How do I help a family member who has a personality disorder but won't get treatment?

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Deeper Global · Accepted Answer

Helping a family member with a personality disorder who refuses treatment is one of the most challenging situations families face. Personality disorders involve deeply ingrained patterns of thinking, feeling, and behaving that the person often doesn't recognize as problematic, making them resistant to seeking help. Your approach must balance supporting your family member while protecting your own wellbeing and that of other family members.

Understand that you cannot force someone to get treatment or change their behavior, no matter how much you love them or how clearly you can see that they need help. Personality disorders often involve limited insight into one's own behavior patterns, and the person may genuinely not understand why others are concerned or may view suggestions for treatment as criticism or attacks.

Focus on what you can control rather than trying to change your family member. This includes your own responses to their behavior, the boundaries you set, how you communicate with them, and the support you seek for yourself. Accepting that you cannot control their choices can be liberating and allow you to focus your energy more effectively.

Educate yourself about your family member's specific personality disorder to better understand their behavior patterns and challenges. This knowledge can help you respond more effectively, reduce your own frustration, and develop realistic expectations about what changes are possible. However, avoid trying to diagnose or treat them yourself.

Set and maintain clear, consistent boundaries to protect yourself and other family members from harmful behaviors. This might include limiting contact during crisis periods, refusing to engage in certain types of conversations, or establishing consequences for specific behaviors. Boundaries are not punishments but rather necessary protections for your own wellbeing.

Avoid enabling behaviors that allow your family member to avoid consequences of their actions or that prevent them from recognizing the need for change. This might include repeatedly rescuing them from financial problems, making excuses for their behavior to others, or taking on responsibilities that they should handle themselves.

Don't take their behavior personally, even when it feels very personal. Personality disorders involve fundamental difficulties with relationships and emotional regulation that are not really about you, even when you're the target of their behavior. Understanding this can help you maintain emotional distance and avoid getting drawn into their emotional chaos.

Communicate clearly and calmly when you do interact with them, avoiding emotional reactions that might escalate situations. Use "I" statements to express how their behavior affects you rather than criticizing or trying to change them. Keep conversations focused on specific behaviors rather than character judgments.

Look for opportunities to plant seeds about treatment without being pushy or confrontational. This might include sharing articles about mental health, mentioning when you've found therapy helpful, or expressing concern about their wellbeing in non-threatening ways. Don't expect immediate results from these efforts.

Consider involving other family members or friends who might have influence with your family member. Sometimes hearing concerns from multiple people can help someone recognize that their behavior patterns are problematic. However, avoid ganging up on them or staging interventions that might feel like attacks.

Take care of your own mental health by seeking therapy, joining support groups, or finding other sources of support and guidance. Living with or caring about someone with a personality disorder can be emotionally exhausting and traumatic, and you need support to maintain your own wellbeing.

Protect other family members, especially children, from harmful behaviors. This might require difficult decisions about limiting contact, supervised visits, or other protective measures. Children are particularly vulnerable to the effects of personality-disordered family members and may need additional support and protection.

Document concerning behaviors, especially if they involve threats, violence, or other dangerous actions. This documentation can be important if you need to involve law enforcement, seek protective orders, or make decisions about safety measures for yourself or other family members.

Consider crisis intervention if your family member becomes dangerous to themselves or others. This might involve calling emergency services, mental health crisis teams, or seeking involuntary psychiatric evaluation if they meet criteria for imminent danger. While this won't necessarily lead to long-term treatment, it can provide immediate safety and sometimes opens doors to treatment.

Be prepared for the possibility that your family member may never seek treatment or change their behavior significantly. This is a painful reality that many families face, and it's important to grieve this loss while still maintaining hope for improvement. Focus on building a fulfilling life for yourself regardless of their choices.

Avoid making threats or ultimatums unless you're prepared to follow through with them. Empty threats can actually reinforce problematic behaviors and reduce your credibility. If you do set consequences, be prepared to enforce them consistently.

Look for small signs of progress or openness to change rather than expecting dramatic improvements. Sometimes people with personality disorders become more open to treatment after experiencing significant consequences or life changes, and being ready to support them when they do show interest can be important.

Consider family therapy or consultation with a mental health professional who has experience with personality disorders, even if your family member won't participate. A professional can help you develop strategies specific to your situation and provide guidance about when and how to encourage treatment.

Remember that recovery from personality disorders is possible, but it typically requires the person's genuine motivation to change and sustained effort over time. While you cannot create this motivation, you can position yourself to be supportive if and when they do become ready to seek help.

Maintain hope while being realistic about the challenges involved. Many people with personality disorders do eventually seek treatment and make significant improvements in their lives and relationships. Your consistent, boundaried love and support may be an important factor in their eventual decision to get help, even if it doesn't seem to have immediate effects.