When my sister was hospitalized for psychosis for the fourth time, she reached out to me for help and asked me to be her care advocate. At the time, my parents were her conservators. During that period, I witnessed my father attempting to influence her providers and push medication decisions. My sister explicitly asked for my support and described my father as being “obsessed.” I wanted to work collaboratively with her and her care team to do what was actually best for her, rather than what was driven primarily by fear or control.
My sister has never been suicidal or homicidal. She does not accept a schizophrenia diagnosis and has suggested bipolar disorder and schizoid personality instead. Her behavior can be troubling, and if medication helps her, that clearly matters. At the same time, she is now 51 years old, and I believe she should be able to work those decisions out directly with her providers. For the sake of her family, she wants to be as present and functional as she can be for her three daughters. Before her illness became severe, she graduated from medical school. She has not physically harmed anyone, though there have been serious issues, including an attempted grand larceny and a situation where medication side effects contributed to psychosis and placed a child in questionable danger.
I understand that a court deemed her incapacitated at the time, and that medical care and conservatorship were intended to protect her. My focus here isn’t to question the system or her treatment decisions, but to reflect on how family dynamics have affected all of us over time.
From my perspective, my family has long operated under an extreme and pervasive level of fear. My father has significant control and rigidity issues, and the patterns I observed with him, my mother when she was alive, and my siblings include over reactivity, extreme defensiveness, obsession, paranoia, judgment, criticism, and impossible standards. Over time, mental illness and fear seemed to become intertwined with control.
Living inside that environment for decades has shaped me in ways I am still trying to understand and untangle.
I’m genuinely interested in hearing from others. For those living with schizophrenia or psychosis, and for family members or caregivers, does this resonate at all? Have you experienced family dynamics where fear, control, and mental illness became so intertwined that it affected everyone’s sense of reality?
I have a lot of thoughts here. The first and foremost is that your sister is very lucky to have you. of course I can’t see into y’all’s lives other than what you’ve written here but based on that, I would say that you were doing exactly what you should be doing.
I’ve mentioned Britney Spears in here a few times and how that case has affected peoples view of guardianship and conservatorship. One of the biggest refrains you will see in Brittany communities is how shocked people were at the level of control that her father exerted over her life while everybody else stood by and watched.
This can be an extremely vulnerable place for people whose parents are not emotionally regulated themselves. It gives them an incredible amount of power, and like you said control. some people cannot be trusted with that level of control over another person‘s life, especially their own children. After my son‘s diagnosis, I saw two psychiatrist just to make sure that I was not going without treatment myself while forcing it on my son.
The fact is that your father will probably die well before your sister or you. His main goal should be moving her towards independence, even with the new life circumstances that she has before her. If he is not doing that, I think it is more than appropriate for you to step in and ensure that that is the goal of the treatment that she is in.
I’m also gonna drop this here because I share this with most new people here, but I do think that it has some resources that will be helpful for you in this journey.
https://www.reddit.com/r/SchizoFamilies/s/TEIugn49ni
This is well said. The question that we often ask in our family when evaluating a given person's opinions about, or input into, someone's life is, "Do they have [that person's] best interests at heart?" If your father is primarily, or even partially, making decisions about your sister from a place of "significant control and rigidity issues... over reactivity, extreme defensiveness, obsession, paranoia, judgment, criticism, and impossible standards," then I'd say the answer to that question is no; he primarily has his interests at heart. That's a bad situation for anyone, but for someone with a serious mental illness, it can cause a lot of damage.
Thank you both. That is a really clear way to think about it. I do believe my father, as the sole conservator since my mother passed, genuinely thinks he has my sister’s best interests at heart. There is no financial gain for him, and it is definitely a burden. At the same time, he seems to believe she has to behave a certain way, for her children, his grandchildren, to avoid homelessness, or to prevent other serious consequences. The way he goes about it, through control and asserting his version of reality, is damaging in my opinion and experienced as force and compliance rather than support (my read on the situation). Power is the correct term.
Even though I understand his perspective, the impact of his actions has been harmful. I am hearing that these dynamics are not common in other families. My father would never consider being evaluated himself. That would be completely wild. My mother attended NAMI support group meetings with me decades ago when I was trying to understand what was happening. He would not go because he was embarrassed, that was my impression. Reflecting on my own experience growing up in the family environment, I feel like fear has always been there and has warped everyone, including my other siblings.
I hope you’ll consider also going through the NAMI class called family to family. It’s much different than a support group there are times to share, but it’s really just to learn about mental illness and how it works within the family unit.
The one I attended in the 2000s might have been similar, although it may not have been called that at the time. It was taught by another family and included material on how to talk with your loved one. For me, I have distanced myself from other family members because of the dynamics in the family.
That sounds like it!