Family Emotional Process
and the Big Picture  by

Andrea M. Schara, LCSWA

 

Reprinted from Family Systems Forum, a publication of the
Center for the Study of Natural Systems and the Family, Volume 9, Number 3,
Fall 2007

It is one thing to consider a broad picture of
mental health.  It is an entirely different matter when a close family
member is diagnosed with a mental illness.  When the latter happens, the
pressure is on for action: What am I going to do now?   What can you
do if you cannot see both the forest and the tree?  Seeing the
forest but not knowing the tree is a broad view but partially blind. 
Seeing the tree without knowing the forest lacks perspective.  One without
the other does not make for a systems view.  This paper will present both
a broad and a personal look at a bipolar diagnosis in one family. 

Mental Illness Oversimplified

Mental illness can be over-simplified as the
inability of one person to “fit in” with a family or a society’s expectation of
normal behavior.  Animals, including pets, can behave in strange
ways.  “Diagnosing” pets or people is said to lead to proper
treatment.  After all, we need to know what to do about the “condition.”
 Here we see the pressure exerted by the forest for trees to grow
properly.  A tree must bend to the conventional wisdom. But what if
diagnosing people adds to the problem?  Diagnosing in itself suggests that
one is the sick tree, and the other not-so-sick trees need to help the sick
one.  The family is split, as is society.  Mental illness is not a
small problem when 27% of the population is said to have a mental illness or an
addiction problem. More than two million Americans have been diagnosed with
bipolar disorder.  (U.S. Surgeon General) Despite research and costly drug
treatments, many questions remain as to the long-term efficacy of all
treatments.  While diagnosis of bipolar illness has increased
tremendously, especially in children, the prognosis remains very guarded. (Archives
of General Psychiatry)  If we consider what benefit this kind of
illness might bestow on families or society, we are taking a different position
and opening different possibilities.  Bipolar people often have a very
creative streak and are contributors to society.  In a family, with rules
and regulations for proper and acceptable behavior, there may not be enough
room for a person to be creative without being somehow too different. A person
who is different can draw negative attention.  The research of John
Gottman and others shows that too much negativity destroys relationships. 
 

That one person in a family or a social group often draws more
negative attention is just the way nature organized us.  We have testimony
from Jack Calhoun’s mice that scapegoating comes naturally.  One or two
absorb the problem-focus, while the others are freer to go about their more
ordinary lives.

 

One person’s absorbing more of the problems
may benefit the larger group. Researchers like Dalton Conley elaborate on the
dynamics of differentials in family functioning. Families appear to have an
automatic away of “knowing” how much to invest in which of their children.
Wealthier families seem able to mitigate some the effect of this general
tendency to treat children differently.  

Looking at the big picture, we can see that many forces operate
out of awareness to put more negative pressure on some children.  The
child can, of course, adapt to the pressure.  Some do so in most
interesting ways. Let’s take hallucinations, as these are often the challenge
that leads people to put their loved ones into hospitals, often as part of a
manic episode.

 

Hallucinations

Research suggests that at some distant time
hallucinations were useful for society.  Researchers, including Julian
Jaynes and Al Sheflen, have discovered both brain functions and historical
reasons for their presence.  Jaynes notes the presence in very early
written materials of the word “we” and the length of time it took for the word
“I” to develop. In prehistoric tribal society, there was no “I” statement.
There is no record of the use of the word “I” until Homer’s Odyssey (c. 800-600
BC).  One possible explanation, Jaynes hypothesizes, is that disruption in
the chain of command was a threat to society.  In those early eons, humans
may have been more socially organized, like ants.  Jaynes postulates that
early societies were very oriented to command and control.  This operating
posture left traces in the brain.  When deaths or loss occurred, when
times were tight, as happens during war, families and societies were required
to operate more as a “we.”

When geographical disruptions, deaths or
separations occurred, hallucinations became more evident in the population.
They provided a way to imagine staying connected to the needed voice of
authority.  People could “imagine” what needed to be done. 

The well being of society was facilitated by
the ability to “imagine” how the “other” would direct one when the “other” was
gone.  We currently see that the occurrence of schizophrenia increases
when children leave home and try to function independently.  

Jaynes offers evidence that more democratic societies and
families are far more capable of promoting the emergence of the
“I.”   Families with more anxiety and uncertainty would have more
difficulty allowing for the development of a more separate individual. 
One might be able to imagine how, in our own time, the disturbance generated by
the death of a family leader could set off a very old pattern in a social group
and in the brain. This is not to rule out
other social and viral disruptions that may be part of a cascade leading to
“mental illness” in one person in a family. My focus is that disturbance in
relationships can also lead to regression. One could say that the brain and
behavior of persons are disrupted, and they “act” as people did in earlier
times.  Hallucinations may be one way to adapt to the loss of meaningful
relationships. 

 

After-Care Plan

Finally, we were able to develop a plan to get
Drew out of the state hospital.  Margie wrote a letter, which I helped her
compose, to the hospital director, detailing Drew’s lack of progress and our
concern about his regression, drug treatment and fear of dying as his father
had. We also drew up a plan for a two-week after-care program at my cousin
Liz’s home. 

We hired people to be with Drew, as he could
fall and hurt himself. He was to see a local MD to rule out Parkinson’s disease
and see a local therapist, untrained in Bowen theory but a friend of my
cousins. He was also to have polarity therapy (a combination of massage and
acupuncture using the energy centers of the body), breathing and yoga classes.

After his reaction to the anti-psychotic drugs
and his fear at being in the hospital, Drew’s shaking made it difficult for him
to sit and relax.  For the first two days, he was a shadow of his former
self. Unable to hold his head up and make eye contact, he just
shook.  Over two weeks, he radically altered his functioning for the
better. 

My goals were to: 1) Diminish my own fear and figure out how to
relate to him to make him smile. 2) Keep the group surrounding Drew focused on not knowing and
observing. 3)
Observe: I bought a journal to write down observations of all our
interactions with Drew. I asked each person to write down what seemed to work,
as none of us knew which of the things we were going to try might make a
difference.  4) Goals for
communicating: I used the idea of three A’s to monitor how he was doing in
regard to his affect, loose associations and his ambivalence.  

The first day I put him on WWW.ZENGAR.COM  neurofeedback
equipment, he had a moment when he stopped shaking for the first time in four
months. I immediately went out and bought a video camera to tape this process
and learn more of what was happening.  In the first five days after his release from the hospital, Drew
did seven neurofeedback sessions, building on sessions he had had once a month
from May to August. 

Initially, he could manage only ten minutes on
the equipment.  We also kept asking Drew if he could stop the shaking. 
This gave him the idea that he had the ability to focus and take charge of his
life little by little.  I used humor and paradox to bring up such fearful
issues as dying in the state hospital.  Then we would relax with
neurofeedback. 

Finally, Drew realized he could gain control
over his fear and shaking.  Drew was surrounded by  his family and friends on a beautiful
farm, and we also set limits with him.  He had to take a shower every
day.  We encouraged him to walk, draw, rest and take vitamins with a
protein shake. His wife also did neurofeedback each day and was able to alter
her way of telling Drew what to do. Liz had set up appointments to offer
Drew other kinds of help. One of her friends
did a forty-minute session of polarity therapy with him.  During the
time on the table, he did not shake. Another woman came with a guitar, and they
sang. All in all, we had fun and it paid off.

Changes in Extended Family: Many people in my father’s family were able to
visit and support Drew.  This was a major change in family patterns. 
Five family members offered money to help support Drew until he got on
disability. People who had been afraid of persons in a manic episode began to
have confidence and make better contact with Drew. I think that my work over years to be a calmer
individual and in better contact with people in my family helped to create an
environment in which change could occur.  Changes happened both in the
family and in Drew, for which I am grateful and amazed. 

What
made the difference? 

1.   
Being with his family, undoubtedly the biggest factor.

2.   
Reorganizing his brain using neurofeedback  training.

3.   
Setting limits and working with him to restore his cognitive and
affective functioning. 

Summary

We have been deep into
the forest to see how one tree makes it through a lightning storm.  Every
forest is slightly different – the songs that are sung, the food, the dance,
the fights, the silliness.  

There are many variations
of the struggle to relate to others as well as possible.  Coming into
“good enough emotional contact” is an adventure. 

 

There is no answer in
command and control.  There is some answer in telling your story about
life as you see it. People will make what they will of the neurofeedback and the
family, but few can argue how amazing it is when the impossible becomes
possible.This story is one of hope and possibility which lives in any social
group. It is in relationships that the possibility for transformation exists.

 

References

Archives of General Psychiatry,  February
2006.

Bowen, Murray.  Family Therapy in
Clinical Practice (Northvale, NJ: Aronson, 1985).

Calhoun, John.  “Population Density and
Social Pathology.”  Scientific American, 1962.

Conley, Dalton.  The Pecking Order:
Which Siblings Succeed and Why.  New York: Knopf, 2005.

Gottman, John.  gottman.com/research/.

Jaynes, Julian.  The Origins of
Consciousness in the Bicameral Mind.  New York: Houghton Mifflin,
2000.

Sheflin, Al.  Levels of
Schizophrenia.  1981.

U.S. Surgeon General.
surgeongeneral.gov/library/mentalhealth/chapter2/sec7.html