Finding appropriate help for my brother

Postby User051720 » Tue May 12, 2020 2:27 pm

Hello all,

I want to thank you in advance for taking time to read this post in its entirety. I need to get my brother medical assistance, but he is resistant to going to the doctor. He experiences panic attacks, anxiety, and depression. He constantly tells me that he is tired of living and does not want to continue on in this world. He has a lot of built up anger because of all of the hate in this world towards "people like him" (referring to the LGBQTIA+ community). From what I do know, he has tried group counseling for individuals who identify as a part of this community; however, he didn't seem to be receptive. It made him even more upset.

One additional description of his behavior is that he identifies as part of the black and brown community even though he does not look physically black or brown and is not genetically black. Our father is white and my mom has Spanish roots, however, we were not raised knowing the Hispanic culture. I only provide this information to stress that there is a disconnect with how we were raised/the community that we were apart of and how he is identifying himself. This also contributes to him perceiving himself as an outcast and thus causes suffering and anxiety. I can understand why this perception can cause suffering, I see overlap between this and being gay.

On top of the mental pain that he experiences, he experiences physical pain that at times is debilitating (i.e., lower back pain). However, he refuses to go to the doctor to get an assessment. I feel that this is because of his current mental state, which in my opinion needs to be addressed before he can bring himself to go to a physician.

I am worried that I am running out of time to get the help that he needs.

Any feedback would be greatly appreciated.
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#1

Postby Richard@DecisionSkills » Tue May 12, 2020 6:40 pm

Appropriate is a difficult part of the equation here.

Appropriate in one sense is to encourage your brother to seek out a good therapist that can help him unpack the crisis of identity, etc. In another sense appropriate is encouraging him to find a group/location where he feels accepted, even if it is temporary or superficial.

The difficult part is focusing on what the appropriate role you play as brother? As a brother you are limited in what is appropriate or what is possible. You can encourage him, but not control him. You can try your best to watch out for him, but at some point you must allow for the fact that he will make his own choices and that you and other members of your family might suffer from his choices.

You can focus on trying to prepare and be ready for those outcomes while at the same time encouraging him to find a therapist, a priest, or any person that might otherwise help him reframe how he currently views his world.
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#2

Postby User051720 » Tue May 12, 2020 7:20 pm

Richard@DecisionSkills wrote:Appropriate is a difficult part of the equation here.

Appropriate in one sense is to encourage your brother to seek out a good therapist that can help him unpack the crisis of identity, etc. In another sense appropriate is encouraging him to find a group/location where he feels accepted, even if it is temporary or superficial.

The difficult part is focusing on what the appropriate role you play as brother? As a brother you are limited in what is appropriate or what is possible. You can encourage him, but not control him. You can try your best to watch out for him, but at some point you must allow for the fact that he will make his own choices and that you and other members of your family might suffer from his choices.

You can focus on trying to prepare and be ready for those outcomes while at the same time encouraging him to find a therapist, a priest, or any person that might otherwise help him reframe how he currently views his world.


Unfortunately, I know that what you are saying is true. As his older sister I feel responsible and I need to do everything I possibly can to prevent a negative outcome. He has isolated himself from our family (except for me) and is not religious. There has to be another way to reframe his world view.
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#3

Postby Richard@DecisionSkills » Tue May 12, 2020 8:05 pm

Yes, there are many ways that a person might reframe. This could include reframing your own feelings of responsibility or reframing what it means to you for an outcome to be considered negative. And what about your parents reframing?
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#4

Postby Richard@DecisionSkills » Fri May 15, 2020 5:21 am

Silence speaks.

For anybody that may come across this thread, when trying to find "appropriate help" for a family member it is necessary to equally consider the "appropriate help" that you and other members of the family might also need.

A common example is a family that believes homosexuality is immoral. If a member (such as the brother) modifies their belief this can create problems, it can create a major divide in the family.

A mistake many families make is focusing only on getting "appropriate help" for the family member that no longer holds the same beliefs. Members ignore their own role in the situation. They believe that their is no need to reevaluate, reframe, or otherwise modify their own beliefs. They expect that if they can just find "appropriate help" the person will realize the error(s) they made and return to the belief that homosexuality is immoral.

This is no easy issue. There are strongly held beliefs/convictions that can be intractable or unresolvable. Two that come to mind are religious and/or political beliefs. A member of a family can be disowned, shunned, etc. until they renounce what they believe. This typically just pushes the person further away from the family.

My advice, if the goal is to maintain a relationship with the brother, is to work on finding some middle ground that acknowledges the need for both sides to reframe. This doesn't require surrendering one's beliefs.
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#5

Postby Candid » Fri May 15, 2020 6:24 am

It's also possible a troubled family member is troubled only because the family thinks he or she needs 'fixing'.

Assuming the brother in this case isn't intellectually sub-normal, he's surely aware there is 'help' available if he wants it. Maybe he doesn't. Maybe it's the sister who should consider getting help for herself.
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#6

Postby User051720 » Fri May 15, 2020 2:12 pm

Richard@DecisionSkills wrote:Silence speaks.

For anybody that may come across this thread, when trying to find "appropriate help" for a family member it is necessary to equally consider the "appropriate help" that you and other members of the family might also need.

A common example is a family that believes homosexuality is immoral. If a member (such as the brother) modifies their belief this can create problems, it can create a major divide in the family.

A mistake many families make is focusing only on getting "appropriate help" for the family member that no longer holds the same beliefs. Members ignore their own role in the situation. They believe that their is no need to reevaluate, reframe, or otherwise modify their own beliefs. They expect that if they can just find "appropriate help" the person will realize the error(s) they made and return to the belief that homosexuality is immoral.

This is no easy issue. There are strongly held beliefs/convictions that can be intractable or unresolvable. Two that come to mind are religious and/or political beliefs. A member of a family can be disowned, shunned, etc. until they renounce what they believe. This typically just pushes the person further away from the family.

My advice, if the goal is to maintain a relationship with the brother, is to work on finding some middle ground that acknowledges the need for both sides to reframe. This doesn't require surrendering one's beliefs.



I think this is a very important point. My brother and I lost connection with our family because of the inability for either side to modify their beliefs. It destroyed us all. My brother and I are very close and discuss our feelings often. Yet, even after many years I still struggle to truly understand what he is going through; however, I know my understanding is also improving. I also know that I will never know exactly what he is going through.

I guess what motivated me to create this post was my inability to reframe my thinking in regards to him potentially committing suicide. (The word choice "appropriate help" in my feed was referring to the need to help prevent him from committing suicide). He brought this up two times in the days leading to me writing this. We also discuss him feelings towards suicide, he wants me to accept that it is his choice -- and doesn't want me to be devastated by it. Sometimes I feel that the only reason he has not done it yet is because of me; like I am the source of his suffering because of his concern for my well being.

It is easier to accept the idea of suicide when there are no personal ties. I understand that nature does not care about the individual. So yes, as mentioned earlier and by a second post on this feed; I agree that I do need help as well.

There are so many details that are difficult to put into words. It helps to get different perspectives and challenge my current biased beliefs.
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#7

Postby User051720 » Fri May 15, 2020 2:14 pm

Candid wrote:It's also possible a troubled family member is troubled only because the family thinks he or she needs 'fixing'.

Assuming the brother in this case isn't intellectually sub-normal, he's surely aware there is 'help' available if he wants it. Maybe he doesn't. Maybe it's the sister who should consider getting help for herself.


He is aware but states that he doesn't have the energy or metal capability (i.e., due to depression) to get himself there.
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#8

Postby Candid » Fri May 15, 2020 2:24 pm

Do you not believe him?
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#9

Postby User051720 » Fri May 15, 2020 2:57 pm

Candid wrote:Do you not believe him?


I do believe that he cannot do so. If there was some way that I could alleviate a tiny portion of the pain that he was feeling and get him there, I would want to do that.

This is where I am having trouble accepting that; where I would need help.
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#10

Postby Candid » Fri May 15, 2020 3:27 pm

Yes, I would recommend counselling.

If there was some way that I could alleviate a tiny portion of the pain that he was feeling and get him there, I would want to do that.


But you can't, so the next best thing is to get the help you need.
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#11

Postby Richard@DecisionSkills » Sat May 16, 2020 2:25 am

kjt1 wrote:I guess what motivated me to create this post was my inability to reframe my thinking in regards to him potentially committing suicide. (The word choice "appropriate help" in my feed was referring to the need to help prevent him from committing suicide). He brought this up two times in the days leading to me writing this. We also discuss him feelings towards suicide, he wants me to accept that it is his choice -- and doesn't want me to be devastated by it. Sometimes I feel that the only reason he has not done it yet is because of me; like I am the source of his suffering because of his concern for my well being.


I agree. Arguably one of the toughest beliefs to reframe.

A good start is euthanasia. At what point do we allow a person to end their own life?

We suffer, we cry, we experience emotional pain as we put down the horse with a broken leg or the old family pet that is in such poor health, but a human? A family member? Almost inconceivable. In some belief systems it is a sin. The person must continue to live until they die of “natural” causes, regardless of the suffering they must endure.

For someone with observable physical suffering, for an elderly person with a declining quality of life and condition we begin to revisit our beliefs, but it is not easy. In some places in the world the best they do is stop providing food/water, Euthanasia is illegal, so the person is kept on pain killers, their lips moist, in as comfortable state as possible until dehydration finally takes them. And we call this humane? No, but at least we didn’t sin, right?

And from the above we must still make a big leap from incurable physical suffering to a suicidal person. We think that their suffering is either temporary or curable. We wouldn’t endorse euthanasia for a person with a physical injury that can be healed and the same goes for a mental injury. The problem most certainly being that the mental we cannot see and we cannot know. Therefore we err on the side of caution. We claim that life is worth living, regardless of the mental demons a person might carry.

Again, I agree. I’m not saying suicide and euthanasia are comparable. For euthanasia it is a community decision. It is a shared recognition that the person is suffering beyond reason and that death a moral option. My only point in bringing up euthanasia is that it is a good starting point for helping shift beliefs.

Suicide is not euthanasia. Suicide isn’t about incurable pain. The motive to go down the path is almost always driven by feelings of anger, revenge, and control...hence the suicide note. Your brother talks to you about suicide, because it is a weapon, it is a means of manipulation and control.

I’m not saying his actions are intentional. I’m saying that the path towards suicide is often adaptive. The person has not learned how to achieve control in healthy ways. At some point your brother tried to gain power/control using unhealthy ways. It worked well enough that he used it again, and again, and again until the unhealthy behaviors became the adaptive norm.

Your fear of him ending his life is what gives him power. Suicide is the poor man’s ultimatum. “Accept my conditions or you will feel my wrath.”

Your brother needs therapy to learn other tools to navigate problems. These are probably not tools that you can teach him.

What you can do is encourage him to seek therapy, tell him he needs more tools, more life skills, and at the same time not allow him to use suicide as a tool. Reframe your beliefs towards acceptance that it is your brothers decision and if he was to go down that path it is 100% on him, not you. You stay true to the belief that there are other tools he has available, that he can learn. If he chooses not to seek out those other tools, that’s on him, not you.
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