It is important to start with the understanding that everyone thinking about and desiring to have a family is not only with great expectations but with many hopes and aspirations. Unexpected events result in shocks and traumas impacting everyone and each family system based on many factors including individual and/or family system resiliency.

Couples and families go through stages in their own life cycle. These phases and stages are somewhat universal, but also unique to the characteristics of the individual, their support system, as well as their own resiliency and emotional fortitude. No two couples, like no two families, are exactly alike.

When there is realization and/or news of any kind of abnormality or unusual concern, it shakes the foundation of the family and extended system.  Often on a short-term basis, this system halts to absorb the shock.  Many times, it starts with a disbelief that something is not “NORMAL.” Difficulty accepting the emotional shock puts many things on hold and may even derail the regular course of development for the children as well as the couple and the extended family. The family needs to focus diligently and dedicate a great deal of effort and time to addressing and recognizing the situation and trying to cope. In at least some situations, they may have to make permanent adjustment to the irreversibility of the condition(s). Siblings, older and younger, if present, not only need to understand at their developmental level, but their course of development and emotional needs may be affected by the needs and demands of the family member who is not well.  Many times, they are not able to verbalize effectively how they feel about the changes in their family life.

Mansour (Max) Banilivy, PhD

Any change requires an appropriate explanation to the children at their level.  Often the couple’s and family’s focus and time may unintentionally be solely focused on the care of one family member at the expense of some others. Trauma response, physical and emotional exhaustion could and does result in burnout.

There are many nuances to these dynamics.  Behavioral and mental illnesses present their own unique challenges based on lack of understanding, stigma, myths and, in some cases, a “perfect” cure.  Although some have their roots in childhood with a genetic and organic cause, others do not fully reveal themselves until sometime in childhood or adolescence.  The expectation and need for a clear and real explanation (as well as a cure, if applicable) are quite understandable; however, this is not always available and more rarely on a short-term basis.  Often, diagnoses are not clear, are provisional, or there is no agreement among professionals. Families can have a different perception of the problem which results in different reactions and expectations.

Psychological and emotional challenges have similar and different impacts on the families compared to physical, medical, and developmental disabilities.  There is a wide range of challenges and ongoing consequences that many must deal with and address.  For some, unfortunately, it becomes unresolved grief, loss, and unfinished business indefinitely.

Some of the specific consequences can include despair, sadness, worries, anxiety, anger, shame, helplessness, guilt, frustration, disillusionment, compassion fatigue, and hopelessness.  At times, it may include wanting to give up on life as the pain and the trauma become unbearable.  The toll and the long-term consequences for the affected individual, and the rest of the family, can be unpredictable and often negatively affect the quality of life for many.  This can result in unintentionally neglecting and overlooking other needs.

An older sibling once said to his parent, “I will give my right arm if my sister could be normal again.”  The parent answered, “Unfortunately, nothing can make her normal, but we still love each other and are a family”.  We can all collectively help the one needing more assistance.  There are many kinds of opportunities.  Our reactions and adjustments to traumatic experiences are quite varied and a function of many factors.  Many unpredictable negative events happen to a large portion of the population.  Lifetime implications necessitate not only one adjustment, but many adjustments.

SCARS REMAIN BUT WOUNDS CAN HEAL.  It is essential that collectively we maintain our focus on the fact many families are under emotional duress and that “MENTAL HEALTH MATTERS”.  Family members may need to develop new ways of taking care of themselves, relating to others and incorporate lifestyle and standard of living changes.  On the positive side, many families do adjust and become resilient as a result.  It is essential that we learn from them to help others.  Key factors that families need are readily available professional and supportive services and education that is compassionate and factual.

Mansour (Max) Banilivy, PhD, is Director of Clinical Training, Education and Internship Placements, at WellLife Network. You can reply to


Sederer, L.I. (2015). The Family Guide to Mental Health Care W.W. Norton & Company

Rosalyn, C. (2011) Helping Someone with Mental Illness: A compassionate guide for family, friends, and caregivers. New York: Three Rivers Press

NAMI (National Alliance for Mentally Ill) local chapters:

The post Ask Dr. Max: Family Life Cycle and Mental Illness Challenges appeared first on Behavioral Health News.

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