Caregivers, how do you navigate the relationship with your spouse/partner?

I’m hoping for some advice on how caregivers maintain their relationship with a spouse who has a different view on caregiving? Particularly caregivers whose spouse or partner struggles to set healthy boundaries with the SMI family member. How did you learn to discuss things in a constructive way to come to a compromise? How has your relationship withstood the challenges, burden and sadness of caregiving?

My husband has a SMI sister. She has been sick for over a decade, never fully treated and often not medicine compliant. She spends most of her time fully immersed in her delusions and unable to reliably interact with the real world or take care of herself in any meaningful way.

Recently things got worse as she refused medication for months and her behavior escalated to hitting her parents and making 911 calls to say her father was molesting her.

My husband and I have very different views on healthy boundaries and it is already straining our marriage. Before getting married we discussed his sister with a counselor and a financial planner and I made clear that while we would do what we could to help her, she could never live with us and we can’t bankroll her life the way his parents have. He agreed, but over the last 8 years of marriage he has routinely been unable to set boundaries with his family of origin.

We are stuck in this negative pattern where trying to talk about or compromise on boundaries is just making us more resentful and less trusting of each other. I have been in therapy for 3 years to work on communicating better and with more empathy, and have worked hard to educate myself on the disease. He won’t go to therapy and believes he has dealt with his feelings about his sister being ill, but often he directs his anger at the situation at me. He recognizes and apologizes for it later, but can’t seem to stop.

He also recently expressed that my boundary was unreasonable when I said his sister could not be around our 2.5 year old and our 7 month old while she was unmedicated, hitting people and making serious false accusations against her father. It was pretty shocking for me to hear him say that setting the boundary that she will only be around our kids if she is medicated and not verbally or physically abusive was unfair. I knew we had different views, but I thought he would have been on the same page in this particular instance. I’m worried that once he becomes the main caregiver for his sister it will destroy our marriage.

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I probably am not the best person to reply because I do not have a significant other by choice.

Caring for my mentally ill son for the past 16+ years, I could have never done it as well as I did and have juggled any other significant relationship with it, never mind a relationship with a person that was not on the same page as I was. That is just my own point of view. I am sure everyone has very different views. I also have a seriously mentally ill sister who I seldom ever see for many reasons one being that she also doesn’t get treatment and I can’t risk the very negative impact she has on me and my son when she is around.

I have to commend you for getting therapy as I know for a fact the therapy is what kept me grounded through the worst of my son’s illness and times when I was dealing with my sister and has helped me understand myself better as well as (like you said) be a better communicator. I stay in therapy.

As a person reading your post and looking from the outside in. I think you have to stay the course with your own self-care, and I think your boundaries with your sister-in-law concerning your child is exactly what is needed for your child’s safety. Mentally ill or not I wouldn’t allow a young child of mine around anyone not rooted in realty or anyone who is essentially unpredictable in their behaviors. You are 100% right to stand your ground. Other than that, I would say you have to decide if you want to stay with your spouse the way things are indefinitely, or if you really want something different for both you and your child.

One thing I have learned in therapy is I can change nobody but myself. You can change the course of your own life, but if honest rational conversation can’t convince your spouse how important the boundaries and mental health care is for both of you, then you have to decide if you are fine with that, or if you aren’t, it’s a difficult and very personal thing to consider.

I wish you only the best going forward and hope whatever you decide going forward gives you peace. :peace_symbol:

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I really can’t give you any advice as my spouse was on the same page with me regarding caregiving to my adult daughter. He was on the same page with helping her even when I waivered, and even while she called the police on him often during her psychosis.

Your situation is different because you have the young children. I could never have had her in my house if there were young children as she was unpredictable though never violent with anyone but me.

I am sorry that your spouse isn’t keeping his agreements with you about his sister’s boundaries.

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Thank you for your thoughtful reply. A month ago I had no doubt my husband and I would eventually find a way to talk about his sister and work as a team. But when he got upset at me for not allowing a visit when she was unmedicated and being physically violent I realized there really may be no way to fix this.

Truthfully, his reaction scared me - he said he would never let anyone else in the same condition around his kids but somehow the risk was not just ok, but necessary, because it’s his sister. I asked him what more it would take for him to feel she wasn’t safe to be around and he could not articulate anything, instead he said we could just watch her very carefully and leave if anything happened “that made us uncomfortable”. I asked what boundaries he felt were appropriate and the only boundary he had was she could not be alone with our kids.

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Thank you @oldladyblue. I think the dynamic may also be different when it’s a child versus an adult sibling. In my view, your children have to take priority over extended family and my husband says he agrees but his actions prioritize his mother and sister over our children.

I’ve given up on my in-laws changing their ways and have distanced myself knowing that we are soon approaching a point where it will not be safe or feasible for sister in law to continue living with them. When that happens I worry they will guilt by husband into promising to take care of his sister despite their not having done anything to prepare for her future - because “it’s too hard for them and they don’t want sister in law to hate them” but of course my husband will take care of it all, right?

My fear is that if my husband can’t keep prioritize us and keep his promises now when there is no acute need for his sister, there is no hope that he will be able to do it when she can no longer live with their parents and has no place to go. I won’t ever allow my children to live the way my in laws do - without a moment of peace in their own home. We also can’t afford to care for her the way they do and certainly not without taking resources away from our kids.

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I’ve always read that mental illness can be a hereditary condition if not genetically then at least influenced significantly through environment. In my case, with my own son, there was significant mental illness on both my side and his father’s side of the family, then with me being a single mother raising him and his brother, I have no doubt that the stress in his early years was pretty great. We do the best we can with what we know.

I think in your situation, you are not only advocating for yourself and your child in the present day but for the years to come and on behalf of your child’s development and sense of peace. The more stress and discord you and your child have to endure, the more your sound minds are compromised over time. You sound like a very strong and responsible woman. I have no doubt that you will do what is right for your family. Sending positive thoughts your way.

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While not married, I will bear a larger share responsibility for my SMI brother when my mother pases due to proximity, so his care is built into the package of any relationships. He’s had periods of violence in the past related to his illness and alcohol abuse.

Some questions:

What benefit does your husband see in his sister’s interactions with your children that outweighs the risks?

Per the special status of his sister versus refusing contact with anyone else in similar condition, what if roles were reversed and the diagnosed person in question was your brother? How would he respond then? Is her status absolute? Is their any line she can’t cross?

What age would your children have to be for you to be comfortable with his sister to be in contact with them in her present state?

Are plans being made by your husband and his family to provide for her future care?

I’m keenly aware of patterns of family denial in these situations. My parents bought my brother a small home and set up a trust for his care, only after he became violent toward my mother. My father only funded the trust and finalized his will a year before his passing, even though 10 years had passed since my brother moved out.

While this probably sounds escalatory to you, I’d consider consulting a lawyer about how a family or divorce court might be disposed with his and his parent’s child custody status in the light of his sister’s mental illness and history of violent behavior and her accusations of molestation by his father with records of repeated 911 calls.

He seems to be naive about the consequences of the appearance of child endangerment by his inaction when it comes to litigation, and it may be a motivator for him and his parents to take his sister’s care and your concerns more seriously. I’ve had enough contact with lawyers, paralegals and mediators to know these sorts of issues can put clients at a serious disadvantage in divorce and separation proceedings depending on the state in question.

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Hi @Maggotbrane,

He hasn’t articulated a benefit other than she’s his sister and family so he wants her to be included and have a relationship with the boys. Before she was physically violent we did see her and she is so ill she barely realized our toddler was there at all. I think the real “benefit” is that his mom wants this and he has been conditioned to never do anything to upset his mom. She needs to pretend that things aren’t as bad as they are and she wants everyone to pretend along with her.

Her status seems absolute. I thought the line would be that if she wasn’t medicated and being physically violent he would agree she shouldn’t be around our kids but I was wrong. In retrospect I probably should not have been surprised because he expected me to be around her even when she was verbally abusive and even when my doctor told him I shouldn’t be because I needed to control stress during a high risk pregnancy right after losing my prior baby at 20 weeks. If it were my brother I don’t know how he would react - I would have the same boundaries.

There is no age at which I want them around her when she is unmedicated and hitting people. When they are old enough to understand an explanation of her illness, ask questions and express what they are and are not comfortable with I would be open to visiting her if she’s medicated and not violent.

There is no plan for her future. We set up a special needs trust ourselves and are funding what we can and plan to put whatever my husband inherits into a fund for her. They think a trust is “unfair”. These are the same folk who spent years pretending she was not sick and hiding her from the rest of the family. They said (and this is just what I witnessed firsthand) that it was PMS, insomnia, a demon that would be cast out by a miracle, and then a curse of the Masonic Eye because her dad is a Mason and some scam artists they met on the beach said they could lift the curse (for $ of course). It took her going catatonic and requiring ECT years later for them to finally admit it was mental illness. Even then they went “doctor shopping” anytime a doctor told them she needed residential care for any chance at stabilizing. She just got worse and worse for 10 years. The plans they’ve shared are: she’ll meet someone and get married; we will find her a mentally ill roommate to live with; she will live in her own house (she owns one but hasn’t lived there in 10 years because she cannot take basic care of herself in any way). Then they asked their cousins, who are also in their mid 70s, to take her after they are gone - the cousins said no, of course. Now the plan seems to be that she will continue to live with them and then ??? We’ve have told them she will never live with us but as they get older and more desperate because they haven’t out anything in place I am sure they will try to guilt my husband into moving her in.

The pattern of family denial here is so strong. As a example there was a stretch of at least 8 months where his sister didn’t bath at all. She was so dirty that she had infections on her hands and face. When we explained she could not be around the newborn or in the hospital during labor per our doctors, her dad yelled that the doctors were wrong that staph and herpes is not dangerous to babies and that she was the “person most excited about the baby” (not me, the mom who lost the prior 3 pregnancies and had several rounds of fertility and a high risk pregnancy). His mom would make dinner and his sister would stick her hands in the food, lick the food and pick at it. And then his mom would insist on serving it to everyone, denying she had put her hands all in it, and get upset when people refused to eat what was served. I could go on but I think you get the idea. This is the very reason I don’t think his parents are safe people either - in order to pretend she isn’t as sick as she is they will do anything. I have no doubt that my mother in law would hand my baby over to my sister in law because if she didn’t she would have to admit her daughter was too sick to be safe around a baby.

I have spoken to a divorce attorney and I have pre/post-nups that separate my assets, ouot the house in my name, etc. Where we are there are no grandparents rights and my husband would need my permission to take the kids out of state (in laws are 4 hours away in another state). I’ve discussed this with my husband but not the child endangerment aspect - you are right and that may be the next step here.

I agree with you @BDinVA1 that your in-laws are probably not going to change their ways without many controlled conversations between your husband and his parents. It appears that he will not have those needed conversations.

Family dynamics ARE different when the ill person is a sibling and not immediate family. I think the idea of seeing an elder care / family planning attorney is a good one. Does your husband even know if his parents have a will and what they are able to leave behind to care for their ill daughter? If he doesn’t, it seems that is the place the conversation should start. He may never have that conversation, unless you can get him to do it.

Once, decades ago, my mother-in-law knew that she should have a conversation with me about future plans. My sometimes abusive husband (now deceased) was NOT a good provider, money came in and went out quickly with no planning or savings. And his anger was pretty bad. She took me aside and told me that I needed to start a hidden bank account to save up for when/if my husband and I split up and I needed to leave to protect myself and the children. If you seriously think that your husband might take in his sister despite your protests, or spend family money needed for your children, if/when the future arrives and his parents are gone, then perhaps you need a secret escape fund so that you and the children will be safe. You cannot control what another should do, only what YOU should do.

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Thank you @oldladyblue. From the beginning of our marriage, because I could see how sick his sister was, we kept separate finances mostly because if my husband were to become her guardian we live in a jurisdiction where guardians can have some liability for the actions of their mentally ill family member. So keeping finances completely separate would protect us in the event that he got sued for something she did. Now I’m finding that there’s a whole other set of reasons to keep that in place. I am lucky that he was agreeable to our post-nup agreement which also moves the house into my name in the event that we separate.

I wanted to clarify that my husband has had the difficult conversations with his parents about his sister needing to be in a residential facility, and about how living with them was not a plan. He, with my help, has spoken to guardianship lawyers and residential facilities and given his family all the information and contacts. They just won’t do anything with them.

He constantly asks what the plan is for her future, and they give the answers I shared about, or refuse to talk and react by getting angry and yelling or by crying or by simply walking away mid conversation. His mother in particular just will not discuss anything. She just keeps saying I have hope and I have faith. Normally I think having both hope and faith are very good things, but they have crossed over to the point where hope and faith are just excuses for inaction and denial and ways to end conversations that they don’t want to have with other family members who are trying to come up with a solution.

They do have a will and are well enough off that there will be some amount of money available to a sister. Like I said we will also put whatever portion my husband inherits in the trust for her. But she is only 40 years old and there’s certainly isn’t enough money for lifelong care. Also in the moments where she’s slightly more lucid she spends money incredibly quickly. When she gets her SSI and SSDI she spends.

Their refusal to put the money in a special needs trust is going to have two bad results in my mind. First she’ll run through the money very quickly and secondly if she just inherited that my understanding is that she will lose some of the current government benefits that she’s on. We’ve explained this to them. We’ve had a lawyer explained in writing why special needs trusts are important and should be administered, not by another family member, but by a professional so that it doesn’t interfere with current or future benefits. It made no difference.

You ask about how this awful disease affects a marriage and how to come together over decision making? One thing I realize ( hopefully not to much of a generalization) is that men have trouble acknowledging the reality of the disease. That it isn’t just difficult behavior and that to some extent the sufferer is now “lost”. So for a man possibly a sense of impotence to “fix” the problem which can lead to anger. Also possibly here a sense of being caught between his natural caring for his sister and wanting to honor your sensible boundaries.
Better, calm communication between you two is the only solution to your relationship and I would perhaps insist on couples therapy as your husband is clearly suffering too.
My husband and I have had different approaches to 12 years of parenting our daughter with schizophrenia but I see that his sadness and fear for the future was the barrier between us in many conversations.

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I think you’re right about the anger that comes from it being able to “fix” this. He says he’s made peace with the situation, but he gets angry and because he feels he can’t direct the anger at his parents he directed at me. So for example he was angry that his parents had not told him that his sister was refusing all medication for months and he was angry that they had not told him (likey they tried to hide it from him) that she was hitting them, but instead of discussing with his parents why he was upset that they weren’t sharing this information, he got angry at me for setting the boundary that she couldn’t come in that current condition.

I’m working on not taking his anger personally and recognizing that it comes from him not being ready/wanting to accept the reality of what his sister’s illness means. Instead I say “if you are angry that she is sick, I did not make her sick. If you are angry that she’s not getting appropriate care, I’m not the person who’s making decisions about her care. If you are upset that the situation is unsafe, it’s not my behavior that’s making the situation I’m safe. So please don’t direct your anger at me.” Usually that seems to work, but it’s tiresome that he won’t deal with his anger at the situation band his anger at his parents so I have to bear it.

I’ve been in “couples” counseling for 3 years. We were supposed to do it together but he’s probably attended 5 times in 3 years and he stopped when the counselor told him that he should be prioritizing his postpartum wife who is 6 weeks into recovering and had postpartum anxiety, not trying to accommodate his parents. The only way I can see him going is if so simply say we won’t see his parents - in our city or their city - until he starts therapy and shows he’s sticking with it for a while.

It seems to me that it’s almost like you have to use Dr. Amador’s LEAP method with your husband to see if you can get him to accept help for himself which will better your relationship. I have used the LEAP method to overcome situations in my family that weren’t related to severe mental illness, just stubbornness, and it helped. Right now, he can’t see that he needs help, and he probably can’t see that you are suffering, because of the anger he directs towards you over a situation that makes you feel very vulnerable and could be far worse in the future (lack of planning for your sister in law’s care). Have you read the book? It is hard to wade through in some parts, but the Listen, Empathize, Agree (even if just to agree to disagree) and Partner steps are very good in my opinion. If he could agree to couples counseling, it seems like a good solution for now. My husband will often not take my advice, but WILL take it from someone else.

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I’ve read I’m Not Sick, but didn’t find it very helpful - I think it works if 1) the person is well enough to engage in a conversation (sister in law often can’t have even a basic conversation with anyone because she is so detached from reality) and 2) it presupposes some kind of existing relationship (I never knew her before she was ill)?

Maybe the LEAP approach would work with my husband. I will try. It’s pretty similar to the technique I’ve been using based on my therapist’s recommendation.

I think the bigger question for me at this stage is do I want to keep dealing with this situation given that he refuses to change or work on how he reacts to the family dynamics. I don’t think he’ll get to the point on his own of acknowledging and accepting that his sister may play a very limited role in our nuclear family life now and in the future, given that she’s only gotten worse and there’s no plan in place for her. It’s exhausting and discouraging and I feel like my choice is arguing constantly with my husband or giving in to a situation I sincerely believe is not safe for my kids. I’m resentful that anything the in laws do is excusable because “they are doing the best for their child” but I’m terrible for trying to do what is best for my children.

I also just need to really accept what you all have told me on here several times - that I can’t change how others behave, I can only change my behavior and reactions. I’m struggling on that. Sometimes it makes me very angry comparing the caretakers on here who are doing so much to try to help their ill family members to my in laws who aren’t and who want to force the rest of the family to include sister in law no matter what. I know that’s my issue and I’m working on it.

Marriage is hard with a loved one MI or not; I’ve seen couples getting divorced when challenges of this kind are present: autistic, slow or down syndrome children, even a dog that’s has not been properly trained. We can’t control what others do only what we do and even then we don’t change overnight ourselves. The times that your husband’s SMI have called 911 has been an opportunity to have her SMI be taken to the hospital and have her put on medication, it’s not uncommon that she accused her father for molesting her, it’s her delusional mind but she lives with them and it’s hard for the police really do something especially with the bad rap the police have these days. I have called 911 myself and a few times they kind of reason with my son to take his meds at that moment and that’s it; and I get it, it’s really traumatic for everyone concerned, but your husband’s parents with your husband’s help can initiate a court order if in your State you can do so to be able to get her the help his SMI needs. I myself don’t want to risk my grandkids to my son’s presence even if they are older and he’s medicated at the moment much less when he is not and I upfront tell my daughters or my youngest son it’s better for us to meet somewhere else for family gatherings since it’s also stressful for our loved one.
Sometimes my husband and I have not been on the same page but I reminded him about the steps we have to take according to NAMI when he’s psychotic or delusional. I have seen that they are so keen to emotions: if they perceive fear or anger they react to that. It’s really helpful to have the NAMI family to family classes, and know yourself: your triggers, what makes you angry and fearful, how you can control it, it’s very important to know ourselves. I know couple of times I’ve been not prudent with my words; I’ve tried to learn a new language, communication is very important with everyone especially with your loved one. Much we can do if we stay in control of ourselves. I’ve seen some cops having this gift of communication when they’ve been over our house; many nurses and social workers have to have this skill, it doesn’t come easy, we have to watch our body language, our tone; humility works wonders; it’s been mentioned so many times: “try to see and talk to the person you see, not to the illness”! There’s a new person there, different person and in need of love too. I’ve been in your shoes, our son is the oldest of 5 and he started his hard journey when he was 19 with problems since he was 12-13. The difference is he’s our son. Sometimes there was not only one MI but seems it was 2 and me ready to check in at the psych unit!

I have signed up for the emotional resilience class offered by our church and I found it not only very enlightening but a great way of support since we are paired each week with a sister activity to check on each other. The point is not to react, there’s so much to learn of ourselves. I get it your concern is your kids safety.

A podcast I listened to: Conflict is Inevitable Contention is a Choice.
You can choose your battles. In a divorce everyone looses. There’s ways to talk and much that you can do in a kind way. Battles are not won by force but by intelligence.
Hugs to you!

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Isolating the big question for yourself is very good. Working out your answer is probably harder, and may take time. But you have some time to plan.

I got divorced in 2009 after marrying in 1993. He was a mentally and physically abusive man, father to my 2 sons, then teenagers. It took me 5 years to decide to leave. I felt like a loser. I wanted to handle his anger towards me. Despite counseling in our church we could never behave rationally enough to have a happy marriage and the drama in front of the kids was awful. I should have by then had a plan and money in place to be able to leave a man who couldn’t or wouldn’t change. But I didn’t, and left anyway, being homeless for 3 months.

Give yourself breathing time, try to keep the environment as calm as possible for now. Give yourself a time limit on how long you are willing to continue to try to solve the problem. Plan out how you would make a big move, like forcing separation if he insists on having his sister-in-law in your home. At least your pre/post-nups were done! (I wish I’d had those, I left with nothing at the end of my marriage.) If you separate you will keep the house, so the legal road is already in place to force him out if it comes to that. But right now you are not in danger right?

Do try LEAP, the listen and empathize steps may have to be done over several week’s time over and over to at least get his anger deflected off of you and his view on the correct problem (his sister and the parents).

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Thank you @rosyd. The problem is that neither he or his parents will ever use the 911 call to try to get her held and medicated. When she hits them, the answer is “we will report it next time” every time. They refuse to do anything differently and there is no plan in place for her future other than for my husband “to take care of it.”

If my in laws were like you and recognized they shouldn’t put their grandkids at risk by having them present with the SMI family member this would all be entirely different. They don’t recognize that - instead they yell, cry, guilt and manipulate my husband to get what they want and they try to force everyone around them to pretend that there’s no risk, even as they themselves are being physically and verbally abused.

My triggers are when they try to manipulate my family into putting our kids in an unsafe situation and when my husband prioritizes his mother’s feelings over our children’s safety. His parents are adults and it’s their right to live this way, but they have no right to force their decisions or the consequences of their decisions on us. And at the end of the day by only job is to do what’s best for my kids, which is to keep them far away from an unsafe situation and a very unhealthy family dynamic.

Oh @oldladyblue I am sorry you had to go through that. I can only imagine how difficult and scary that must have been for you and your family.

Thank you for your advice and insight, I very much appreciate it.

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Your perception is very understandable, your children are your priority; now, your situation may need a different approach: does your husband’s SMI listen to him? Can he persuade her to take her meds? I don’t think so, she’s in a delusional state and she doesn’t listen neither your husband; can he live with them for a few days so he can open his eyes? Men don’t see as we see.
Your husband can listen to you but the same way we all do: when we are not talked to in a nagging way, we don’t like being lectured but be persuaded and be respected. And for this to happen we need a lot of praying. Prayer has a lot power.
With our son we had to decide and do what is best for him since he was going out of control and we needed help, no one else was going to do that for him or for us, we accepted the help of my brother and we took a leap of faith. We are learning to live with a new person. But it really takes courage, lots of it.
There’s other means of help, you/ your husband can check if they have ACS (assertive community service) in your area, or OCT (outpatient community treatment), they come to the house to check on the person, sometimes the MI listen to another person.
Offer your husband suggestions for his SMI, it doesn’t have to be doom and gloom. There’s hope even when paranoid squizophrenia is a very scary disorder of the brain, I know it’s unpredictable. The difficulty here is his parents, how old are they? And I’ll tell you, the Mental Health System really isn’t that great either. We’ve had to overcome many obstacles ourselves, it’s very discouraging many times because they (the MI) have also many laws on their side to protect them. Most likely that is why we end up accepting what we can’t not change and face it the best way we can. Shelters/nursing homes are full, people end up on the streets or incarcerated. Learning the most we can about the illness and ourselves is empowering. Thank you for sharing your experience with us.

My best wishes for you and your family.

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No she does not or really cannot listen to my husband. Recently on a weekend long visit when he went down to try to talk to her about medication and care, she didn’t even realize he was there and trying to speak to her until it came time for him to leave.

I don’t know that living with her for a few days would change anything. He’s been there when she was catatonic, he’s heard her threats to kill herself, he’s seen her go months without bathing and develop infections in her face and hands, he’s seen her spend 12+ hours per day walking the exact same path around the house over and over again while talking to voices. And this is what she is like when she is medicated. I don’t think it’s an issue of him not seeing how sick she is. I think it’s an issue of him being conditioned to never upset his mother and being unable to process and accept that his sister will very likely play a very limited role in our lives for the wellbeing of our kids.

His parents are in their 70s now. I worry for their health and safety, especially as they get older. It is a terrible way to live but they refuse to try anything different and we’ve exhausted the ways we have available to help. It seems the only thing that will appease them is for me (and my kids) to enter the elaborate denial they’ve created for themselves and dragged my husband into.

Edited to add that I appreciate and agree with your insight on being respectful and communicating calmly. I am trying my best to do just that, but admittedly have sometimes failed. It is hard to maintain calm when I feel lied to, manipulated and not prioritized by the person who is supposed to be my partner in life. We will respectfully discuss an issue, come up with a compromise, I’ll do what I promised to do, and then he’ll break his promise because it’s not what his parents want. It feels like the decision makers for my nuclear family are my husband and his parents instead of me and my husband.

It’s so hard not to respond in anger when my husband directs anger at me that is really about being angry at his parents and the situation. I did not make his sister sick and I certainly had no say in the choice to not seek any medical help for her for years and then to ignore the severity of her illness for several more years. Yet I bear the brunt of it.

It’s 3+ years now of this dynamic and I’m the only person in therapy, trying to change the way I communicate and trying to be a better partner to my husband as he navigates this. If he were in therapy and trying to change I would feel very differently. But he is not - last night after I agreed to have his parents come visit and he started pushing for his sister to come too, he said he doesn’t need therapy and that it’s not reasonable to set the boundary that she cannot be around our kids when she is unmedicated.