Set boundaries for dealing with sister's mental illness

Q. I don't know how to help my troubled sister. She has been fighting the world since she was a little girl.

She is so unhappy and stops speaking to friends and family members, including me, on a rotating basis because we have disappointed her or stood up to her.

It is always someone else's fault, and she doesn't see herself as the common denominator. I have learned I can't fix this for her and any advice I provide puts me in the hot seat for an hour or so of verbal beating.

I love her because she is my sister, and I won't abandon her as several of her close friends and family have. I know it is hard to be her and I am sad this is her life.

I think the only thing I can offer is to listen to her problems, which are many and daily. I would tell her to go see a therapist, as this isn't what I want to do anymore, but she has chased them or bullied them all away.

I have set boundaries and don't always answer the phone, but feel occasionally I should reach out and call. But then it is another hour of saying "uh-huh" as she tells me her current troubles. When I cut her off and say I have to go, I feel guilty, even though I am so often on the receiving end of her venom.

I guess my question is, how do I stop feeling so sorry for her? And is there anything I could do to support her better? She is married with grown children, but that is another story I can't fix.

Broken Sister's Little Sister

A. Standing by her is a thoughtful gift you're giving your sister.

Note: Gift. You are not making good on an obligation or repaying a debt. Unless, that is, you see kindness to the afflicted as a cosmic debt we all would do well to pay I'd agree, within limits.

But even if that's the source of your guilt, please know you can be kind and boundaried both. They're not contradictory. In fact, listening without limit isn't support, it's enabling; unloading on you satisfies any need she has to talk, thereby rewarding her choice to reject the much harder work of therapy.

That your sister has been - and bless you for this phrasing, it's perfect - "fighting the world since she was a little girl" does aptly convey your sense of futility, but it also suggests you're in over your head in trying to help.

To support her at this point, consider a session - or three - of professional help for yourself. It's unrealistic to expect families to both diagnose and respond helpfully as laypeople to someone's mental and emotional challenges.

So while you can certainly tweak your current approach, consult your conscience and patience, make a sparser call schedule, set shorter time limits, follow meticulously. There's no substitute for an informed understanding of what you and she are up against.

A call to the National Alliance on Mental Illness helpline (1-800-950-6264 or nami.org) is free and might be all you need. Your guilty feelings, though, hint at deeper entanglement, in which case your family doctor can likely start you off with some therapists' names.

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