What To Do About the Mental Health of an Ex?

“What To Do About the Mental Health of an Ex?”

By Bill Schacht, MS, LCSW

 A POD member asked for information about his ex-spouse having a substantial and sudden change in mental condition.

It is obvious that whether we are considering a commitment in a pre-marriage situation, a current marriage relationship, or in divorce situations in which minor children are involved, the mental health of both partners is essential to the health and joy of relationship interaction.

A relationship can only be as good and satisfying as what the individuals bring into it.  In my clinical practice, over 85% of the couples who come to me for marriage/relationship counseling involve mental illness in one or both of the partners.  What is most shocking is that over 50% of those who present with such disorder report that they have never been psychologically evaluated, diagnosed, or treated!  And, a vast majority of these folks are in significant denial that there is anything wrong with them.

When these couples come for counseling, they tell the therapist that the relationship is “the problem.” What emerges in the therapy is that the problems are caused by the mental disorder existing in one or both of the partners.

Psychologically unhealthy humans rarely create healthy relationships over time.  Undiagnosed and untreated physical illness can also lead to relationship breakdown.

Any psychological disorder can and will negatively impact relationship.  The relationship killer in people with psychological disorders is FEAR.  Fear negates the experience of LOVE.  It is impossible to allow one’s self to be vulnerable in a relationship when frightened.

The most frequent diagnoses that I observe people in couples’ counseling present with…

• Undiagnosed and untreated or ineffectively treated post traumatic stress.  This usually manifests from  sexual, physical, and/or emotional abuse, in soldiers with battle experience, in police and other law enforcement personnel and firefighters who witness trauma and/or have near-death experiences,  and in EMT’s, Emergency Room and other health care professionals who are exposed to patient trauma.  These individuals find it very difficult to feel safe in relationship and have trouble being emotionally present/available in relationship because their pattern of suppressing the painful emotion of the unresolved trauma will present as either emotional avoidance or instability/volatility.
• Addictions.  Alcohol, drugs, gambling, sex/porn, food, shopping – whatever.  These patterns consume time and resources and cause people to be inattentive in relationship.  The addiction is presented as more valuable than relationships.  Remember, many addictions, especially drugs and alcohol, are self-medication efforts for other conditions.
• Anxiety of any type.  People who suffer from anxiety make choices based on what worries and frightens them.   Social anxiety, which makes it impossible for a person to enjoy interactions with people who are unfamiliar, will quickly breakdown a relationship in which their partner enjoys social interaction and meeting new people.
• Chronic Pain/Pain Disorders.  Enjoying anything is hard when a person is in pain.  To the extent a person is consumed by pain, they cannot be present in relationship.  When pain increases during sexual activity, it is difficult for people to fully engage and enjoy a sexual encounter.

Psychological health can deteriorate quickly as our associate has noticed in his ex-spouse.  Trauma, grief (over the loss of a loved one, job, etc.), financial problems, post-partum depression, and physical conditions including pain, thyroid dysfunction, hormonal imbalances, and many other situations can cause sudden psychological distress which results in change in relating.

As POD’s, our first concern of mental health should be our own.  If I know I am psychologically struggling, I must have the courage to be evaluated by a qualified and competent mental health provider, ensure accurate diagnosis, and get effective treatment.  It is irresponsible to try establish and maintain a pleasurable love relationship if we are not psychologically healthy.

When dating, it is imperative that we are certain of our potential partner’s psychological health.  I meet too many people who enter committed relationships knowing that their partner has a psychological disorder not under control.  Many engage with the false hope that the relationship itself will make their partner better, only to learn later that the responsibility of performing well in the relationship causes them to get worse.

If you are in a relationship in which you know your partner is suffering from a diagnosable mental disorder, do not choose the path of relationship counseling first.  Focusing the problem on the relationship will distract your partner from what is their primary responsibility – to get themselves healthy.  Their pathology that shows up in the relationship counseling, if not individually treated, will cause the relationship counseling to fail.

In a divorce situation, an ex-spouses mental health deterioration, especially when that results in abusive, inattentive, negligent, or unhealthy parenting of minor children, must be addressed.  May times the healthy spouse will balk at addressing the issue with the ex to avoid generating increased conflict.  But, this is a situation in which the well-being of the children must be priority.

A progressive process of getting your ex’s attention to their psychological condition can be followed:

• A direct attempt to get our ex’s attention to address the issue is the best first move.  A private, face-to-face disclosure of your concerns is optimal.   A letter that defines your concerns can be effective also.  Remember to be empathic and compassionate – not blaming or accusatory.  Do not speak or write about psychological diagnoses.  It is best to communicate actual observations of behavior and/or mood (i.e. excessive anger, etc.) and the negative impact that was observed on others (i.e. the children, etc.).
• If a direct communication fails, securing the attention and support of ex-in-laws can be an effective next step.  It can be much easier to “hear it” from loving family members.
• Securing the support of clergy that has a good relationship with an ex is another option.
• If an ex refuses to address unhealthy behavior and mood and children are being negatively impacted, the involvement of a Guardian Ad Litem (GAL) through the family court system may be necessary.  Communicating the situation to your family law attorney to get advice on how to proceed or contacting a recommended GAL in your county is recommended.

In such a situation, the only thing that is not recommended is doing nothing.  It may take several attempts and much effort and expense, but having the children and your ex at increasing risk due to mental illness in not acceptable.

We will have many conversations and discussions about mental health as we support one another in our goal of…

Never Again!

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