BApK

Bundesverband der Angehörigen psychisch erkrankter Menschen e.V.

Counsel for Families

Relatives of psychologically ill persons are grateful for support in many everyday situations. They live from exchange with others affected in the same way. Handling life with a psychologically sick person works by exchanging information with those affected and with those in your environment who are also affected. The section “Councel for Families“ shall provide some important pointers on how to deal with each other more harmonious, how to counter prejudice and stigmatization.

Mistakes and misconceptions

A few brief remarks on wording and on widespread misconceptions: persistent prejudices and opinions are an additional burden for sick persons and relatives, along with the real problems they face. The presentation of psychological illnesses and sick persons in parts of the media is also unsettling and alarming. Those affected and their relatives should try to free themselves from this.

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The widespread belief ,“if you’re psychologically ill once, you’re always ill“ is incorrect. It is not rare for the illness to disappear or at least that it can be well controlled. It is also encouraging that considerable progress has been made in recent decades in research and in the treatment of psychological disorders, despite reservations and risks involved, and also as a result of new medication.

The shift from good to less good times is also apparent for chronically sick patients; even seriously ill persons have “healthy islands“ which have to be used for co-existence and dialog.

And yet we still have to criticize that psychologically ill persons are often treated and cared for too late, insufficiently or not at all, and coordination between various therapeutic components remains inadequate.

Widespread prejudices include the idea that psychologically sick or emotionally impaired persons are the same as mentally disabled persons. This is not the case as can be seen when one considers psychologically sick persons who are highly gifted and who produce work, including artwork, of the highest quality.

By emphasizing this difference, we do not intend to demean those who are mentally disabled – we merely mean, that psychologically ill persons require a different form of support.

Such people used to be termed “mentally sick“ and were even killed in their thousands during the fascist era. Today, the term “mentally sick“ is no longer used, we speak of “psychological illness“ and “psychological patients“ to clarify the change in attitudes and findings.

"It’s only psychological ... "

To clear up another misunderstanding: these pages do not involve minor “emotional lows“, as experienced by everyone in the course of their lives, but involve serious illnesses which have a massive impact on the life of the persons affected and their families.

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When we talk or write about psychological disorders, we are not referring to a temporary phenomenon that everyone experiences in their daily lives. Such disorders are often serious illnesses which have an immense effect on the life of the patients and their families.

Fortunately, there are many positive developments. However, a comparatively high percentage of patients suffer a relapse or remain permanently impaired. This means: the life of the respective families develops differently to what they had hoped for, plans and wishes are put to one side, all involved have to experience painful adjustments and learning processes until finally – perhaps – a new balance can be created.

This is the experience made by many families and their psychologically ill members. If you have only recently been confronted by such psychological illness as a relative you may find such a description depressing. You may feel relieved because you recognize your own experience, and your suffering is not glossed over.

In this section we try to find the right tone from relative to relative:

  • We would like to convey information and understanding, without creating illusions, and
  • To illustrate methods of support, without concealing problems.

Concealing the issue is widespread in families – sometimes out of shame, often with good intention, namely of being kind to the ill person or to find more understanding in the environment. The disadvantage of such behavior is that problems and suffering are unfortunately played down, and not taken seriously. “It’s only psychological“, is what many say and mean: “It’s not that bad and if you pull yourself together, things will be alright.“ The effects of such attitudes are far-reaching and are surely a reason for the insufficient support which families often complain of.

Conflicting feelings

It would appear appropriate to speak openly to the psychologically sick person about the conflicting feelings of the relatives. On the one hand one feels understanding and wants to protect him, on the other hand one is angry and frustrated when family life is upset by the behavior of the sick person. You know very well that it is the illness which is the cause of this – and yet it is still difficult to bear, if at all.

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It would appear appropriate to speak openly to the psychologically sick person about the conflicting feelings of the relatives. On the one hand one feels understanding and wants to protect him, on the other hand one is angry and frustrated when family life is upset by the behavior of the sick person. You know very well that it is the illness which is the cause of this – and yet it is still difficult to bear, if at all.

There are many positions which develop in the course of such conflicts. Some relatives take the side of the sick person “against the rest of the world“. Other relatives do exactly the opposite: they are so frustrated and unnerved that they disassociate the sick person. Others fluctuate between understanding and sympathy, on the one hand, and rejection and anger on the other – a nerve-racking roller-coaster of emotions.

The sick persons as well as doctors and other support staff take part in this game and the “buck“ is passed on from one to the other party and back again. All of this is understandable on account of the difficult situation which is continuously changing, but it does not necessarily contribute to finding solutions which are acceptable for all involved. However, that is what the aim should be. The motto of the Relatives‘ Federal Association sums this target up in the sentence:

Living with psychologically sick persons, with confidence and in solidarity.

Let’s take a look at the relationship to professional helpers, especially doctors. It would be wrong to consider those providing treatment with suspicion – at the same time it is also wrong to expect them to work wonders. The doctor as a “God in a white robe“ will certainly not help you out of the misery, but he is an important partner in the alliance against the illness.

The following claim may appear somewhat like an imposition to you, but it is the experience made by many relatives in the past: your most important helper is you yourself! And that is why it is so important that you not only care for the sick person, but also for yourself.

The first step to self-help is information. The more you know about an illness, the better you can handle it, and can understand and overcome its effects. Relatives can contact doctors and other professional helpers, read books and visit consultancy centers. However, when it involves many questions and uncertainties relating to everyday life with the psychologically sick person, the “expertise“ of other relatives is an irreplaceable source of help and information. Find out where a group exists in your neighborhood. If the group is lively and functions well, it can be a huge support in your difficult situation, and can help you to find the right path for yourself.

Ten “Rules“ for Relatives

Questions concerning the„“correct“ way to handle psychologically sick family members are often the initial reason for those seeking advice from the consultancy call centers, state associations for relatives or local self-help groups. No one should expect a simple formula for the solution to a problem from such a conversation; but he may benefit from the experience which others have made in similar situations. In the following we have compiled the most important experiences made by relatives, and summarized them in ten basic rules.

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Questions concerning the “correct“ way to handle psychologically sick family members are often the initial reason for those seeking advice from the consultancy call centers, state associations for relatives or local self-help groups. No one should expect a simple formula for the solution to a problem from such a conversation; but he may benefit from the experience which others have made in similar situations. In the following we have compiled the most important experiences made by relatives, and summarized them in ten basic rules.


They look simple but in reality it’s usually very difficult to follow them. However, it’s worth the effort, because there is a lot at stake for you , your sick relative and your family. Your behavior can help avoid stress and disputes in the family, and ensure a relaxed life together.

  1. Restrict yourself to the most important things and simply overlook some behavioral problems. Set priorities!
  2. Leave the patient alone – too much care is neither good for him nor for you. Do not protect and care for him too much and leave him to have as much independence as possible. But let him know you are there, if he needs you.
  3. Give yourself and the patient time, especially after an acute phase of the illness. Don’t wait impatiently for the “great leap forwards“, but support small steps and be happy about them.
  4. Adjust your expectations and requirements to the situation, avoid overstimulation and overtaxing.
  5. If you want to achieve something (for example tidying up the room), consider beforehand how to proceed best, and wait for the right moment. Express yourself clearly and objectively. If you proceed in an annoyed state or with pressure, you reduce the chance of achieving your target and create additional stress..
  6. Remember that the symptoms of the illness are not an expression of bad will, but the attempt to handle a disturbed manner of perception.
  7. Also remember that, even if he is ill, the patient still has healthy elements and help him to strengthen and develop these elements.
  8. Try to show a relaxed attitude – even if this is sometimes difficult. Seek to reduce conflicts and tension in the family. Ask yourself whether it helps you when you lose your temper or show your frustration.
  9. Take a considered view of medication. In many cases this is necessary and helpful, sometimes over a longer period. Taking medicine is in principle an issue for the patient and his doctor. You yourself can  remind the patient about his medicine, but should avoid feeling responsible for medicine being taken, and should not exert any pressure.  
  10. And finally: look after yourself! Handle your strength with care, keep up with your contacts and hobbies, and spoil yourself from time to time.