It’s enormously frustrating when your adult child has a serious psychiatric disorder like bipolar disorder or schizophrenia—but refuses to accept that he is mentally ill. Many parents in this situation conclude that their child is in “denial” because these ill adults won’t agree that they are mentally ill. But this lack of insight is often sincere and is not a form of denial. He really hears those voices and she really “knows” that people are plotting against her. As a result, even if you were the world’s most brilliant debater, when a person lacks this insight, you would lose every discussion about whether the auditory hallucinations, paranoid delusions and other symptoms of severe mental illness are real. To the ill person, they are incredibly real.
So what do you do when your child has a serious psychiatric illness but won’t believe you and thinks that she is fine? Here is a list of do’s and don’ts.
Do NOT
• Argue with your child that her she really is very sick and that the hallucinations are fake. It won’t work. To her, they are real.
• Tell her that the doctor, you and everyone else knows she is mentally ill. This won’t generate sudden insight and instead, it will cause dissension between you.
• Tell him that talking to the voices in his head while in public is crazy behavior. He hears the voices and he is responding to them, which makes perfect sense to him.
• Tell her that she should take her antipsychotic medication so she won’t be crazy anymore. She doesn’t think she’s mentally ill now.
Do:
• Talk about how other people react to some of her behaviors. For example, tell her that sometimes other people get upset when she talks aloud to people whose voices they can’t hear. It confuses them.
• If asked, tell her that you don’t see the visual hallucinations or hear the voices either. You understand that she sees and hears them, but she needs to understand that you do not. This means you can’t really be a part of the experience.
• Try to really listen to the person. The more you listen, the more you will understand their viewpoint. It may be a completely irrational viewpoint—but you will then understand what your child believes and may discover something you didn’t know before.
• When your child wants to take irrational actions, try talking about consequences that might occur and use a calm and nonthreatening voice. For example, if your child thinks the neighbors are plotting against her and she wants to call the police to report them, ask her what she would tell the police that they are doing. Explain that the police don’t go by people’s thoughts but rather by their actions. As a result, even if the neighbors harbored very dark thoughts about your child, if they don’t do anything, then calling the police would be futile.
Unfortunately, not all of these individuals are able to develop insight, and there’s no way to magically make it happen. Antipsychotics can help the person exhibit normal behavior, but medication compliance is often a challenge.
As maddening as it can be, using logic and reason to convince your child to accept her mental illness may yield little fruit. Instead, learn to develop strategies to help your child deal with her symptoms, and do everything you can to encourage treatment and long-term treatment compliance.