He broke the huge two-inch thick glass dining room table for six that had been with his family for 40 years. In a fit of rage over a question his mother had posed, he overturned the table and smashed it into pieces. Stunned, the senior citizens he was living with swept the broken shards, and a week later, had the glass table quietly replaced.

As a 14-year-old, in an argument with his sister, he hurled around their entire living room set, missing his sister’s head by a few inches. Today, three decades later, single and unemployed, he continues to wreak havoc, with people resigned to the fact that he has anger issues.

Because mental health continues to carry a stigma, there are still many people who refuse to acknowledge a problem even if it’s staring them in the face, and worse, refuse to seek help.

What does one do when a family member refuses to acknowledge that he or she is in desperate need of mental health treatment? The condition is called anosognosia, or a lack of insight—a symptom of psychosis itself. In some cases, it’s due to denial, or shame.

More often than not, there is an enabler within the family, a person who wields power, usually a parent, who will condone the behavior, refuse to see it for what it is, and simply explain it away as part of the child’s inherent personality traits: “Mainitin lang talaga ang ulo niyan, pagpasensyahan na lang natin,” or “Medyo spoiled kasi, patawarin mo na lang.” It’s the kind of dynamic that sometimes sets off World War III within families.

As a family member or friend, you may feel powerless. However, there are certain strategies you can apply in order to preserve your sanity, and try as much as you can to keep the peace.

Denial

1. Remind yourself that the work of accepting that there is a problem can only be done by the person. No matter how much you try to convince the family member of the need to seek help, there will still be denial. You can try to discuss the issue and listen with compassion as much as you can, but remember that it will often take several incidents or discussions before the light breaks through.

Meanwhile, you must learn to set your own boundaries for your own health and well-

being, and remember that you are not responsible for their mental or physical health and their peace of mind. Sometimes—the most difficult thing to do—you simply need to let go.

2. Keep your emotions in check, and do not hit back. You do not need to tolerate the verbal abuse. Keep distance when it is needed to protect yourself. Ensure, too, that the person with mental illness will be safe and not at risk of harming himself/herself or harming someone else. If there is a risk, take the necessary precautions by calling the police or the barangay, or taking the person to the emergency room to calm down.

3. Assess whether you are the best person to talk to your loved one. If your conversations always end with tempers flaring or someone walking out, then another person, someone whom the family member with mental health issues listens to and respects, might be in a better position to get through.

4. Stop the power struggle. People with mental illness want to be heard and understood. Rebuilding bridges is not easy, but it can be done. A very good reference for this is the book “I’m Not Sick, I Don’t Need Help” by Dr. Xavier Amador, which is available on Amazon.

5. Do not try to help the family member on your own. You know the instructions the flight attendant gives before take-off: Take care of yourself first, before you help someone else. You will be useless if you feel overwhelmed, irritated and anxious. Find a supportive friend or family member, seek the help of a health professional for your own well-being, and build up your own stores and reserves of emotional support and encouragement.

6. Stay connected, no matter what. Give yourself breathing space, but let the family member know that you are still in their life. When the time comes that they finally recognize that they need help, they need to know that you will be there with no judgments, and only love, no matter how many times they have pushed you away in the past.

7. Pray unceasingly. Keep praying for your loved one, and for yourself. For clarity, courage, strength and discernment.

Find strength in the words of Catherine the Great: “I beg you take courage, the brave soul can mend even disaster.” The road to recovery is long and arduous so you need to hang on, but recovery is possible. Never, ever lose hope.

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