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Madness and the Family: What Helps, and What Makes Things Worse?

Families are often very important for people encountering severe mental and emotional difficulties.  but how can family members really know what is helpful, and what is likely to make things worse for the person having problems?  Similarly, for those who want to help families, how can they know what will really be helpful for those families, and what will make things worse?

H. L. Menken wrote that “There is always an easy solution to every human problem–neat, plausible, and wrong.”  In the case of madness and families, there are a number of such easy solutions, all, unfortunately, also quite wrong.

But that doesn’t mean there can’t be real solutions.  It just means that we might have to reject the simple, formulaic solutions in order to search together for the humanistic, complex, and individually tailored solutions that might really fit particular people and families.

Paris Williams recently wrote a 3 part series on Madness and the Family, see Part 1, Part 2, and Part 3.  If you found those interesting, you might also appreciate hearing a 45 minute talk he gave on the same subject, which you can view by going to

One of the trickiest issues in just thinking about families and madness is the whole question of whether or how much to “blame” families for the madness that seems to be located in a particular family member.  Biopsychiatry and NAMI of course would say families have no responsibility, other than most likely to have passed on what are presumed to be bad genes, while at the opposite extreme, there have been those who thought the existence of madness was proof the family had essentially created the madness.

But when we step outside the world of biopsychiatric or other sorts of dogmas, it appears that issues are much more complex, even perhaps “diabolically” tricky.

As individuals, we try to make our lives better.  But sometimes our efforts to make our lives better makes other parts of our life get worse, or even way worse.  And if we don’t recognize what is happening, our whole life can spiral out of control, can spiral into “madness.”  Similarly, even well intended families can do things they hope or believe will make things better, but these things may really cause problems for family members or make existing problems worse, in ways that may not be recognized.  And then of course the mental health system and other outsiders can also come in and try to make things better, but really make things worse, in ways that may not be recognized.

So, at all levels, even well-intentioned efforts can become part of a “storm” of madness, and while this storm often appears centered as a “disorder” in one person, really the confusion of many can be playing a part in the chaos.

Of course, when not everyone has great intentions, and when abuse is or has been present, things can get even more complex.  So abuse etc. is important to discuss when it has been present, but it’s also important to not presume anyone has been abusive.  Each story of madness is unique, and better approaches are interested in that uniqueness.

One way of understanding it is that people go mad when they encounter key life issues, binds or double binds, that they can’t resolve within the understanding of themselves and their world that they have put together up until that point.  Madness in a family member in turn creates huge and confusing dilemmas or binds for the rest of the family, and this makes it difficult to respond in ways that don’t inadvertently feed the madness.  But when all of this can be talked about, pathways to healing and recovery for all sometimes open up, even if not easily.

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