Ina world fraught with unpredictability we are all seeing an increase in reported mental illness. For those of us working on the mental health frontline, we are also noticing more people who may not have a mental illness but are feeling distressed and grappling with difficult life challenges. When the person who is distressed is a loved one, figuring out how to help them can be a struggle. It can also take a toll on our wellbeing.
For John*, contact with his daughter Averil* has been incredibly painful over most of this year. He sees and hears her struggle with anxiety and depression, which has come to a head in the last six months, and tells me how helpless he feels to say or do anything that might alleviate her distress. His experience of supporting Averil often feels like an emotional rollercoaster. There are ups, downs and arounds – followed by more ups, downs and arounds. Then, right in the whirl of this difficult ride, he is hit with a whack of strong and often contradictory emotions.
On the one hand, contact with Averil brings on grim worry feelings of distress, sadness, guilt and often, hopelessness. And, on another, strong emotions of anger, frustration and impatience. It was no surprise to hear that John would sometimes avoid replying to calls or text messages, as the dread of what Averil would say made him want to put off connecting with her. This exacerbates the downward guilt spiral – John loves his daughter, so why is he avoiding her? He tells me how distressing this feels:
The hardest parts are the feelings of helplessness and despair. I feel despair that this adult seems childish and at 30 years old is unable to build herself a stable and fulfilling life. She burns out relationships and doesn’t stick at any jobs. And I feel helpless because I’ve learned that handing over money is a mistake; giving advice is pointless; and doing things for her will be misconstrued. But at other times I see flashes of the happy girl she was. I’m her father and it’s hard not to wonder, ‘Is this somehow my fault?’
For any of us with a partner, child, friend or family member who is struggling, figuring out how to support them – without getting so caught up that we end up struggling – can feel like walking a tightrope. With permission, I’m sharing John’s experiences and psychological learning. Our most important goal for him has been for him to show love and care for his daughter, while staying emotionally intact and balanced.
One of the psychological models he has found helpful is called dialectical behavior therapy. At its simplest, DBT encourages a balance between opposites. Often when we are coping with difficult experiences, we fall into a habit of “all or nothing” or “black and white” thinking and we find it hard to see the gray.
Putting this theory into action for John has meant practising holding dual realities – sometimes he wants to help his daughter and sometimes he wants to avoid her. During some conversations he feels hopeful, during others hopeless again, and each of these dual realities are valid and true. One of the strategies that has helped John to get more comfortable with this dual perspective is a coping skill used by psychologists who practice DBT called holding the “and”.
John and I have talked at length about this “and” in his relationship with his daughter. We acknowledge that it is possible to find positives in her life and in his relationship with her and also experience distress, sadness or worry about her future. As an act of active acceptance (that is, not giving up but reminding ourselves “this is how things are, for now”), John is learning to acknowledge these dual states, sit with them, and then take steps to tackle what is in his control.
Some of these steps have included setting boundaries around how and when he is available for contact with Averil – late-night calls are off limits as these interfere with his ability to sleep and make the following day difficult for him. After weighing up the pros and cons (once again, finding the balance) he has also given himself permission for “time-outs”, sometimes a day off from contact, sometimes a weekend or a longer period of time. He will let Averil know in advance that he’ll be unavailable – even when she responds negatively. He is able to remind himself, “I want to be available to support Averil and It’s OK for me to take time out to recharge my energy and care for myself.”
Other steps that John has taken that are in his control and have been helpful for him are enrolling in a course to learn more about mental health, joining a support group for parents, and picking up a new hobby. The hobby is something he has control over and becomes absorbed in for periods of time. These mindful times where he’s absorbed provide a recharge and a time-out.
After several months of trying out these steps, John’s relationship with Averil is not magically healed. The rollercoaster is still there – with its ups, downs and arounds – and John has been able to observe the ride with a pinch more compassion towards himself and his daughter. Taking time for himself and embracing the opposite, sometimes contradictory, emotional states he feels means he has freed up emotional and cognitive space to support Averil in new ways.
Practising holding the “and” isn’t a quick fix but, for John and many others, it’s a gentle way to find peace in the gray “in-between” of life.
* Names have been changed to protect privacy