Three Legs of a Triangle

This piece is a gift from Replanting Lives author Nancy Pizzo Boucher

If you have a loved one living at home with you who has a serious mental illness, you will likely have times together as a family when  illness symptoms flare and lead to a crisis situation that is tumultuous at least and tragic at worst.

Our son had his first psychotic break 23 years ago when he was a freshman in college . Except for a few months in the beginning years of his illness, he  has lived at home with his dad and me since then.

In support of families dealing with a loved one with  mental illness crises at their homes, I want pass along to you practices that we have learned as a family to do. These practices have kept us alive and going forward together,  and minimized the suffering for all.

The conceptual framework that I use to hold  our practices is a triangle.

A triangle structure predictive of escalated and serious outcomes  in crises in a home  has these 3 legs :

1. proximity opportunity and access to things that could be used a weapon

2. family member with serious mental illness experiencing illness symptoms which can have a level of emotion that is disinhibiting , driven and impulsive –

symptoms such as : paranoia, delusions, and confused thinking

3. person / persons present in the home for the loved one in crisis to outlet his/ her intolerable internal distress ontoIf you take away even one leg of the triangle  described above, the level of violence is de-escalated,  and tragedy is diminished.

Family members have some  control over legs 1  and 3 of the this potentially explosive situation and thus hold a key to greatly weakening/ diminishing the probability of injury .

As parents, here is how we addressed leg 1 of the triangle:

We began to look at anything in our home  that could be used as weapon and remove it far enough out of sight and impulsive reach. For example, we got rid of our knife block on the counter and moved  our knives into a holder in a drawer.  We vigilantly put any tools like hammers etc. that were  being used in house fix it projects away after use.

As parents, here is how we addressed leg 3 of the triangle:

We left the house  as soon as serious symptoms began flaring and our son began using threatening words.  When we first began this practice, we verbalized to our son the following:  We are so sorry not feeling well, you are having serious illness symptoms, your words are threatening and your behavior is not safe. Use one of your cool down strategies. You can calm yourself down. We believe in you. We love you always. Call us when your mind has cleared and it is safe for us to come home . When we realized  that verbal input was way too much for him, we transitioned to just leaving the house quietly, and leaving a written note  with the same basic  messages- then off we’d go to Denny’s all hours of the night!

In essence before we left,  we administered what I call family CPR.  Some of this guidance I learned from our son by seeking and listening to his direct feedback when he was not symptomatic and his mind was clear, and  by being  attentive to his reactions .

Family CPR:

Compassion:

Parental Guidance:

Reassurance:

Direct family education about practices such as our family uses is a proactive and preventative step that could make a critical difference in outcomes for family and for their  loved ones who suffer with a serious mental illness. It shouldn’t take a great deal of funding, but it could have a huge positive impact.

peace and goodwill Nancy Pizzo Boucher