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Elliott, LPCC, NCC
Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience:  35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
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Hi, My mom has sufferered from anxiety and depression all of

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Hi, My mom has sufferered from anxiety and depression all of her adult life. She takes medication mostly every day and has been in therapy for over 45 years. My brother suffers from some form of mental disorder, though is not diagnosed, mostly he seems paranoid, though is very capable and is full time caregiver to my dad who has multiple system atrophy and is completely unable to do anything for himself. My mom, brother and dad live together in the same house we grew up in. We have another brother who lives in Virginia with 6 children and his wife, though he loves us, there has been much tension between my two brothers over time and so my brother in Virginia does not often communicate or visit with my parents and brother. He and I communicate as we always have a once or twice per month. My brother who takes care of my dad, and essentially, my mom, has such a difficult job. He does all he can and does it well, though doesn't wish for anyone to visit. The only person who is permitted to visit is myself. I take my mom where she needs to go and try to take her out sometimes to lunch, shopping, etc. She has not ever been very independent, my dad did everything for her and now my brother and I do. I have a husband and two children, 21 and 16. They wish to visit always and I tell them my family is in one way or another all of them, ill and they think differently than we do. Though it is a great sacrifice, all I can think of to do is to respect their wishes, or my brother's wishes, as he is the main caregiver. It is such a difficult situation, though it wasn't too different when my dad was well. My mom says outwardly that she wishes visitors, though then expresses to my brother that she'd rather not have people there, it makes her very anxious. My question is, today, I wrote my brother to say that my kids ask always to visit, that I tell them no always and that I just wanted to mention this to him. Also told him that I know there are many reasons why this is not possible. I am not sure what he will answer with, or if he will even answer. If he does, and it is a negative answer or if he doesn't answer, how do I express to my children what he says or doesn't say without hurting them in thinking that they are not loved by him. Mental illness as you know, is so very difficult to understand and deal with. Everyone seems to learn on their own how to deal with it, or they don't learn and just feel frustrated or angry with the mentally ill person in their lives. I cannot save my kids from any pain due to this, I am just hoping for the words to express to them in the best way that this might be something that they must look at as a loss and grieve this loss in whatever way is best for them. I apologize for the long message. Thank you.
Submitted: 1 year ago.
Category: Mental Health
Expert:  Elliott, LPCC, NCC replied 1 year ago.

Elliott, LPCC, NCC :

Seeking expert counseling is a sign of strength. A personal relationship with a caring professional is proven clinically effective.

Elliott, LPCC, NCC :

Dear friend,

Elliott, LPCC, NCC :

I believe that I an help you.

Elliott, LPCC, NCC :

I understand your situation very well as you have articulated it quite clearly.

Customer:

Thank you.

Elliott, LPCC, NCC :

I understand your dilemma in wanting to protect the wishes of your brother and of your mother, while trying to shelter the pain of rejection from your children.

Customer:

yes, that is it

Elliott, LPCC, NCC :

Your children are old enough to understand that there is mental illness in your brother and mother.

Elliott, LPCC, NCC :

She is helpless, dependent, and very fearful.

Customer:

yes, they certainly are. my husband and I have always expressed this to them.

Elliott, LPCC, NCC :

Your brother, it seems, has a bit of a personality disorder, perhaps with elements of Paranoid Personality Disorder, but more likely of Schizoid Personality Disorder.

Customer:

I mentioned to my daughter that I left this message for my brother and that whatever his answer may be, we must respect it. Yes, my mom is exactly this.

Customer:

yes, this is what seems to be the disorder my brother has.

Customer:

He has so much to deal with, I generally comply with what he asks, as I wish not to add to the stress this situation creates.

Elliott, LPCC, NCC :

Let me give you the official criteria, from the psychiatric manual DSM-IV, the "bible" of diagnoses, for Schizoid Personality Disorder. I want you to see if this fits.

Elliott, LPCC, NCC :

Give me a few moments while I copy and transmit it from my file, please.

Customer:

To add to it, my dad is a wonderful man. He had always been my brother's best friend. He was so good to my mom and to everyone. Now he is basically gone and they are watching him daily slipping away, needing 24/7 care. It is a very difficult situation as I know you understand.

Elliott, LPCC, NCC :

I am sorry. That is so sad for all of you, and so hard to watch him deteriorate.

Customer:

Thank you. I always remind my children that it is not about them, not about my brother/mother not loving them. They are ill, they cannot help how they feel or relate to things. They are doing the best they can.

Elliott, LPCC, NCC :

Here are the criteria.

Elliott, LPCC, NCC :

Diagnostic Criteria for Schizoid Personality Disorder


A. A pervasive pattern of detachment from social relationships and a restricted range of expression of emotions in interpersonal settings, beginning by early adulthood and present in a variety of contexts, as indicated by four (or more) of the following:



  • neither desires nor enjoys close relationships, including being part of a family

  • almost always chooses solitary activities

  • has little, if any, interest in having sexual experiences with another person

  • takes pleasure in few, if any, activities

  • lacks close friends or confidants other than first-degree relatives appears indifferent to the praise or criticism of others

  • shows emotional coldness, detachment, or flattened affectivity


B. Does not occur exclusively during the course of , a Mood Disorder With Psychotic Features, another Psychotic Disorder, or a Pervasive Developmental Disorder and is not due to the direct physiological effects of a general medical condition.


Note: If criteria are met prior to the onset of Schizophrenia, add “Premorbid,” e.g., “Schizoid Personality Disorder (Premorbid).”


Associated features



  • Odd/Eccentric/Suspicious Personality

Elliott, LPCC, NCC :

This is NOT schizophrenia.

Customer:

My mom does come to my house very occasionally, she texts and emails my kids. I have tried to help them understand that this is her way of relating to them. She loves them and we all have to accept certain things in life. if this is the way they are able to see her/communicate with her, it is a good way, just not what they want. Unfortunately, in life, we cannot always get what we want, and oftentimes realize that what we wanted was not good for us in the long run. It would be very difficult for them to see my dad as he is now.

Elliott, LPCC, NCC :

Does your brother meet four or more of the criteria?

Customer:

yes, he does

Customer:

not all of the criteria, though 4 or more, yes

Customer:

he understands his condition, he knows himself well. doesn't wish to see drs or take medication. did when he was a teenager see therapist, had a brief period in a psychiatric hospital and took medication. my dad talked/listened to him always, as he did for my mom with her fears/angers, etc.

Elliott, LPCC, NCC :

In that case he is diagnosable. I sent you this document so that you have something "official" to show your children so that they can understand that your brother has a real diagnosable condition. His behavior, then, does NOT reflect on his feelings for them.

Elliott, LPCC, NCC :

There is no medication for this condition.

Customer:

thank you very much.

Elliott, LPCC, NCC :

Your mom is doing her part to stay in touch, and this is the optimum circumstances for now.

Customer:

i have been looking on and off to try and find a description of my brothers condition.

Customer:

i will definitely use this tool to help my kids understand.

Customer:

yes, she certainly is and I agree, thank you. this is exactly what i tell them.

Customer:

i will continue to tell them the same.

Elliott, LPCC, NCC :

It would hurt your children to see your dad, but they must understand the process of dying, because they will face it all of their lives. They will develop compassion for him and it will make the grieving process easier and more understandable in the long run.

Elliott, LPCC, NCC :

He will not just disappear.

Customer:

i feel badly for having even sent my brother the message about my kids wanting to see them. i really am the one person other than my parents that he trusts as much as he is able to trust anyone. i am hoping that he will accept the message as informative and not as a request for something that is so difficult for him to succomb to.

Customer:

yes, this is true. my son just lost a friend, 16 to a terrible freak accident this summer and we have lost a few young persons in the past year that were close, not so closely related to our family.

Elliott, LPCC, NCC :

Your brother is intelligent an he understands that families have needs to be together at times. He may not like it, but he could understand an accept it and accommodate it once in a while.

Customer:

yes, he is very intelligent. yes, he could and so possibly the message will open a door and we will be able to go visit with the kids.

Elliott, LPCC, NCC :

I think he can be reasonable, and put up with the discomfort caused by his condition, or even leave the house for a little while if he feels overwhelmed.

Customer:

to the kids credit, they really want to see my dad, regardless of how he looks or seems. they love him and want to be with him. it is i who was trying to rationalize my brother not accpepting their wish to visit as it being better so the kids don't have to see my dad as he is. they wish to see him in whatever condition he may be in.

Customer:

he would not leave the house, as he is the sole caretaker of my dad. he will stay with us and go about doing what needs to be done as we are there.

Elliott, LPCC, NCC :

You will have to work with your brother's strict demands.

Customer:

yes, i certainly will and i do. thanks so much for your help, most especially for the description of the condition you provided.

Elliott, LPCC, NCC :

Your children sound wonderful and intelligent and I believe that once they understand that your brother has personality disorder, the focus will sharpen.

Elliott, LPCC, NCC :

You are so very welcome. It is always most gratifying to me to be able to help.

Customer:

they are, thank you. thank you, XXXXX XXXXX exactly what i needed to provide them with.

Elliott, LPCC, NCC :

I shall keep all of you in my prayers.

Elliott, LPCC, NCC :

:)

Elliott, LPCC, NCC :

You have put a big smile on my face.

Elliott, LPCC, NCC :

Warm regards XXXXX XXXXX and your family. I wish you all the best.

Customer:

and i will keep you in my prayers. yes, you have done the same for me.

Elliott, LPCC, NCC, Psychotherapist
Category: Mental Health
Satisfied Customers: 7663
Experience: 35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.
Elliott, LPCC, NCC and other Mental Health Specialists are ready to help you
Expert:  Elliott, LPCC, NCC replied 1 year ago.
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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  • I can go as far as to say it could have resulted in saving my sons life and our entire family now knows what bipolar is and how to assist and understand my most wonderful son, brother and friend to all who loves him dearly. Thank you very much Corrie Moll Pretoria, South Africa
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Elliott, LPCC, NCC
Elliott, LPCC, NCC
Mental Health Professional
7663 Satisfied Customers
35 years of experience as a Licensed Professional Clinical Counselor, National Certified Counselor and a college professor.