What do you do when you’re trying to get your husband to follow medical advice and all you get from him and your kids is grief?Click To Tweet We’ll talk about this and a whole lot more on this week’s podcast, My Family Is Stuck And It’s Killing My Husband.

Today we’re hearing from June and June is from Toronto, and she writes:

Hi Neil,

My husband and I have a 23-year-old son who just graduated from university and moved home and an 18-year daughter who is a senior in high school. My husband's health has been deteriorating. It started when he went to get a colonoscopy and was rushed to the ER with heart failure and atrial fibrillation. He would not return the doctors calls (for follow-up I assume) and the doctor called me and said he is in denial.  (Of course, A fib brings a significant increase in the risk of a stroke.) Later on, he suffered acute appendicitis which had several complications; a perforated bowel, a lung collapsed, and he was in the ICU for two weeks. The kids are constantly telling me I am making this up and they guilt him into buying them car parts. We are in counseling, and I am considered the "Bitch". I feel like I have three children. I am very surprised that my husband is alive, but he is still playing Disneyland dad.

The kids are still playing me like I am bad for making him follow up with the doctors. Any advice would be great.

June of Toronto

 

Now to June’s question:

June, you sure are dealing with a ton and getting no respect or appreciation for who you are and what you’re doing.

It’s like the house is on fire and everyone’s sitting around playing checkers. That must be maddening!!Click To Tweet

The doctor told you that your husband is in denial so I’m guessing he’s refusing to go back for follow up treatment. Although you say the kids tell you that you shouldn’t “make him go”. That makes me think  that you bug him and nag him or perhaps yell at him and “make him go” because given that he is a grown-up, you really can’t make him do anything. Your son is back living at home after graduating college. It’s good that he went to college and graduated, now what?  Is he working, growing towards a career?  

Your daughter is a high school senior. Is she working with her father for car parts too? High school seniors generally are very interested in their social lives and not very interested in what’s going on with their parents.

And you say, “we’re in counseling”, and that you’re considered the “bitch”.  June, who is in counseling, the four of you, just you and your husband?  Somehow in the family and in the counseling environment, you are identified by your husband and young adult children as “the problem” when what you want is for the kids to stop “working Dad for stuff” and take responsibility for their own needs, and for your husband to wake up and take responsibility for his health and stop indulging the kids.

If I’m right about that, that would be completely reasonable, kids and husband should all be more responsible.

June, you say it feels to you like you have three children. I can understand feeling that way but unfortunately, you don’t. You have a profoundly dysfunctional husband and two young adult children. If they were all children, you could be in charge and manage it. Can you be in charge of your 23-year-old son?  Can you be in charge of your profoundly dysfunctional husband?  And while being undermined by your husband, can you set limits and appropriately guide your 17-year-old daughter?   

June, family therapists think about a number of variables when addressing issues. Let’s look at a few of those variables and how they apply with your family.

One is the stage of development of a family. A family interacts in some ways with infants and young children and differently as kids get older. If families responded to each and every need a 10 year old has the same way they did when they were two, that would be inappropriate, right. June, your children are young adults and need to be on their own paths forward. Your daughter is in high school so of course you’re supporting her, setting limits, offering guidance and the things parents do for older adolescents, and if she’s continuing her education after she graduates, you’ll support her in that endeavor as well.  Ending high school and doing what’s next is a huge transition for kids. Your son is 23, out of college, that you may have helped him with, and he should at this point be on his own and supporting himself. If he lives at home, he should be helping out, maybe paying rent, and having a life plan that he’s working on. Certainly not just mooching off his parents and embroiling himself in family dynamics. So the way your family is functioning, is as if you are in a younger stage of development.

Another variable is the structure or the patterns of interaction within a family, the choreography, the dance if you will. In your family there is a pattern where you ask everyone to be responsible, they all see that as you being mean and unreasonable and resist and complain. Next you either nag or argue with them or yell and get mad, and then sometimes when you get upset enough, they do some of what you ask them to do. You say that your kids accuse you of unnecessarily “making Dad go to his medical appointments” and assert that “he really isn’t sick.”  In family therapy terms, what you have is a coalition, with Dad and the kids aligned with each other against Mom. That is the structure or kind of pattern you have in your family.  

Now the other variable to notice here is the flexibility of a family; the ability of a family to change as circumstances require. How responsive are they to therapeutic intervention or guidance?  How responsive are they to developmental changes such as kids growing up, parents getting older or someone getting ill? 

If we look at these three variables together, the stage of development in your family being one of young adult age kids with a quite health at risk father.  An entrenched coalition of kids and father against Mom, and a ridiculously rigid system where the behavior is way outside of reasonable, we have quite a set of challenges here.  

June, let’s take a look on the more positive side. Your son has graduated college demonstrating some maturity and skill. To accomplish that he needs to apply himself, work hard, focus, function reasonably well independently. Your daughter is a senior in high school and planning to graduate I assume. I’m not hearing anything about substance abuse or violence, and they want car parts, so they’re interested in maintaining or decking out their cars. That’s better than a lot of other things they could be wanting money for like partying, drugs, eating out, fun, fun, fun

Other positives are that you are in counseling with your husband and maybe all of you. That’s impressive and hopeful. Either your husband and the kids are complying with your request to go to counseling or the family pattern where they complain and resist, but you get upset enough and they comply is getting everyone to the counseling office. Maybe they don’t like how things are and perhaps want you to be less upset and demanding or realize that they need to do some changing. And then of course, you listen to my podcasts and are reaching out for guidance, so you want change and that’s promising. So, June, there are positives here and there is some opportunity to address these issues.

It seems June that you are the main person wanting change so we can take a look at your participation in the choreography, the repetitive pattern in the family, and if you have the flexibility to shift out of your normal way of moving things, and try some new behaviors, we can see what happens next. It may be that you can only save yourself, but maybe you can lead the family in a new and healthier direction.  

You say it seems to you as though you have three kids and you’re right.  Your family is functioning as if you are the parent in the room and the other three are your children.  What happens if you stop being the parent to three difficult children, and start being an adult with your husband, and the kind of parent appropriate to one’s young adult children, differently from parenting our pre-teens. What happens if you no longer worry about who thinks you’re the “Meany Head”? I like that better than the “B” word, and you set limits without getting mad or upset. I don’t know exactly what’s going to work in your family since I don’t have a lot of details, but you can start by talking with everyone with a clear strong voice. 

What happens when you say you are no longer buying into being called a name or being accused of being unreasonable.  What if you told your young adult children, “I have no interest in needlessly pushing Dad to go to medical appointments. His doctor contacted me directly and said your father is in denial, and he needs my assistance in helping him get critical health care. Your Dad was in the ICU for an extended time because he was gravely ill, and he has several risk factors that need to be treated and monitored. There is no place for childish thinking and fooling around with this. I have a real challenge getting Dad to be responsible for his health. You joining him in not taking care of his serious condition is making my job harder and is supporting your father in an early loss of function, a stroke, or death. You need to knock it off.  This business of good parent and bad parent and I’m the bad parent because Dad is soft and gives you money and I get pissed about it, is childish and ridiculous.  You know how to manipulate your Dad, and you know damn well that it’s wrong.”

June, some ways you can be strong and serious without getting upset are:

1. Make sure you have their attention before talking.
2. Don’t talk across a room.  Be close.
3. Be calm and clear, not emotional. 
4. Talk more softly than you normally do so that it changes the tone, and we want change. And it makes them listen more carefully to hear you.

Now to your husband, using the same change in your approach except you talk to him as your partner and friend.  Once again, not emotional, or blaming, or dramatic; simply clear.

“You have a serious medical condition that puts you at risk of stroke and death or loss of functionality. Your doctor has asked for my support helping to get your cooperation and compliance with treatment. There is what I can do, and what I can’t. I can help you keep track of your appointments, at least for now, and I can help with reminding you to take your life-saving medication. I can’t make you do anything and I’m not going to treat you like a child. It’s disrespectful of you, it’s horrible for our young adult children to see us acting so childishly with each other and it embroils them in our issues. It’s also unhealthy and disrespectful of me to allow myself to be put in that position. I will remind you that if something were to happen to you, and you had a stroke and lost much of your functioning, you’d be putting me in a position of needing to be your caregiver, and it would be horrible for our kids to needlessly lose an abled Dad, or not have a dad at all. So, you have an obligation to yourself and your family to be an adult here, and to be responsible with your health.”  

There’s something I want you to see here June. You very much want your husband and young adult children to change here. Of course you do.  In order to facilitate that change, the pattern in the family needs to change and since you can’t directly change anyone but yourself, when you can see your personal participation in the dysfunctional family pattern, and end your participation in the pattern, then the pattern changes and that opens up the best possibility for others to change. When we try to change others, they resist change. That’s a Control Battle. When we change ourselves, it opens up the opportunity for others to do so as well. 

So parents, therapists and folks who work with families, June gave us an opportunity to learn or review a few of the variables that family therapists need to think about. 

1. What is the developmental stage of the family and is the structure of the family appropriate for the developmental stage? 
2. What is the structure or pattern of interaction in the family that supports the problem? 
3. What is the level of flexibility of the family to respond in a healthy way to problems and changes in circumstances?  

Then, at the end of the day, to effect any change in others, we need to change the pattern of interaction that’s been established. And to accomplish that, we need to change our participation in it. Click To Tweet

Thanks for tuning in listeners and special thanks to June for sharing her very challenging situation with us and we all wish you and your family the best June. 

Before we close, let’s do this together, take a slow deep breath, hold and then exhale very slowly, ready?  Inhale through your nose, 1,2,3,4,5,6,7, good, now hold, 1,2,3,4,5 and exhale very slowly 1,2,3,4,5,6,7,8,9,10.  One more time,  inhale, 1,2,3,4,5,6,7, good now hold, 1,2,3,4,5, and now exhale and send your stress away.  Are you remembering to slow down and breathe and do other easy positive things for yourself? They’re important because as I’ve said many times and I’ll say it again, this parenting business ain’t easy so self-care is essential; you need it, you deserve it, you’re worth it.  Bye for now.