Please help with paranoid family member - page 2

I need help. I was having alot of trouble with my daughter-in-law and just couldn't figure out what was going on. Our relationship had deteriorated over several years from warm, close to hostile... Read More

  1. by   finness
    Quote from CliveUK
    We have two examples of her behaviour that lead you to think she might be mentally ill: - one seems to me to be a heightened concern about an ex-partner. Perhaps the ex was abusive (her description of him "going postal" suggests this): it is not uncommon for people who have suffered violence to be over-vigilant. The other example seems to me to be the kind of hyper-vigilance and anxiety about the baby's wellbeing and her ability to cope that again is not uncommon in mothers of new babies. I would hesitate before proceeding on the basis that this woman has a mental illness, a conclusion reached after a chat with a counsellor and a look on the Net. If you go looking for personality disorder, you can find it in everyone!
    Obviously more pronounced in some.
  2. by   Ishmail
    Quote from finness
    Obviously more pronounced in some.
    Hardly a very helpfull response to a lady whom is obviously in distress.

    As a UK-based mental health professional with extensive experience of both acute and psychiatric rehabilitation clients, within both in-patient and community-based settings, I absolutley agree with the comments posted by CliveUK.

    CliveUK quite rightly points out that
    Quote from CliveUK
    I would hesitate before proceeding on the basis that this woman has a mental illness, a conclusion reached after a chat with a counsellor and a look on the Net.
    This is an opinion of one who has obviously evaluated the available information within its wholistic, professional, context. To presume clinical diagnosis in the abscence of fact, and then proceed to assume the need for treatment based upon what is effectively hearsay evidence, is helpful to neither ernurse2244 or DIL. This lady needs advice, not speculation.

    If any of the available information were absolute, then clearly DIL's behaviour and mental health needs to be assessed within a professional, clinical framework of reference, and potentially addressed through a psycho-social approach. One which balances her own perception of her beliefs with others perception of problem and need. However, the use of the term "paranoid" should be avoided until explored in greater detail, and clinically evidenced. CliveUK justifiably points out the potential post-natal influence, and this was my initial thought when reading the post. However, such speculation on my part would be tempered by the lack of available information.

    I urge ernurse2244 to seek further advice and guidance upon the matter before accepting a somewhat isolated and detached diagnosis from a counsellor who may not have had the oportunity to assess DIL directly. My unfamiliarity with US-based services does not help you, but here in the UK I would advise those in your position to contact a community-based mental health team for assistance in sourcing professional guidance. Psychiatry is not always preferrable to psychology.
    Last edit by Ishmail on Jul 27, '04
  3. by   finness
    "Hardly a very helpfull response to a lady whom is obviously in distress. As a UK-based mental health professional with extensive experience of both acute and psychiatric rehabilitation clients, within both in-patient and community-based settings, I absolutley agree with the comments posted by CliveUK."

    Well, SNAP, I guess you told me!!! I tried to be as helpful as possible in my TWO previous replies. How silly of me to have added that off the cuff one-liner in response to CLIVE about personality disorders being present in many, but more pronounced in some. From the sounds of it, I am not NEARLY as polished and professional as you. I didn't realize that we were limiting our responses on this board to those with the appropriate credentials, rather then those with personal experience and empathy.
  4. by   Nurse Ratched
    Whoa. Let's back off a second, folks.

    This is not ask-a-nurse. I think legitimate thoughts have been offered here with appropriate disclaimers. No one questions the distress the OP is in.
  5. by   blondebuddie
    Quote from ernurse2244
    Thanks for all the answers and questions. I have worked 24 of the last 36 hours so haven't gotten back to you before now.

    I didn't give you alot of details about my DIL to keep my post short. As an ER nurse, I see mental health patients in crisis situations, but don't have much other psych experience. However, I did do alot of research on the 'net about Paranoid Personality Disorder after my counselor suggested that as a possible dx for my DIL. It certainly explained her reaction to many things I did that I did not understand caused such a problem. Just a couple of examples of her behavior...I wanted to put their picture in the paper with an engagement announcement before their wedding. I live in a rural town in Georgia, less than 600 folks...she said no because her ex-boyfriend, who lived in Texas, might see the announcement and "go postal". She won't take the baby to a mall if she can't wear her contact lens because if she has her glasses on she doesn't have good periphereal vision and someone might run up and kidnap the baby.

    All I am asking is for you guys, the professionals, to give me advise on how you approach paranoid patients. I am convienced as I view many of her past behaviors with definitions of paranoia and realize that this explains her behaviors, that she is Paranoid, with a capital P. I can't help her, I doubt that I can get her to seek help. I doubt that I can convience my son to push for her to get help. I only want to know what I can do. I can only change my behavior...not her's and not my son's.

    I feel that now I am a target for her paranoia...maybe I should let that keep happening so she won't change to my grand-daugher and/or my son. Just don't know. I have been carrying the burden of this for several years, blaming myself and trying to jump through the hoops that she has created, thinking I could change our relationship if only I did something different. Each hoop I jumped through created two more hoops.

    Please...just some suggestions about how you approach and carry on with paranoid patients.
    I have two views on this. One is if your daughter in law is as paraniod as you say she is, then probably nothing you do will allow her to bring down those walls. On the other hand, what are the chances of your DIL trusting you? Can you work on that part of the relationship? Usually patients respond to our skill in being very empathic. This does not mean agreeing with them, but rather showing that you understand their situation and how they feel. If you can break some of those walls down, perhaps she may begin to trust you. I always say when in doubt, empathize, empathize, empathize. It does sound like however that these paraniod behaviors are well engrained.

    Good Luck!
  6. by   Thunderwolf
    After reading all this, I give my thanks to Nurse Ratched for stepping in. Persons can be fearful or paranoid for many reasons. Without having alot of info but hearing lots of advise, all I can recommend that even if a person has a mental disorder/personality disorder or not, fear is the primary emotion/thought process here. Empathy is good if it is genuine (understanding that person's frame of mind or emotional angst from their own perspective...the DIL). Trust comes with time, never rushed, without an agenda. Come to understand the person's fear in order to understand the rationale of the behavior. Depending how entrenched the fear or paranoia is, provide reality checks as a means to reassure that the environment or others are safe, but never to force the point. Sometimes, empathy can be provided by sharing similar feelings or experiences we have had that have caused similar distress and learning how to cope through it. A person with paranoia, if it is present, feels like everybody's eyeballs are on him/her. Sometimes when interacting with someone of this nature it is helpful to keep the focus on oneself (as you observe the other person), allowing the person to present his/her own concerns when he/she begins to feel more comfortable sharing that info. When it occurs, don't just jump in both feet by digging in deeper. Take a one down position, letting the person be the master of their info. Go slow and at that person's pace. Discuss with an interest to understand how it is like for that person to carry that concern and how tiring/frustrating it might be, especially if he/she has to make major adjustments in his/her life to accomodate this fear/concern in his/her daily life. When the person begins to feel you're trustworthy, he/she may begin asking for "your" point of view. Even here, go slow and be sensitive. The person may be simply testing the waters to see if you are really safe. Do not lie or be dishonest. If you don't know an answer, simply say so. Don't therapize a truely paranoid may distance him/her. Be genuine, honest, empathetic from his/her point of view, matter of fact, and non-confrontational. I don't know if this helps. But, I hope it does.