Dear family (personal, extended, and cultural),
As you know over the past few years, some members of our family, myself included have experienced emotional/mental difficulties and or illness that has resulted in the necessity of counseling, medication and in some cases hospitalization. Some of these challenges are well known to the extended family and some are not and only include the knowledge of a selected few. As a part of the process working with some family members to ensure they are taking advantage of the medical and therapeutic supports available, family meetings, side discussions and email epistles have been had by some members of the family as a way of support, disclosure, and venting. For the most part, those conversations seem to have assisted in the therapeutic/supportive process of caregivers, siblings and spouses. One concept that has been a consistent among some of those is that mental difficulties and illness are a result of our family history or more concisely due to genetics. I have been a bystander with many of these discussions and some of those comments have been a result of my own battle with mental illness throughout my life. While in observation of these discussions I found myself focusing less on constructive contribution to the discussion and more on the feelings of shame and guilt related to what I supposedly [genetically] received from our parents, grandparents and so on, lived with and then as a result of the miracle of life passed on to my own children. This has been emotionally damaging to me, and I believe others. As a result, I have reflected on the possible motives of such a statement from family, in-laws, spouses, etc. I cannot figure out any other motives other than bias, ignorance or the basic absence of compassion. Is it nature that is to blame? The dominant gene that is passed down from generation to generation? The World Health Organization (2001) argued for the perspective of genetic complexity (instead of genetic predisposition), in which multiple genes act in concert with non-genetic factors to produce a risk of mental disorder, or the vulnerability of such. This is a powerful statement because, for me, it has removed ill-informed finger pointing from family history to the complexity of genes and environmental factors that create a risk of mental difficulty or illness and not directly causality of such.
Consequently, being raised in a family that has such a strong focus on literal belief and adherence to both formal and informal cultural sets of rules seems to foster a complexly novel set of factors to be considered. Meaning, our culture has had past of avoiding and even demonizing psychology and psychiatry (see Mormon Doctrine and its link of psychiatry to the Church of the Devil). Interestingly, though, Utah the epicenter of Mormonism has been recently ranked as having the highest rates of mental illness in the United States, with 22% of all adults experiencing mental illness at some point in their lives (www.dailyherald.com). That’s an astounding number. I now question the influence of our family’s physical, social, cultural, and attitudinal environment upon my past and current psychosocial wellbeing. As I have thought about it, it seems that other risk factors or vulnerabilities may be just as, if not more powerful influences on the psychosocial health of myself and our family. These would include but are not limited to culture/subculture, negative or toxic family relationships, shaming (private, public, institutional) employment/productivity stressors/demands, the absence of health/healthy lifestyle, emotional, sexual, physical or institutional abuse, chronic physical illness, the lack of or excessive sensory stimulation, lifestyle changes, etc. What is even more poignant is that I function in a rich environment within the Mormon faith tradition to which it seems less than compassionate to pull the genetics or familial card when it comes to the reason, purpose, or prospect of mental difficulty or illness. Specifically, many of the acute and chronic episodes of mental illness in my life and in those around me may be so vividly related to the milieu of Mormon subculture or even policy or doctrine yet those seem to be quickly ignored. My personal perspective is that such a statement or mindset is ignorant, lazy, a scapegoat, and unaccountable of other just as valuable and significant contributors to the condition and experience, so I took a brief look at the peer-reviewed medical literature. It is quickly evident how mental difficulties and illness might emerge as a part our human experiences.
As a part of that exploration, I would like to present what I discovered in a simulated context of an LDS congregation, likely in many of the areas I have lived in. Let’s say that many of you attend a congregation where an average of 263 members attend each Sunday’s sacrament service. According to the National Institute of Mental Health reports, 46.4% of American adults will suffer from some form of mental disorder throughout their lives. That’s “throughout” and not just “at some time” in their lives. 120 members who are attending our sacrament services is almost half. Additionally, 4.1% of those are serious mental illnesses or: “A mental, behavioral, or emotional disorder (excluding developmental and substance use disorders)…resulting in serious functional impairment, which substantially interferes with or limits one or more major life activities.” That would equate to an additional 10 members who regularly attend sacrament meeting. Wow, those or some amazing numbers. They don’t make as much sense when the only argument used is that of “ mental illness runs in the family”. However, when the numbers are viewed through the lens to of mental illness having its roots in biological, personal and environmental vulnerabilities and risk factors. I also thought about the demands that are placed upon us as humans, the demanding and unnatural environments in which we live, the stressors we apply to myself (1st world problems) and stressors that are imposed via work, school, family, culture, and religion. When I have been thoughtful and reflective about those valid yet significant factors, and have a bit of self-compassion, it is not as surprising to see how many of us as family, neighbors, coworkers, church members struggle with mental illness.
Yet, in an effort to create angles for teaching moments and awakenings, aspects of control and responsibility have come to mind. I or we cannot control our familial risks/vulnerabilities related to any inheritable diseases. The genetic imprint is just there, immovable. Yet there are some actions to counteract or minimize the possibility of mental illness, and reduce the condition/experiences impact upon family members, spouses, and the family’s culture. One concept I have been ruminating in my mind for some time is the ability that some family members are resilient in spite of challenges. Some individuals, siblings, and families have this ability. And some members of our family seem to exemplify this. The concept of resiliency is best described as the protective factors that a person at all stages of development has in order to ward off the effects of risk or harm. The term embodies other behaviors such as a person’s hardiness, sense of coherence, learned optimism, and successful adaptation to challenges (King, Brown, & Smith, 2003). Its seems developing or enhancing our family’s ability to be resilient in spite of the risks or vulnerabilities related to mental illness seems to be paramount, as opposed to merely accepting our family history or being fearful of the future possibility of an acute or chronic mental illness. That being said, our family tends to be one of action and doing, therefore the time to change biases, bigotry and perceptions and transform them into informed understanding and compassion is now.
To solve this problem, we should put into action these behaviors:
- Refrain from making unfounded statements related to family history and mental illness, understand the data and facts (http://www.nami.org/#).
- Consider the possibility of the increased risks and vulnerabilities that may be a result of family maladaptive relationships, abuse, neglect, religious doctrines, policies and practices, maladaptive cultural norms, and expectations. One many need to accept those possibilities as a concrete reality.
- Identify, discuss, plan, implement, and repeat practices, relationships, activities, etc. that foster and enhance a member of our family’s ability to be resilient in light of, or, in the absence of any doctrine, policy or practice.
- Practice self-care – we live in a culture where it is the expectation to put others first, yet we need to consistently tend to our own needs as well.
- Be proactive with how we feel, identifying what we need, what we want, create a plan of action.
- Make every day meaningful. Do something that gives us a sense of accomplishment and purpose every day. Set goals to help us look toward the future with meaning and hope.
- Learn from experience. Think of how we’ve coped with hardships in the past. Consider the skills and strategies that helped you through rough times. You might even write about past experiences in a journal to help you identify positive and negative behavior patterns — and guide your future behavior.
- Remain hopeful. We can’t change the past, but we can always look toward the future. Accepting and even anticipating change makes it easier to adapt and view new challenges with less anxiety.
I would like to thank you for taking the time to consider this letter. I love my family, they are such a meaningful part of my human experience.
A Concerned Family Member
Hyman, S. E. (2000). The genetics of mental illness: implications for practice. Bulletin of the World Health Organization, 78(4), 455-463.
King, G. A., Brown, E. G., & Smith, L. K. (Eds.). (2003). Resilience: Learning from people with disabilities and the turning points in their lives. Greenwood Publishing Group.
McConkie, B. R., & Kelling, H. W. (1966). Mormon doctrine (Vol. 97). Salt Lake City, UT: Deseret Book.