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Establishing boundaries with children suffering from mental health problems

My husband and I are having trouble with our 25-year-old son who has some mental health problems...

Question: My husband and I are having trouble with our 25-year-old son who has some mental health problems. Our son lives with us because there are times that he cannot live by himself. This would be fine except that he does not show any respect for us or for our house.

For example, he expects his dinner to be on the table for him and gets angry if something we are doing means that he has to feed himself. He comes and goes at all hours of the night and wakes us up. He uses a lot of foul language, especially when he is not well.

My husband says I have been too soft with him and I probably have, but I want this to change and I need help.

Answer: It is very difficult for parents when a child of theirs has serious physical or mental health problems.

Mothers and fathers work hard to provide the best care they can in the hopes that this will help their child get better.

They may experience some feelings of guilt as they consider the possible causes for the illness. They may also feel angry or ashamed and then try to hide these feelings, possibly behind extra efforts to behave generously towards their child.

All of these things are very reasonable reactions to having a child with a serious illness.

The problem is, of course, that they can lead to the abandonment of expectations and boundaries for the child's behaviour. This pattern can continue into adulthood and result in the sort of situation that you are describing in your family.

To start changing the way things are going with your son, you and your husband need to consider what he is actually capable of. I don't know what your son's illness is, but most people are capable of following routines and house rules.

I suspect that your son is also capable of taking responsibility for some tasks around the house and for monitoring his own use of foul language.

If you are not sure what he is capable of, consider how he behaves outside of your home. If he has been able to manage a school or work routine then he is capable of meeting expectations for routines at your house.

When you think you have a clear sense of your son's abilities then you can choose one thing that is important to you and decide how you want it to change.

Perhaps you would like to sleep at night without being woken up by noise. Be clear with yourselves and your son about your expectation for quiet at night and be prepared to follow through with action if your son does not comply.

As you are successful in establishing a boundary in one area you can begin to add others.

When people in families decide to make changes they can expect some resistance, both in themselves and from other members of the family. You may find yourself feeling guilty or afraid, and your son will likely make efforts to keep things just the way they are.

If you are serious about the changes you want, however, you will need to accept these things as normal and be prepared to push through them.

Changes in family life can be difficult. If you find yourself feeling overwhelmed or stuck, it may be time to consult with a professional in the mental health field such as a counsellor or a social worker.

If you would like to ask a question of the counsellors, for a response in future columns, e-mail them at askpacific@shaw.ca. Consult a Counsellor is provided by the registered clinical counsellors at Pacific Therapy & Consulting: Nancy Bock, Diane Davies, Leslie Wells and Andrew Lochhead. It appears every second Friday.