Watching loved ones struggle, whatever their age, is always excruciating. It leaves a gaping hole in your stomach and a heaviness in your heart unlike anything else. It produces a deep desperation to make everything better. But what if your loved one does not want your help (or maybe anyone else’s)? How do you continue to show up for them and empower them to get the help they deserve? And how do you know when you have done all you can?

Work to Understand Your Loved One

As afraid as you are, keep in mind, your loved one likely has just as much (if not more) fear than you do. They may be showing it differently or hiding it completely, but there is a part of them that is aware that things have gotten out of control. That was never their intent, but it has happened. Each day is a new attempt at proving they are okay enough or that “it’s not that bad.” And at the end of each day when it still is “that bad,” to get through to the next moment or the next day, the minimizing, denying, and numbing start all over. If they are to acknowledge that they may need additional support, that would require them to admit that somewhere along the way they lost control, and that is terrifying. If they are to accept the help that is offered, then maybe things are not okay. And if things are not okay, maybe they are not okay and never will be. Maybe there is something broken in them that cannot be fixed, or at least that is what they are telling themselves. So if they can continue engaging in their behaviors exactly as they are, then maybe they can prove that they are okay. Or at a minimum, they can numb so much that they can try to convince themselves (and everyone else) it doesn’t matter.

In all reality, there is a war going on. They are a prisoner in their own body. As horrible as the war is, they have learned how to navigate the chaos. Asking for or accepting help would be like waving their white surrender flag. It could get them out their situation, but it would require them to take the risk of making themselves vulnerable by relinquishing some control to allow another person to walk with them in the chaos they have spent so much time and energy trying to hide for fear that others may see them as weak, damaged, or less than in some way. For some of our loved ones, it also requires letting go of the few things that have provided them with relief amidst the pain of the war: things like eating disordered behaviors, workaholism, substance use, perfectionism, and self-harm.

The idea that they may have to let go of the one or two things that have helped them survive up to this point (no matter how damaging the behaviors may have been in other ways) is also terrifying. It’s like asking someone who has been relying on a full suit of armor to keep them safe from the war that has been their life to start taking their armor off. For a multitude of reasons, they may have needed their suit of armor to protect them from the dangers around them or help them hide from the threats or expectations of this world. Maybe their suit of armor allowed them to be someone different, someone they felt was more acceptable than themselves. They may not need the suit of armor to keep them safe in the same way anymore, but they have learned to find comfort in it. And since they have genuinely needed it to survive at one point, they have learned to rely on it to get them through each day.

Have a Conversation

When we feel helpless as humans, it is natural for us to try to control situations or get overwhelmed and shut down. As understandable as both of these reactions are, neither are very productive when helping a person who is already struggling. If we start controlling and directing, this could feel like we are trying to take away the little amount of control our loved one has left. Conversely, if we shut down, we are inadvertently reinforcing the beliefs about worthlessness our loved ones are already struggling with.

So how do we respond in a way that is supportive but not directive? We educate ourselves, prepare resources, and provide options. Do your research on available treatment options, support groups, and therapists who have specialties in what your loved one is struggling with. Look into what services and providers may be covered by insurance so cost is not a potential barrier. Print or obtain materials from those services so that you can show them to your loved one as you are explaining what options are available.

When you approach the conversation, do so knowing that you may face some resistance. For all the reasons talked about above, your loved one has understandable reasons to be afraid. Fear often appears as anger, as for many people anger feels less vulnerable than acknowledging or showing fear. And if your loved one is still trying to convince themselves they are okay, your conversation is a direct threat to their defense mechanism of denial.

To navigate this conversation, it may be helpful to do the following:

  • Stay emotionally grounded and rational. You care for this person, so of course this conversation is not easy. But if you can stay grounded, you can provide them with a stable person to hang on to amidst the chaos. If you show excessive emotion, your loved one may feel guilt or shame from the belief that they caused this pain for you. They may feel a need to hide what they are experiencing or try to care for you. Their emotions also may be exacerbated by your high levels of emotion, which could result in increased defensiveness, running away, or completely shutting down.
  • Validate their pain and their struggle by verbally noting what you have observed. Sometimes we need other people to see and acknowledge our pain before we can acknowledge it ourselves.
  • As helpful as it may be to validate, please never tell your loved one that you understand. Even if we have experienced something very similar to another person, their experience of it is always going to be different than ours. Just because something worked for us, does not mean it will work for another person.
  • Explain that there are options that can help relieve some of their pain and teach them ways to cope with the day-to-day challenges they experience so they don’t feel like engaging in unhealthy behaviors or suicide are there only two options. It is a really hard place to be to feel like your only option for relief is restricting, purging, using a substance, exercising excessively, self-harming, killing yourself, etc. Validate that no one should have to experience the pain they are experiencing on a daily basis.
  • Provide multiple options you have researched. Describe what you know about each and have materials ready to provide if helpful.
  • Be prepared to answer questions. If you do not know the answer to the question, explain staff would be happy to talk with them about the services further and answer any questions they may have. Offer to call or tour with them if possible.
  • Normalize their fears and assure your loved one you will be there for them and with them throughout all of this.
  • Allow your loved one to choose what support option they feel would be best for them (even if you don’t agree). This is their journey. If whatever they choose is not working as effectively as it needs to, you can always revisit this conversation. Ultimately, some support is better than no support.

So what happens if this doesn’t work? What happens if your loved one gets defensive, denies there is a problem, or walks out?

Let me first clarify that many people will not accept help the first, second, third, and maybe fifteenth time they are offered it. Denial and fear are incredibly strong emotions. So when your loved one tells you they are fine, that you are overreacting, or that it’s really none of your business, know those are all normal responses they are using in an effort to keep themselves guarded and safe. What they may not be expecting is that you will continue to show up to support them and will still be there when they are ready to allow someone to enter into their war, walk them to safety, and help them start taking off the heavy armor they have been carrying for so long.

Walking with someone who is experiencing denial and defensiveness looks a little different than walking with someone who may be motivated for change, despite the presence of fear. When we love someone who gets defensive, denies there is a problem, or walks out, it can be helpful to validate the challenges in the situation and make sure that person knows we will be there if and when they decide they would like additional support. Try not to push them or guilt trip them. Empower them to feel in control of what happens next.

Sometimes it can be helpful to identify what would necessitate further support if your loved one does not feel it is necessary at this time. Questions like this may be helpful in assisting your loved one in assessing that:

  • How would you know if you needed further support?
  • What kind of behaviors would suggest further support may be helpful?
  • What kind of services do you think could be helpful if you ever needed that support?

There are exceptions to allowing our loved ones to be in control of what happens next, however. When we love someone who has a high chance of lethality through suicide, homicide, severe eating disordered behaviors, or addictions that have a likelihood of lethal overdose or dangerous withdrawal effects, hospitalization may be needed for stabilization. If your loved one’s life is in imminent danger, emergency services should be called immediately.

Set Healthy Boundaries

It can also be helpful for your loved one (and yourself) to set healthy boundaries. For example, “I am not going to pick up more alcohol to make sure you do not go into withdrawals. If you would like support with your withdrawals, I would be happy to take you to a local hospital or a licensed detox center to assist with your withdrawals in a safe setting.” Or “I will not speak with you when you are yelling at me. You are welcome to come talk with me when we can have a calm, respectful conversation.” It is also okay to set boundaries around the support you are providing, as it can feel very heavy to try to navigate a loved one’s pain alone. It may be helpful to communicate something like, “I will be here to listen; however, I am not sure what I can do to help outside of listening. I want you to have the best support possible, and I know there are people with specific training who could help you. I would be happy to help you find someone to support you further if you would like.”

Recognize When You Have Done All You Can

As much as we desperately want relief for our loved ones, it is also crucial that we recognize when we have done all we can do. Our loved ones are genuinely the only ones who can decide to make a change. Tony Robbins once said, “Change happens when the pain of staying the same is greater than the pain of changing.” The key to the change process Tony referenced is that the person who is experiencing the pain is the only one who has the ability to decide if the risk they are taking in changing is less daunting than the risk they take by staying exactly where they are.

Either way, we know there is risk and pain for everyone involved. So when you have validated emotions, provided options, and set healthy boundaries, have confidence that you have done all you can do. As helpless as that realization can make you feel at times, you have planted a seed. You have shown your loved one that there are other ways to find relief if they can muster the courage to take the risk. You have shown them that hope and healing may be possible. You have shown them they don’t have to do this alone. And eventually, when the pain they experience in their current state outweighs the pain they could experience from enacting a change, they will know they have options and someone who will still be there to support them