Mental Illness: A Family Affair

Posted on May 2, 2013

Dr. Robert Hilt, Victoria Costello, Dr. David Reiss, Program Chair Andrea Roy, and Emcee Consuelo Mack Dr. Robert Hilt, Victoria Costello, Dr. David Reiss, Program Chair Andrea Roy, and Emcee Consuelo MackOn Monday, April 29, 2013, Fountain House hosted its 10th Annual Symposium and Luncheon at The Pierre in New York City. This year’s theme was Mental Illness and the Family: Relationships, Resilience, and Recovery. Once again the inestimable Consuelo Mack, Executive Producer, Managing Editor and Anchor of Consuelo Mack WealthTrack, served as Master of Ceremonies. She led a learned panel through a discussion of mental illness and its relationship to familial attachments.

This year’s panel, all of whom toured Fountain House before the Symposium and Luncheon, consisted of

  • Dr. Robert J. Hilt, Associate Professor of Psychiatry at the University of Washington and Director of Community Relations, Department of Psychiatry at Seattle Children’s Hospital;
  • Dr. David Reiss, Clinical Professor in the Child Study Center at the Yale School of Medicine; and
  • Victoria Costello, Emmy award-winning science journalist and author of A Lethal Inheritance: A Mother Uncovers the Science Behind Three Generations of Mental Illness.
Let’s start with an incident from Costello’s book, from a chapter titled, "Alex by the Dumpster, March 12, 1998" (“Alex” is the pseudonym Costello uses for her son):
“The psychiatrist on duty at the UCLA hospital adolescent ward, Dr. C. looked up from her desk where she’d been scrutinizing Alex’s admission paperwork.
‘How would you describe your son’s recent behavior?’
“I flashed on the afternoon when I found him hiding by the dumpster behind Fairfax High School. I can’t tell her that. I quickly decided, searching for some less awful way to describe Alex’s troubles.” (p. 1)
Depending on your family of origin, this may be an all too familiar scenario. We who live with a mental illness are so used to telling our stories that we sometimes forget that our parents, siblings, or other relatives live part of their lives through our challenges. Sometimes it’s hard for them to tell outsiders, a shame and self-stigma Costello calls, “the destructive power of family secrets.” But family and family support is so important, especially for those of us living with mental illness. As Fountain House President, Kenn Dudek, commented, “Members who have families are extremely lucky. Members who don’t have family have Fountain House.” 
Ms. Mack opened the Symposium by asking for a show of hands to the question, “How many have family members with mental illness?” There was a wide showing of hands. Ms. Mack then stated, “Or should I say, how many don’t have a family member with mental illness?” to which there was only a spattering of hands. She continued, “Family is where it all begins for us.”

Each panel member had his or her own specialty. Dr. Reiss explained why the family history is so important. He pointed out that while children can inherent their parents’ illnesses, adopted children will suffer from depression only if the mother suffers from it. (This brought up a quick murmuring about men/fathers and their influence, but the panel discussed parental relationships later). Dr. Reiss stated that we need to explore the role environment plays in mental illness. 

Dr. Hilt discussed psychotropic medications and their use by young people for such disorders as ADHD, psychotic experiences, autism, and bipolar, among others. He explained how there has been a three-fold rise in medication use in young people. While this increase has raised concerns among the public, the greater public health issue is really a pervasive lack of treatment and a lack of early intervention.

Ms. Costello reported that her son, “Alex” is now 32, fully functioning, working, and has a social life.” She discussed self-stigma and self-medication, and how crucial early intervention is for those with mental illness. She discussed three generations of mental illness in her family which included a sister addicted to drugs, a father who was “sad” all the time, and a grandfather who may have committed suicide on railroad tracks. She went on to explain how we who are parents must treat ourselves first; get interventions for our loved ones as needed secondly; and last but not least, we must recognize that “nurture trumps nature.”

In the round table discussion, nature versus nurture was the final topic.   Dr. Hilt discussed “good enough parenting” and how parents must learn to “be calm … be consistent … and to be caring.” Dr. Reiss stated that, “parents who relate well to each other don’t worry about being bad parents … while single parents need the community.” Ms. Costello pointed out “parents/families are first responders.” In summation, Dr. Hilt called for “maintaining hope” and Ms. Costello reminds us “treatment works, recovery is possible.”

Honoree Andrew Solomon and FH President Kenn Dudek Honoree Andrew Solomon and FH President Kenn DudekAfter lunch we viewed a film featuring a Fountain House member who continued the theme of the day by stating, “I’m glad I have a home.” And then Mr. Dudek presented the Fountain House 2013 Humanitarian Award to author, lecturer, and philanthropist, Andrew Solomon. Mr. Solomon is a force to be reckoned with in the fields of mental health, education, and the arts. He has authored award-winning books The Irony Tower: Soviet Artists in a Time of Glasnost, The Noonday Demon: An Atlas of Depression, and Far From the Tree: Parents, Children, and the Search for Identity, which won the 2012 National Book Critics Circle Award for non-fiction. Here’s an especially thought-provoking excerpt from that book: 

“There is no such thing as reproduction. When two people decide to have a baby, they engage in an act of production, and the widespread use of the word reproduction for this activity, with its implication that two people are but braiding themselves together, is at best a euphemism to comfort prospective parents before they get in over their heads. … it is often ourselves that we would like to see live forever, not someone with a personality of his own. … Children whose defining quality annihilates that fantasy of immortality are a particular insult; we must love them for themselves, and not for the best of ourselves in them, and that is a great deal harder to do. Loving our own children is an exercise for the imagination.” (p. 1)

Parents want more for their children than they had – higher degrees, better jobs, more money, and bigger houses – as if materials things are what make us strong. In their unconsciously selfish way, many parents live through their children; they are but reflections of mother and father. But what do parents do when that reflection becomes a funhouse mirror full of the kind of distortions mental illness can reflect? What do educated parents do when their son or daughter has his or her first psychotic break freshmen year of college, making it impossible to continue with studies? How does the CEO tell his friends that his son has a temporary job as an outdoor messenger, and he’s having problems getting to work because his medications make it difficult for him to wake up in the morning?

Is the mental illness a disease that will be passed on to grandchildren (Dr. Reiss believes it is likely); will there even be any grandchildren (Dr. Reiss discussed this briefly)? And what if that big house is a three-sided crate under the Brooklyn Bridge or a shared room in a supported apartment? How do parents explain to their friends that they attended this year’s Symposium to get some new insights into how to manage their relationship with their son or daughter, or do they just pass it off as attendance at a charity they support?

Some of these questions are answerable. Others don’t have tailored responses. But I agree with the panelists and Solomon when they stated that there is nothing like familial support, whether that support comes from family-of-origin, extended family, blended family, or created family.

I wrote a poem that ends with these words:

Families: as in who begat whom, and who begat whom, and who begat whom begat the rebuilding of deconstructed lives marred by unhealthy psychological and physiological phenomenon that steal away our hearts, our minds, our souls. But we are still family.

Davida Adedjouma, LMSW
Education Unit and Board of Directors, Fountain House


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