Important information for relatives

The situation of relatives

From social exclusion to a trialogue

For the longest of times, those closely related to the individuals who are affected were dismissed by those active in psychiatry as being disturbing or as actually being the cause for this illness.

Over the course of many decades, biological or social theories were proposed which discriminated against these people in different ways: Whether one would consider schizophrenia to be an hereditary illness or viewed the mother as having schizophrenic tendencies, both being types of reductionism (simplification), would eventually bring a burden to the families. The self-organisation of the releatives of those suffering from these illnesses then began and was followed, in around 1980, by the grounding of interest groups.

These people wanted to and still want to make a change, not only in the psychiatry and the situation for those affected, but also in themselves. All of these groups are linked to one another. Psychosis seminaries or trialogue forums help to organise the exchange between these three groups on an equal level: Their meeting with experts, their reciprocal, advanced training, the improved perception of the different subjective perspectives, the breakdown of reciprocal prejudices, before one can then work together against the public prejudices.

From accusation to solving the problem

This initial phase was facilitated through the book "Freispruch der Familie" (literally, "The Family Acquitted"; Dörner 2001): The allocation of blame being placed on the families could hereby finally be put into question and then discarded. Psychiatry confessed their guilt to the relatives: Schizophrenia is neither inherited genetically nor brought about through certain styles of communication. After the realisation that emotional excitability (high expressed emotions) in the family can be related to the frequency of relapses, the possibility of a far too one-sided classification threatened to develop once again: Does the excitement of the relatives lead to the relapse or is it the (dreaded) relapse that leads to the excitement? The truth is just as simple as it is unspectacular: When people live closely together and additionally also feel close to one another, there is an interaction between all parties involved affecting the psychic experiences and the emotional health interactions, and these can, in part, be constructive or also unfavourable. These interactions are of particular significance if one or more of the family members are (psychologically) ill, but also when all of them are healthy.

Relatives demand more support

In the meantime, it is indisputable that family members require support, precisely as demanded in their role as a parent, child, sibling, partner or friend, and corresponding to their age and the state of their relationship - in common or individual conversations, in groups of those who are affected or in psychosis seminaries, in which several experienced individuals, closely related persons and experts learn together, jointly from one another. In addition, accompanying helpers must discover the "social space", take care of this and also involve them. This is necessary, because patients always spend more time at home, outside of the psychiatric environment. So that this reformation will not take place at the expense of those who are closely related, the aid must occur by making use of an "interdisciplinary structure" (independent of the state of the therapy), with more flexibility and mobility. If not only long-term but also acute help in one's own living space are possible, admission to a clinic can be avoided for the most part. The treatment of psychoses and bipolar disorders without including the relatives is tantamount to malpractice.

The self-help of relatives

Since about 1980, the self-help of those relatives of psychically ill patients has developed progressively. There are several organisational stages available:

Self-help groups for relatives: Unadulterated self-help groups consist exclusively of relatives without professional support. Aside from this, there are guided groups with professional guidance which are generally associated with institutions (clinics, sociopsychiatric services, etc.). Family groups serve to provide relief through conversations with persons in the same conditions of life, who exchange information about medical and social questions as well as their own experiences. Addresses of family groups can be obtained from national organisations of relatives, from self-help contact sites, clinics and other facilities.

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