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Fear of vulnerability can keep families silent about mental illness, even when they know the facts.

Patients and families alike shield themselves against vulnerability, and that armor keeps illness hidden.

Breaking the silence takes curiosity, which requires the very exposure that fear of vulnerability avoids.

My brothers came to every one of my court appearances. They watched me at my worst as I was charged and punished for my actions while in a manic psychosis. But when I transferred to a state psychiatric hospital, they all but disappeared.

More than once, my mother has asked them why. Why did they stand by her through the criminal phase but remain silent through the slower, uglier work of recovery? I don’t know is the answer she hears. Her friends long offered a variation of the same refrain. On an early morning call last year, one close friend confessed: I don’t know enough about it, and I don’t want to say the wrong thing.

Since defense mechanisms, by definition, work outside our capacity to be aware of them, I don’t know may be an honest admission: we can struggle to see what’s stopping us from engaging, from asking a question that makes another feel seen. Stanley Cohen calls this implicatory denial: we accept the facts of what happened but not what they ask of us.

My brothers know the diagnosis and lived the horrors of its history, especially when my manic cruelty turned on their families. Still, I wonder why they turn away from what the knowledge would ask of them, or how it might implicate them. To be fair, I can’t read my brothers’ minds, and fear is not the only reason people keep their distance; anger, grief, and the urgencies of their own hectic lives surely play a part. But fear is a reason we rarely name.

They are not alone.........

© Psychology Today