Maintaining a Healthy Relationship | NAMI

Relating to someone you love who has a mental illness can be difficult and frustrating, but there are strategies you can use to improve your communication with them. There may be a lot you don’t know about how your relative sees things when they’re symptomatic. These tips can help you build a stronger foundation for your relationship.

To get started on a better path in your relationship with your family member, first acknowledge that you can’t change them, only yourself. But the changes you make can improve your lives together. It’s critical to know as much as you can about their illness so you understand what they may be going through.

Don’t Buy Into Stigma

Be clear with yourself about who the person you care about really is. Even if we’re very close to someone with mental illness and advocate for his rights, we may also have our own preconceptions and false beliefs about mental illness. We have to learn to separate the illness from the person.

Understand Confusing Behavior

Because many of the symptoms of mental illness express themselves through social behavior, it’s natural to feel hurt by the symptoms. We tend to assume behavior is conscious and deliberate.

For example, when you invite your brother to dinner with friends and you feel embarrassed by his obsessive checking of whether he locked his car, you’re tempted to see him as someone who’s choosing to embarrass you. This may be how some friends and strangers see him, too—that’s the effect of stigma. When people around you see your relative this way, it can be hard to remember the truth: that he has an illness, and that the behavior is part of his symptoms. That doesn’t excuse cruel or violent behavior, but it’s an important reality to keep in mind.

See Opportunities For Improvement

You and your relative can still make conscious choices that improve your situation. You may agree to cooperate on communicating better, you may each work on keeping up friendships and other supportive relationships, you may each see a psychologist for talk therapy. The fact that you can control some things some of the time doesn’t negate the fact that the illness is real, not a character flaw, or anyone’s fault. Your relative’s capacity to make positive choices will depend on how severe her symptoms are at any given time.

Get Support From Other People

You know there’s more to your loved one than her illness. You may value her sense of humor, her familiarity with your past, her ability to listen and her advice. When someone has a mental illness, she may feel it threatens her identity and self-respect. As with any other illness, your loved one will have periods when she’s learning to cope with her illness’ challenges. During these times, she may seem self-absorbed and unable to give her usual attention and energy to others.

Both you and your relative will be better able to cope if you expand your own support network, beyond her. Strengthen your connections with other friends and family. This takes some pressure off your relative to help you as she did before she was ill. She can instead put that energy toward moving toward living well. At the same time, you may resent her less and feel strengthened by getting the social support you need.

Expect Decent Behavior

Making adjustments to accommodate for your relative’s illness doesn’t erase the need for basic structures and expectations. Tell your relative the standards you need him to meet so you can live well together. Make sure your loved one knows that you see him as a whole person, and that you expect him to follow those standards.

Two of the most important standards to meet are that your home is a safe space and that you have a plan for what to do when safety of your loved one or the family is threatened. Prepare yourself and your family to handle crises. Tell your relative about the standards you expect for daily life. For example, that you won’t continue an interaction with your father if he starts screaming at you. Use the communication tips below to have more productive conversations with your relative.

Learn To Communicate Effectively

Developing good communication skills will improve all of your relationships, but they’re especially important when mental illness is in the mix. Effective communication is largely about building good habits. You can make choices that improve your chances of getting the results you want. Maybe you want to be able to ask your granddaughter to shower without getting into an argument, or tell your husband his smoking worries you without him giving you the cold shoulder.

A very good way to approach this is to use statements that give your perspective, rather than imposing perceived behavior. For example, try “I am concerned because you don’t seem interested in what I’m saying.”, instead of “You’re not listening.” Making thoughtful changes to how you communicate can move you closer to your goals.

See It From Their Perspective

Learn as much as you can about your relative’s illness and what they experience. Because of their symptoms, they may perceive things differently than you think. They may be feeling strong emotions like fear, have low self-esteem or be experiencing a delusion or hallucination. All this may be going on even if they don’t express it.

Put yourself in their shoes and try to think about how they’re feeling, rather than only what they’re saying. Adjusting your communication style with their possible experience in mind respects them, and makes it more likely that they’ll really hear and understand you.

If your friend or relative has done something that bothers you, give them the benefit of the doubt by first assuming the problem is not that they’re not motivated to change, but that they’re not yet able. It can be tempting to assume that the person is deliberately being difficult. Maybe your loved one doesn’t particularly like cleaning up, but she means well. She gets distracted in the moment and forgets to clean, even though she knows she’s supposed to. Ask her if something is making it harder for her to clean. If she simply forgets, would a sign on the kitchen door or fridge help? What does she think the sign should say? Ask her for ideas, so you’re cooperating on something.

You’ll notice that in this example, you’re still able to express the core of how you feel: you’re upset by the person’s actions, and you want them to behave differently because you’ll feel better. This method of communication is less likely to pile on the resentment—both theirs and yours—and more likely to get you both what you want.

Focus On Your Larger Goals

When you’re upset, try to remind yourself what your true, long-term goal is. It may be to live peacefully with your partner, or to encourage your child to eat more healthily. Your true goal is probably not to win an argument or to remind them of how much you put up with for their sake, but when we’re upset, we can get defensive.

Start conversations soon after something happens that upsets you, but after you’ve had a few minutes to cool down and talk calmly. You’ll be more likely to agree on recent facts, and you won’t let dissatisfactions build and worsen into resentment. Pursuing your larger goals doesn’t mean burying your feelings; it means communicating your most important feelings well.

Use Direct, Simple And Clear Language

To have a more productive conversation, start off on the right foot. Get the person’s attention first (“Can I talk to you?”). Cover one topic at a time and share small amounts of information at once (“I want to talk about tonight’s dinner”). Say exactly what you mean (“It’s been a long time since we cooked together, and I miss doing that. Would you help me make dinner tonight?”) rather than hinting at it (“You never do anything with me anymore”).

Describe What You Want And Why

State the facts of the situation, because usually that’s an area in which you can agree (“These forms are due back to your school tomorrow, and you haven’t filled them out yet.”). Say exactly what action you’re requesting the person to take, and how you’d feel if they’d do that (“Please read and sign them before we have lunch. I’d feel relieved knowing they’re done, and we can enjoy the rest of the afternoon knowing you’re ready for school”).

Describing a positive outcome can be very motivating. For example, you could say that you’d appreciate their help taking the trash out, or that if they joined you for a walk you’d be happy to be spending time together. Ask the person for suggestions on how to improve the situation; if they help create the idea, they’re more likely to give it a try.

NAMI HelpLine is available M-F, 10 a.m. – 10 p.m. ET. Call 800-950-6264,
text “helpline” to 62640, or chat online. In a crisis, call or text 988 (24/7).