Getting help for bipolar son-in-law who doesn't think he needs it

Posted by splumm @splumm, Dec 23, 2011

how can we get our son-in-law help,if he does not think he has a problem and blames every body & everyone except himself?

Interested in more discussions like this? Go to the Mental Health Support Group.

You may want to read the book I Am Not Sick, I Don’t Need Help by Xavier Amador. Dr. Amador is a psychologist whose brother suffered from schizophrenia. In the book, he sets out his LEAP framework – listen, empathize, agree, and partner – as a way of effectively communicating and working with individuals suffering from mental illness who do not accept/cannot understand their diagnosis. Some excerpts from the book follow:

In most cases, the medical approach is the wrong approach to take for dealing with the long-term issue of poor insight and failure to take medicine. The medical model is supposed to work, more or less, in the following way:

Once the diagnosis and treatment are decided upon, the patient is informed of both. If the patient refuses, and if he fits the legal criteria for an involuntary admission to a hospital, the doctors take charge. In some cases, medical doctors operating under a benevolent paternal ethic are able to order treatment against a person’s wishes.

We abide by similar, though less dramatic laws every day (e.g., laws that require seatbelts; mandatory rabies inoculation of pets; motorcycle helmets; those that prohibit drunk driving, etc.)

For people with serious mental illness who are unaware of their illness, this traditional approach rarely works. It rests on the mistaken assumption that the patient has come to see the doctor because he feels he has a problem and wants help. It assumes a collaborative approach from the start – the doctor as an ally, not an adversary.

The medical model is the wrong approach when dealing with someone who has, for many years, consistently argued that there is nothing wrong with him and he doesn’t need help. It’s not a bad approach for the short term, but it’s mostly worthless over the long term because the “patient” doesn’t see himself as a patient.


Dear Anonymous,
I’m sure you’ve heard the old saying “we can lead a horse to water but we cannot make him drink”. You cannot force someone to get help. It has to come from within and it starts by admitting that help is needed.
The only suggestion that I would have is find materials on a wide array of issues and suggest that he simply read the materials. Planting a seed can be helpful without alienating the family dynamics.
Be gentle, supportive and know when to step back. Unless, he is a danger to himself or others the choice to seek help is his.
Thanks for caring….

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