Q. I’m writing concerning my best friend (let’s call her “Lucy” for the sake of this inquiry). Lucy’s mother was diagnosed with DID about six years ago. Recently her mother has refused to see her therapist and has decided to reduce the dosage of her medications. As a result, all the symptoms, emotional instability, flashbacks etc. have been worsening. I understand the common position by therapists is that “you can’t help those who refuse to help themselves” and while I would agree with that, I also feel it is as kind of a non-answer to the situation.
Obviously, DID affects the lives of more than just those who have been diagnosed with the disorder. Lucy’s mother is in her mid fifties, single and lives at home with her three daughters who have taken the responsibility of caring for their mother upon themselves, as would be expected. Because of Lucy’s mother’s disorder Lucy has lost many relationships with people she cares about. What would essentially happen is that when Lucy was in high school she would ask permission to go out with friends but when she would return later her mother would forget she gave Lucy permission to go out and a fight would follow thereafter. The fighting contributed to her mother’s depression. Eventually Lucy got tired of fighting and gave up any attempt to have a social life. This has happened time and time again. Lucy would eventually make attempts to have a social life again after a matter of time and her mom would worsen shortly after forcing Lucy to give up relationships again. Lucy is now two years into college and finds herself again unable to maintain any degree of closeness with anyone who doesn’t live under the same roof. I know that I am the last close friend Lucy has outside of acquaintances of hers at school and work.
For the past couple of weeks Lucy has been preoccupied with the concern of caring for her mother and therefore she has not returned any calls or emails or responded to any attempts to communicate. This worries me, because I have no idea of what kind of emotional toll this is taking on her. I think she wonders if it is not better to just give up once and for all on extra-familial relationships since she usually ends up hurting herself and someone else. Since I understand her situation is not easy, I’m willing to continue to do anything I can to be supportive, but it seems to me that Lucy can do nothing to make the situation better. At best she can only avoid making it worse. Furthermore, the fact that she is feeling incapable of having a personal life (like normal friendships or romantic relationships) sounds like this could be some form of emotional abuse. I know Lucy was recently dating someone who she cared about very much, but again because of her mother felt forced to end that relationship. It hurts to watch my best friend unable to have a life. She believes that if she gives more attention and energy to her mother and her sisters at home that it will somehow help the situation. More accurately, she is only trying to not make things any harder at home.
My question is then, as the daughter of a DID patient who refuses to help herself, what is the role/responsibility of Lucy? She plans to move out of her home in a year and a half when she graduates, as she can’t really afford to live on her own right now as a full time student. Will Lucy have to sacrifice having any meaningful relationships outside her home for the next year and a half? It doesn’t seem to me that that is healthy since she has already missed out on a lot of things other high school and college students are able to do. I would do anything to help Lucy. It may be difficult for me to talk to her about this, and to recommend any way of balancing her life because I am outsider to the situation, but if I had an idea of what to suggest for her to do in order to care for her mom and have at least one meaningful relationship outside her home then I could at least attempt to talk to her about it.
I’ve never heard of this situation in all I’ve read of DID/MPD, BPD, PTSD. Nothing. All the sources I’ve found concerning any similar disorder has only discussed the patient and otherwise ignored those who may also be suffering because they are close to the situation. If you have a solution for me, I’ll take it. If you can point me in the direction of any other resources, I’ll take that. I just don’t know what to do anymore. Thank you in advance for any response/advice.
A. Lucy is living with a very difficult family situation. It is great that you are concerned about her. She is lucky to have a caring friend.
Because Lucy has a complicated life situation, there are some harsh realities associated with her circumstances. She is trying to help her mother become stable when her mother is refusing to help herself and to take her medication. It may be that Lucy’s mother is stubborn and is unwilling to help herself or let others help her. It could be that her mother is unable to recognize how sick she is and is refusing help because she does not think that she needs it. No matter what the reason is, the result is still the same: Lucy’s mother is untreated and therefore unstable. In this country, the commitment laws are very strict. These laws require that to be “forced” into treatment into the U.S. mental health care system, an individual has to be suicidal or homicidal. Lucy’s mother may be unstable, refusing to accept her needed medication or treatments and is emotionally abusive towards Lucy but by law she is not able to be “forced” into treatment unless she threatens her own life or the lives of others. With regard to Lucy’s mother, there is probably little or nothing that Lucy can do to improve her mother’s situation.
With regard to Lucy, you said that she has not been very receptive to your attempts to help her. It may be difficult for Lucy to accept help because she may feel obligated to care for her mother and it also does not seem that she can move out for at least another year and a half. All that you may be able to do to help Lucy is to suggest that she seek some form of therapeutic help. Ideally, it seems that it would be best for Lucy to move out of her home but since she financially cannot afford this option she may be able to find emotional help and support for managing her daily living situation from a therapist. You can say to Lucy “I am worried about you and I see that you are suffering. It bothers me to see you like this. Would you consider seeing a therapist for emotional assistance while you’re caring for your mother? I can even go with you or drive you to your appointment. I am willing to do whatever you need me to do to help. Please do something Lucy. It is not healthy for you to live in isolation or to try to manage your mother’s difficult illness alone. There is help for you.”
You could also suggest to Lucy that she contact the National Alliance for the Mentally Ill (NAMI). They are a national organization with state and town affiliates that specifically provide support to individuals who have a family member with a mental illness. They are seasoned experts who advise families on how to manage the difficulties associated with having a family member with a mental illness. They do tremendous work for families across this country. Their website can be found here.
If you talk to Lucy and she is not interested in your help, then there may be nothing else that you can do. In the future, she may be ready to accept your advice but if you offer help and she refuses it, then realize that there are limits to helping others. I know that you said that this type of advice is not helpful to you but it is the truth. If a person is not ready or willing to accept your advice, then it is important for you to see this reality and to respect their decision. You cannot physically coerce Lucy to accept your advice nor could you force her into your car and into a therapist’s office. You can do this no more than Lucy could force her very sick mother into treatment. I know this is not what you wanted to hear. It is a sad and difficult reality but these are the facts.
You can and should offer to help Lucy. Tell her about your concerns and about the NAMI organization. If she does not want your help now, then maybe she will in the future. Again, she is fortunate to have someone who cares about her. Please realize, however, that once you have tried all that you can to help someone, and they tell you that they do not want your help (implicitly or explicitly), then you must stop. Lucy may come to accept and appreciate your help in the future and if she does that is great but she must come to this decision herself when she is ready. Thanks for writing and please consider writing back to let me know how things with Lucy evolve.
Last reviewed: By John M. Grohol, Psy.D. on 1 Sep 2008
Randle, K. (2008). Best Friend’s Mom has DID. Psych Central. Retrieved on December 11, 2013, from http://psychcentral.com/ask-the-therapist/2008/09/01/best-friends-mom-has-did/