of suicide is vital to saving lives.
  • We educate others in order to foster understanding and inspire action.
  • We offer a caring community to those who have lost someone they love to suicide, or who are struggling with thoughts of suicide themselves.
  • We advocate to ensure that federal, state, and local governments do all they can to prevent suicide, and to support and care for those at risk.

Suicide Prevention

You may be overwhelmed by grief, but you don’t have to suffer alone. It’s important to know when to ask for help. You should call 1-800-273-TALK (8255) if you have any warning signs, especially if a problem is making it hard for you to get through the day.

Find a Therapist or Support Group

Speaking to a therapist or attending a support group can help you work through your grief and improve your overall mental health. The following resources can help you find a psychologist, psychiatrist or support group near you.

Grief Support Quick Reference

This tool was developed by the Lifeline Consumer-Survivor Subcommittee and is designed to provide crisis workers with essential and easy-to-access information about suicide grief support.

How to Talk to Children About Suicide

Suicide Awareness Voices of Education has advice on how to explain suicide to children who have lost a loved one.

Respond After a Suicide in the Workplace

This guide is designed to help employers and organizations increase their understanding and confidence in responding to suicide in the workplace. It explores what is involved in supporting employees bereaved through suicide and other practical information about responding effectively to suicide in the workplace.

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