My mom is mentally ill and it's tearing the family apart

Dear Cary,

Nearly five years ago, I realized that my mother was suffering paranoia, delusions, hallucinations -- basically, from some form of schizophrenia. I confronted her, wanting to help; she vehemently denied having a problem, saying that it was my father and her mother-in-law who were to blame. Over three years ago, she had a psychotic break, trying to kidnap my teenage sister and run from "them"; over the phone, I convinced her to check herself into a mental hospital, which I am very thankful that she did. A few weeks of treatment later, she left and threw away her medication; a few Christmases ago, she had another break, and this time, spent a month in a residential treatment program. Again, once she got out, she threw away her meds, insisting that it was my father, me, his family, neighbors and her friends who were hurting her, poisoning her and trying to drive her crazy.

She lost two jobs because of her illness; she also drove away all of her friends and many of her relatives. My father stayed with her despite her illness, and struggled for years to keep her on medication and in treatment; this past spring, my mother again threw away her medication and stopped therapy, and her doctor told my father that her chance of recovery was slim.

She does not want to get better, and nothing that I, my father, my sister or her family has said has convinced her to get better. I've lost nearly all hope that she will ever recover, and have exhausted every possible idea that I've had about how to help her. I want her to be well: I want my mother back. But I also have to accept that this is not my choice, and might not ever happen.

This summer, my parents finally separated after 25-plus years of marriage, and my mother chose to move across the country to be near her family. My father supports my mother financially, and visits her once a month; he hoped the separation would wake her up and convince her to get treatment, but again, it hasn't worked. My father is trying to be strong, but he's a wreck; he still feels responsible for my mother, and I believe he feels guilty about her being so far away. However, he has struggled with her and her illness for years, and could not continue to live with her knowing that her illness was getting worse and that she would continue to refuse to get better. I support his decision completely; my sister does not. She says that he took a vow to be with her in sickness and in health; I say that my father was being destroyed emotionally, and that sacrificing him to my mother's illness would be devastating.

My sister and I have both suffered years of emotional abuse by my mother: But how can you blame someone for abuse when it's illness that's making her do it? I have stopped seeing my mother and returning her phone calls because her illness is getting increasingly worse; I can't bear to get hurt by her anymore, and I can't watch her tear herself apart, thinking that I can do nothing to help her. My sister says that I am heartless for cutting myself off; she herself has only occasional contact with my mother, but gets furious when I try to explain why I just can't see her right now. The issue of our mother is damaging our relationship, and I'm not sure how to stop that.

My father understands how I feel, and reminds me that she still loves us. Maybe there is some part of my mother that is still there and can still love, but I can't see it because of all the hurt she has caused our family.

I realized three years ago that my mother, the one I knew and loved when I was a child, is gone, and probably forever; and I cannot find a way to make peace with what is left of her and keep her from hurting me again. How do I talk to my sister? How do I deal with my mother? How do I help my family heal? And is there really no way I can help my mother get well?

Hoping Against Hope

Dear Hoping,

These are indeed the questions that a good, intelligent person, beset with such difficulties, would ask. They are the kind of questions you ask when it has all gotten to be too much and you have left the dinner table to walk out into a field and look up at the stars.

And if there were a personage of sufficient wattage up there in the sky listening, perhaps he would give you answers big enough to match your questions. Or perhaps he would even divine your innermost wishes and simply make everything right. But I can't do that. I don't have the wattage. I can give you some small answers, though, and a few reminders and suggestions. And I can talk to you like a friend, which perhaps will be helpful too.

So first of all I just want to say that I sympathize with you and I can imagine how terrifying and maddening it must be to be faced with a mother who has lost her mind, who cannot be trusted to take care of herself, who seems dangerous and out of control. This reaches deep down and affects us in ways we are scarcely ready to be affected. So my heart goes out to you.

As to what little answers I may have, they are answers that have been given before and no doubt will be given again, as certain universal principles of action seem always to apply: