I think the best, most healthy attitude is an optimistic one in which we think positively and to try to look for the good things in life rather than spending a lot of time worrying and complaining about the negative experiences. That’s a great idea in principle, but not always the easiest thing to implement in practice.

For example, recently I’ve been dealing with a few fairly difficult situations—I’ll write about one of them here. I have an uncle who suffers from paranoid schizophrenia. He lives in the unit directly above mine. His behavior, some of it undoubtedly due to his illness, is becoming almost intolerable. He refuses to take all the medication that his doctor prescribes for him. He does take some of the meds, but he does not take them as prescribed, so the medicine does not have a chance to provide its full benefits.

I believe strongly in every individual’s right to self-determination, which I see as a fundamental human right. While I remain dubious about the degree to which government can and should guarantee such a right, I also believe people have a right to have competent health care available and to be able to make reasonable and informed decisions about the various options for kinds of health care. However, I also believe strongly in other sorts of individual liberties and those include the rights to be free from harassment, abuse, property damage, or undue damage to one’s reputation; to earn rn a living in one’s chosen, trade occupation or profession; and, perhaps most simply, but fundamentally, to get a decent night’s sleep that is free from constant noise, shouting, pounding on pipes, and irrational ranting.

A problem with my uncle is that he does not follow his treatment plan as prescribed by his doctor. Mental health care in the United States has come a long way since the 1960s when I was a boy and first experienced my uncle’s tortured, irrational, and sometimes dangerous behavior. One can argue that the changes in mental health care have been beneficial or detrimental to both the individual patients on the one hand, and their families and society as a whole on the other hand. However, the law of cause and effect indicates that if one does not follow a competently prescribed plan for medical treatment, then one will not derive the benefits of that treatment. So it’s no surprise that someone like my uncle, who does not take his medication and does not make use of any of the universe of support services that are available to him such as regular psychotherapy and support groups, is not going to get much relief from his condition.

I’m a man who believes strongly in the right to individual autonomy and self-determination. My uncle is free to take or not take his medication to follow or ignore his medical treatment, as he chooses. However, I also believe that being a responsible adult in a free society carries with it the duty to avoid infringing upon the rights of others. As I see it, my uncle is a free and autonomous adult agent, making his own decisions, but he also has to accept the effects that his decisions cause. In other words, while he’s free not to take medication, he’s not free to stay up all night, damage plumbing, make noise nonstop, and disrupt my sleep. That’s not right and I need to do something about it. The solution won’t be easy—and I need to be cautious lest the cure be even worse than the disease—but ignoring the problem won’t make it go away.

This is obviously a very complex issue that has deep roots that extend further back in time than my being a person on this planet. I’m not going to be able to explain all of the subtleties in a blog post and am certainly not going to be able to arrive at a solution here. My uncle’s situation has troubled me deeply over the last year and caused me a lot of difficulty and even hardship for the past year. (I won’t even discuss in detail the severe harm that his behavior helped cause me when I was a young boy; it’s far too painful to describe here. His illness and ongoing failure to comply with treatment made it easy for my SA to be overlooked.) But because the situation has caused a great deal of stress, and cost me several thousand dollars already. I need to find a way to deal with it that is respectful to him but, even more importantly from my perspective, that honors respects me, has its paramount goal to allow me to live my own life in a reasonably content, peaceful manner, and to pursue happiness. After all, if we don’t pursue happiness in this life, why are we here? There’s plenty of suffering in life, and no matter how we rail against life’s vicissitudes, we do not have a perfect world. So my concern is really me first. I need to make myself happy.

To paraphrase something I’ve heard over the years in many different support groups, I didn’t cause my uncle’s illness, I can’t cure it, and I can’t control it. I spent many hours trying to get information and support that would help my uncle, but he refuses to use any of it; he just dismisses it summarily. I lost several weeks of work during the summer of 2007 trying to be supportive to him during numerous all-night conversations riddled with paranoid delusions, and to connect him with various social services that could help him. He rebuffed my efforts. Even worse, he paid back my kindness and compassion with slander, threats, hostility, and extreme verbal abuse.

I’m done. Making me crazy or ill is not going to help my uncle one bit. Moreover, continuing this kind of care-taking behavior will, if unabated, lead me down the road to ruin. I’ve been down that road a few times in my life, and it’s not where I want to be. A while ago, on my previous edition of this blog, I stated boldly that the business of life is really very simple: to love ourselves. Developing the ability to love ourselves, genuinely, unconditionally, and in a way that comports with the rights of other beings and promotes harmony in our world and in the universe is probably the work of a lifetime; it takes a lot of practice, as I am learning. Nonetheless, I am determined to accomplish this business of life, this raison d’être of our human existence as I define it.

I still have compassion for my uncle; I’m deeply saddened to see him suffering. However, until he becomes willing to take his own steps toward recovery and living a happier life, there is nothing that I, my extended family, or anyone else can do. He has managed to alienate most of his relatives and several of them, including me, can no longer have any direct contact with them, because the experiences are so unpleasant and the emotional fallout from them is so severe that living a normal life becomes very difficult as I have more contact with my uncle. While I have compassion for him and wish him well, I have done all that I can. And I need to let go. If I don’t take good care of myself, no one—and I really mean no one other than I—can do that for me. At the risk of unintentionally appearing melodramatic, I’ve come too far in my life, overcome too many obstacles and barriers, and worked too hard for me to give in and allow some other person’s behavior to cause such harm to my life. I won’t do that.

I’m letting go. Yes, I’m doing that as compassionately and lovingly as I can, but I am doing it. Uncle J., I release you into the universe, into the hands of God, and wish you well. I am no longer available to try to do for you the things that you are not willing to do for yourself. I hope you will follow your treatment plans much more consistently and use the help that is available to you, but I can’t do that for you, and I’m no longer going to try. I’m putting an end to this particular cycle of Nice Guy behavior, and moving forward with my life. I’m focusing on getting my needs met, making me a priority, and taking care of myself.

I recently looked at a baby picture of me taken when I was about six months old. It’s a black-and-white photo and I’m propped up against something that looks like a pillow—probably because I’m still too young to sit up well on my own. My left hand is at my side, and my right hand is clutching a small stuffed animal: a fuzzy little dog that has eyes bigger than mine and a very happy expression on his face. Dressed in a white cotton shirt, white shorts, and white baby shoes, I’m gazing forward to my right. My chin already bears the cleft that I have as a grown man, my hair is combed in a way that bears a striking resemblance to the way I comb it today, and, looking deeply into the face of the little boy, I can already see the face of the man he will be about 44 years later.

When I look at this photo, I see a boy full of the potential of becoming anything a human being can be. I also see that he is vulnerable; he needs protection and good care—things that he deserves to have. Guess what? Dad and Mom are no longer in a position to protect and care for that little guy anymore. Oh, they still love him are remain important in his life, but now it’s up to me to provide those things for him.

As I continue to look at the photo, at the little boy, the baby who delighted his parents so much when he was born on the Thanksgiving Day last preceding the taking of that photograph, I see that the boy and I are not the same. Looking at photos of him and me today, though, you would see the similarities I have mentioned, but you would also see a lot of contrasts between that boy and me. At the same time, you cannot really say that I am different than this child, because without him I would not be here today. I suppose you can say that I am the continuation of him. If I am his continuation, and he deserved kindness, protection, in good care, then how can I deserve any less? Indeed, I do deserve kindness, protection, and good care. I am now in a time of my life when I can provide those things to me. And I shall do so with vigor, with enthusiasm, and with no apologies.

Amen men, I wish I had your stregnth, best to you bruddah.

What more is there to say? You set your boundaries and you're sticking with them. Yes, it's time to take care of yourself, others may help you on your way, but, in the end, it's all up to you.

You're right Hauser. It may be an effect of the SA, but I have learned that I am pretty much the only one I can rely on.

I've been on both sides of this type of coin, in the sense of acting in such a way that others close to me say, "Sorry, but i just can't do this anymore", and also having to say the same to others. I had a schizophrenic friend many years ago, and he ended up becoming far too unpredictable for me to continue being in his life; i've had to drop other friends like hot potatoes, when hard drug addiction on their part, and their subsequent behaviors, left me no choice in the matter. Many of those are dead or locked up now- after family and friends of theirs, in far better financial and mental shape than i ever was, drained themselves dry, trying to plug a "black hole", so to speak.
I'd say your attitude is exactly what it should be.

Thanks, dgoods. I think it can sometimes reach a point where we have to operate from a perspective of self-preservation.

Hi zen
This hit home for me too
My mother was diagnosed paranoid schizophrenic back in the 60's
I had to stop all contact for similar reasons

I hope your decision "leaves no ash"

And as you pointed out in a one-way reference to yourself zen, I would add that your Uncle is, HIMSELF, OBLIGATED to take care of and help himself. That means taking his meds and following through on treatment, etc. It's not just his family and friends that are responsible to look out for him. You’ve done YOUR part Zen, and THEN SOME! I think it would be unreasonable for anyone to ask any more of you, and I think you’ve come to realize, with great insight I might add, that its now, at this point, against your best interests to expend any more than a minimal amount of energy for your Uncle. Let someone else step up to the plate now. You have this thing called your life to deal with right now.

ineffable, I am sad for you. How painful it has to be. I know a little of that. My mom is a SA survivor and rape survivor in adult life. She also has severe depression/bipolar and alcoholism. It is very sad.

Hauser, you are right. Thanks for affirming my sense that what I am doing is the only workable approach.

I am very glad you taking care of yourself, and to realize you are not responsible for this other adult person. It is more 'affirming' I think that he be responsible for hiself anyway, and it is not something you should need to do.

VN

I liked that, Zen,

I really think that there an end to caring about an adult person who can potentially carry for themselves and try to live a good life.

Self-preservation is, in this matter, a common-sense deed, and I am glad you made this decision and stopped torturing yourself about the questions you could not solve.

Alexey