I used to hallucinate constantly and I lived in a state of total paranoia. The “normal” thing that most people want to do when confronted by someone like me is to diagnose the “condition”. Give it a name, let’s say schizophrenia, just for the sake of discussion. Then, convince me to name and label myself that. Finally, use the diagnosis, the name, as an explanation for my behavior. “Oh, you act that way because you are schizophrenic.”

This is, of course, utterly wrong and entirely backwards. Diagnoses in mental health are NEVER meant to be explanations of someone’s behavior. In fact, it is someone’s behavior that is supposed to lead to the diagnosis! No one acts the way they do because of a mental illness or any diagnosis. The way someone acts is what convinces a psychiatrist to use the diagnosis, not the other way around!

And particularly for any mental or emotional issue, and also for a great many physical chronic illnesses (especially those having to do with the gut), the diagnosis isn’t even a good place to start anyway. Why? Because the illness is just a symptom of the family sickness. (Family here meaning any emotionally connected group of people.)

And symptoms are often just signals.

Now here’s something about me that really is just genetic. I’m autistic. That isn’t an illness. In fact, it’s not even a disadvantage. But it is true that I do not seem to experience the range of emotions that most people do. However, one emotion I certainly experience is anger.

You know how I know that one of the families I am a part of is getting sick? It’s simple. I feel anger when I think about that family. That’s all I need to know to realize the family is getting sicker.

Now, it’s critical for me to understand that the exact target of my anger is almost never the actual source of the problem. But as a general signal, anger always works. The angrier I am, the sicker the family is.

For many of you, your warning sign is anxiety. Or stomach aches. Or depression. All of which point to a sick family.

But what do so many of us do when we receive these signals? We try to squash the signal. It’s like if a warning light goes off in my car and I deal with it by smashing the dashboard with a sledge hammer. That isn’t going to fix the problem.

And that’s exactly how a lot of us try to deal with anxiety, depression and chronic gut issues. With a sledgehammer. It doesn’t work.

Now the family can be sick for lots of reasons, and in some cases there is no individual who is really sick. But all the members are showing symptoms. Here is a great example: financial insecurity. I strongly believe that nothing in America causes more family sickness that monetary uncertainty. It’s either in first or second place, along with isolation (which can be defined as being part of a family that’s gone beyond sick and may actually be dead.)

The horrors of financial insecurity and isolation are well-known and often discussed. What’s less often discussed is how to deal with a family when the structure of the family itself is what’s producing symptoms, and how to deal with a family where the truly sick member of the family displays no symptoms.

COVID-19 has had very few positive effects. But it has made it easier for me to explain what’s going on in sick families. One of the things that makes COVID-19 so dangerous is that you can be carrying it despite showing no symptoms whatsoever. In fact, you can even be contagious before you show symptoms. This is exactly how many abusive families work. The predators, the truly unhealthy members, are often quite precisely the ones who seem fine on the surface. It’s the members with a conscience, the ones who try to set boundaries, who try to heal, that display the symptoms.

And then they are the ones who get diagnosed.

And then the family pretends that they are the ones with a problem.

Never forget that in any sick family, you are always dealing with the symptoms of the diagnosed person, plus the family’s RESPONSE to those symptoms. And quite often the family’s response is worse than the symptoms ever were. You see this all the time with people who are crushed by shame or self-sabotage.

As a pastor I have seen more examples than I ever wanted to of people whose “sexual sins” were minor, but the shame has had brutal consequences. Even victims of outright sexual molestation at a very young age sometimes tell me that the shame of the incident is worse than the incident itself. Terrible.

So never forget that you are often making things worse by “medicalizing” and labeling the person with symptoms, because often the truly sick person is also the one at the top of the family hierarchy.

Even then, the structure of the family is the problem, not the symptoms, and not even the truly sick predator! I mean that someone can want to be a predator all they’d like, but what is it that allows their predatory behavior to happen in the first place, supports or ignores it, and then shuts down any attempt to deal with it? The family structure itself does that.

Symptoms are often just signals and relationships strive to maintain themselves. And it can be a horrifying problem that the family structure tries to maintain itself. In a healthy family, the resilience of relationship patterns is wonderful. But in an unhealthy family that same resilience can become evil. Even if the family structure is literally killing all the members with chronic physical and mental illness, the structure will resist change.

As a result, in a truly sick family, healing, leadership and setting boundaries are all pretty much the same thing.

A sick family will tell you, “No matter what, we stick together.” And it’s true. You’re not truly together. No, you’re “stuck together”. And being stuck together is awful.

Healing requires you to be willing to leave the family, since being stuck together is such a central problem. If you are not willing to leave, you are not helping. You are not being selfless. You are not being a good child, spouse, father, mother, whatever.

No, you are just stuck.

What are the signs of a “stuck together” family that is deeply sick? Here we go:

  1. Walking on eggshells. This is the simplest way you can tell that your family is deeply, horribly sick. Do you feel like you are walking on eggshells?
  2. Interventions for the labelled family member.
  3. Secrets.
  4. Us versus them gossip. A perfect example is social media chat groups where you talk about someone who isn’t in the chat. Also, delivering messages for people, enabling their inability to set boundaries or communicate.
  5. Constantly trying to save face for those at the top.
  6. Criticism, condemnation and blame.
  7. Shame and self-sabotage.
  8. Incessant competition for position in the family tree. I hate the following truth, but, honestly–competition often causes more suffering than actual harm. Just like shame does.
  9. Using people as chess pieces.
  10. Accusations of selfishness, which are always directed at whoever it is that is actually setting healthy boundaries.
  11. Trying to make decisions about people without their input.
  12. Competing factions where anyone taking one side of an issue requires the opposing faction to take the opposite side. Another way of looking at this is to ask yourself the question, “Do I feel free to say what I think? Or do I constantly have to worry “what side” it puts me on to express my own personal opinion?”

So that’s how you know that you are stuck together. And if you are stuck together, you cannot heal or improve without starting to set clear, rigid boundaries. When you set those boundaries, the family structure itself will rebel against you. So prepare yourself.

If you are just learning how to set boundaries, here’s where you start.

If you want to say no, that’s a good enough reason to say no.

If you want to leave, that’s a good enough reason to leave.