Healthy Personal Boundaries

A carer who continues to learn the hard way!
One of the more difficult areas for carers of people with mental illness may be that of setting and maintaining limits and of clearly defining personal boundaries.

In many instances, mental illness manifests itself in adolescence, when these are issues that parents must struggle through anyway, with the progress towards autonomous adulthood being quite erratic at times, when teenagers quite naturally test the limits imposed upon them as children.

A major problem with adolescent onset of mental illness can be that the journey towards autonomy has been interrupted and the adolescent does not necessarily have the skills to move forward into maturity without professional help. The young relative may be genuinely extremely vulnerable and seemingly helpless, and the parent/s will instinctively move to protect and nurture, as they would a young child. However, the ill person is not a young child, and parents can be easy targets for unreasonable behaviour and unreasonable expectations of rescue and support. Unfortunately this situation can continue indefinitely if the illness becomes entrenched, and the time must come to stand back and take stock. It is all too easy to have to learn the hard way, after our savings are depleted, our own important relationships have become irrevocably damaged and our self-esteem, sense of wellbeing and quality of life have diminished to unacceptable levels.

Becoming a prudent observer may pay important dividends. How did your relative cope with the last crisis compared with the one before? Are there signs that some learning has taken place? In the case of bipolar disorder, are episodes of excessive spending and reckless sexual behaviour becoming more moderate? Is abuse of substances beginning to diminish? How did the person cope with debts incurred? If you had to set a limit on financial help, what did s/he do to deal with the situation? If the relative made demands for emotional support and you were unable to meet them, what was the outcome last time compared with the time before? Is your relative becoming more aware of early warning signs of relapse and going off treatment and medication less often?

Try some discreet checking with others to get a more rounded view of your relative's daily life if they do not live with you; they may be leading a much more satisfactory life than you fear or are led to believe. Many carers will have become caught up in emotionally exhausting scenarios which can leave them feeling mentally battered, confused and possibly very angry, and a pattern of rescuing, responding to guilt and emotional blackmail, and being taken on yet another emotional roller coaster ride can become the distressing and unsatisfactory norm.

Becoming more aware of as many aspects of the situation as possible is vital. Watch your own patterns of response. Do you find you are succumbing to stress related health problems when the pressure is too sustained? Are you convinced that expending all your own resources will improve the situation of your mentally ill relative? You are entitled to have quality of life, good health and personal security, and one way to achieve and sustain this is to set and maintain limits and healthy personal boundaries.

Sometimes it is necessary to stand firmly against your relative, even when their situation may seem at the extreme to you. Make it clear that whilst you sympathise, you are not in a position to help out this time. Do not feel you need a watertight justification for giving little or no discernible support on this occasion. If you do too much for too long, your own vulnerability to stress related disorder can become a significant factor. Show him/her you have faith that solutions can be found, that support is available and gently put the responsibility back where it really belongs if at all possible, and stay firm in your resolve. It can be very hard to watch someone you love enter repeatedly into very basic struggles for survival, but it has to happen, at least to some extent, if growth, dignity and optimum independence are to occur, as they must.

It goes without saying that if we set clear boundaries then this is a reciprocal dynamic, and that as far as possible we need to respect the boundaries of our relative.

Let your relative know from time to time that you are human and vulnerable too. Be aware that if you set a firm limit, there may be a dramatic, wounding and sustained backlash, and that you will have to ride this out. The backlash may well be a sign that your sensitivities are not respected, thus reinforcing the need for the limit.

If you take a long view, you may observe the relative has solved many of the problems they have tried to place, either consciously or unconsciously on your shoulders, and have made real progress of which they and you can be proud.

If you are entering into a conscious phase of limit setting and this has not been your pattern, you may need counselling support for a time, since deliberately distancing yourself from someone with whom you have been more intimate can be quite stressful; new strategies can be difficult to learn and need practice. This is where trusted and understanding friends are often invaluable, particularly those who do not negatively judge your relative. Distracting, absorbing activities also help at such times. It is possible to make an error of judgement if we are used to automatically supporting, but this can happen in any area of life, and with time you will become better at fine tuning and flexibly maintaining limits.

Remember you are not the only human being in the world who can relate to and support your relative. Let other people become involved; your family reputation may take a battering for a time, many relationships will flounder but probably not all, and learning can take place along the way. Your relative may well have much to offer in other relationships; mental illness can be a powerful teacher. If you can learn to like and care for yourself and have clear discernible boundaries, you will be less vulnerable to being manipulated, put down and used, and this is healthy for your relative as well as for you.

Good luck and good health!
Author Unknown

Reprinted with permission ARAFEMI News Volume 8 Issue 4 December 2001.