Category Archives: self-responsibility and self-actualization

A Concerned Sister

Hi Dr. Lee,

I know this is not an easy question! My brother has schizophrenia. He’s 33, and has been diagnosed since his early twenties. He has been in and out of hospitals and on various medications over the years. At this point in his life, he’s not living with family and is making some life choices that we don’t approve of (alcohol, etc.) Despite his illness, he is smart, and has a history of shutting his family out when we try to “meddle” or insist that he stay on medication or keep visiting doctors  In fact, when we push too hard, he tends to sever communications with everyone for months at a time  It is only recently that he’s opened up to me again.

So, my question to you is, should I continue to “be on his side” and not question his choices, in order to keep him in my life? Or should I risk pushing him away by insisting he stay on his medications? I guess the dilemma for me is really that I see he needs the help, but I worry I’ll alienate myself again if I insist he seeks the treatment I would choose for him.

Thank you for your thoughts,
A Concerned Sister, Tallahassee

Dear Concerned,

My first question to you is: Would you rather have a relationship with your brother or be right? Second one: Has what you and your family been doing worked?

Imagine your family telling you what is good for you and insisting that you follow their rules. Here is what I know about people with schizophrenia. They are some of the most creative people I’ve met. I would rather work with them than almost any other group of people. Most use alcohol or other drugs in place of their medication. It may not be the best choice but it’s their choice.

In my clinical work, I found I had to use different criteria than their thought processes for release from the psych unit. If they used good hygiene, at least three-fourth of the food on their trays, and slept at least six hours, they were ready for release. The kicker is they have to understand the criteria before being able to carry it out. I don’t know anyone who wants to be treated like a child and obey someone else’s rules.

People in twelve-step programs use the Serenity Prayer, among other tools, for managing their lives: God, grant me the serenity to accept the things I cannot change, courage to change the things I can, and wisdom to know the difference. The only thing I can change is my attitude and my thoughts. One of the most frightening decisions I ever made was to allow my alcoholic husband to make his own choices even if it led to his death. (Allow? As if I had that much power over him.) Surprisingly, he asked to go to treatment within twenty-four hours of my decision. No, I did not announce my decision, but somehow he knew without my telling him. He later told me he knew I was no longer going to keep him alive and that he would have to do it on his own.

We all have our own paths to follow in this world and it is not my place to judge someone else’s journey through this lifetime.

I hope this helps.

—Dr. Lee