My brother is unwilling to seek psychological counseling?
The situation is as follows: In September 2021, my younger brother (the youngest) just started high school.
After a few weeks, he suddenly changed his demeanor, expressing to my parents that he didn't want to go to school.
He became very silent and expressionless, ignoring anyone who spoke to him.
When my parents inquired about his situation at school, his homeroom teacher reported that he occasionally joked around with classmates or said nonsensical things, but everything else seemed normal.
Later, my brother expressed thoughts of wanting to die, prompting my parents to ask if he would like to see a psychologist, to which he agreed.
After attending counseling, he showed some improvement, but then a new situation arose at home.
My parents asked him if he wanted to retake the entrance exam to switch schools.
Initially, he insisted on studying at home, but since the family couldn't afford that, he eventually expressed a desire to retake the exam.
During the retake period, aside from occasional counseling and classes, he became heavily reliant on electronic devices, rarely going outside.
His father would often ask him if he wanted to go biking together, and he would reluctantly agree to go out occasionally.
As the counseling and retake period progressed, I noticed that my brother spoke to my father very rudely and sarcastically.
However, my father, not wanting my brother to fall back into depression, went along with his behavior.
My brother's demands became increasingly extravagant, and I communicated with my mother that this was not acceptable, but I ended up being scolded instead.
Since I mostly live outside the home, my sister (the second child) had to endure this strange situation at home, and the atmosphere changed significantly from before.
Eventually, my brother passed the entrance exam for high school, and his counseling sessions came to a close.
During his time at school, he was reluctant to attend classes, and my parents never placed special demands on his grades; they only hoped he could enjoy learning.
However, my brother sometimes made strange excuses to take leave from school.
Although my parents allowed him to take time off, I personally felt this was abnormal.
Recently, my father suddenly had an argument with my brother, seemingly exploding after enduring my brother's rudeness for too long.
My father was just joking with him as usual, but my brother, not liking the joke, slammed the door in front of my father.
My father, angry, opened the door and said, "You shouldn't react like that if you don't like the joke." After my father spoke, my brother slammed the door again (poor door).
After that, my brother started throwing chairs in his room.
My mother, hearing the commotion, rushed upstairs to check the situation.
When she opened the door, my brother yelled, "Do you think I'm happy? I'm happy on the surface, but not at all inside! I want to die!" My father was stunned upon hearing this.
Later, my parents went downstairs to discuss things, and although my father apologized for his behavior, my brother remained silent.
Since that day, my brother reverted to his previous state from last year, completely shutting down and spending all his time in his room watching anime, playing computer games, and using his phone.
My parents' attempts to communicate with him went unanswered, and the same happened when my sister and I tried to talk to him.
During dinner, he would come down very late, and I was unsure if he was doing any household chores.
A few days ago, during Christmas, I asked my brother if he wanted to eat something, and he glanced at me before looking away towards the food.
I thought he was contemplating, but after waiting nearly a minute, I realized he was still closed off.
After dinner, he went straight upstairs.
Since my brother's school has been on break, he has been home.
Today, my sister told me that our mother had scheduled an afternoon counseling session for him.
When she went upstairs to inform him, he suddenly yelled, "Don't touch me!" and kept saying "No," before falling silent.
My sister went upstairs to check and found our mother standing outside on the balcony, seemingly trying to hide her tears from my sister.
I believe my mother must have asked my brother about the counseling session beforehand, but I can imagine that my brother likely didn't respond, as he was probably just scrolling through his phone or playing on the computer, which I have witnessed before.
Both my sister and I feel very sad seeing our parents distressed over my brother's issues.
They have become increasingly worried, and no matter how hard we try to cheer them up, it seems difficult.
Sometimes, it even feels awkward for both of us, and the atmosphere at home is very uncomfortable.
Although my brother is currently on break from school, I worry that he might refuse to go back once classes resume.
Given his current state, he is also unwilling to attend counseling, leaving the family very troubled and unsure of what to do.
If this continues, my mother might also develop depression.
Additional note: My brother does not exhibit self-harming behavior, and my parents are generally good at communicating.
However, since my brother's issues began last year, they have become very accommodating to him.
Kunrao de jiejie, 20~29 year old female. Ask Date: 2022/12/28
Dr. Wu Menghuan reply Psychiatry
Hello: The situation described for the younger brother includes a combination of social withdrawal, school refusal, excessive internet use, and gaming addiction.
External influences may include academic pressure from school, family issues, and interpersonal relationship problems.
Internal factors may consist of low self-esteem, feelings of frustration, lack of achievement, and loss of motivation.
Initially, the individual is unlikely to be willing to seek treatment and may even refuse to leave their room.
It is recommended that family members start with "short daily conversations" with the individual, such as basic greetings like "good morning" and "good night," to demonstrate acceptance, understanding, and empathy, while avoiding confrontation or blame.
The conversation topics should ideally steer clear of sensitive subjects such as "academics," "exams," "work," or "the future," and instead focus on the individual's interests, such as comics or games, to gradually increase interaction.
Next, it is important to slowly rebuild trust within the family, establish a regular daily routine, encourage personal hygiene, and organize their living space.
Opportunities for the individual to leave their room and go outside can be created by accompanying them to convenience stores to buy gaming cards or comics.
Additionally, guiding the individual to engage in activities they are interested in, such as shopping, watching movies, or attending anime festivals, can naturally enhance their connection with the outside world.
It is also crucial to be aware of potential co-occurring mental health disorders, such as social anxiety disorder, specific phobias, generalized anxiety disorder, depression, persistent depressive disorder, obsessive-compulsive disorder, and trauma- and stressor-related disorders.
It is advisable to accompany the individual to a child and adolescent psychiatry clinic for assessment and treatment.
Thank you.
Reply Date: 2022/12/28
More Info
It sounds like your family is going through a very challenging time, particularly with your brother's mental health struggles. The situation you described indicates that your brother may be experiencing significant emotional distress, which can manifest in various ways, including withdrawal, irritability, and reluctance to engage in activities he once enjoyed.
From what you've shared, it seems that your brother's behavior changed dramatically when he entered high school, which is a critical transition period for many adolescents. This change can be attributed to several factors, including academic pressure, social dynamics, and possibly underlying mental health issues. The fact that he expressed thoughts of wanting to die is particularly concerning and should be taken seriously. It's crucial for him to receive appropriate support and intervention.
Your brother's initial willingness to attend counseling suggests that he may have recognized the need for help, but his subsequent reluctance indicates a possible regression in his mental state. This is not uncommon; individuals struggling with mental health issues may oscillate between seeking help and withdrawing from it. The pressure of family dynamics, especially if he feels that his needs are not being met or understood, can exacerbate his reluctance to engage in counseling.
It's also important to consider the family environment. You mentioned that your parents have been accommodating to your brother's demands, which might have initially seemed like a supportive approach. However, this can sometimes lead to enabling behaviors that do not encourage him to take responsibility for his actions or seek help. While it's essential to support him, it's equally important to set boundaries and encourage healthy coping mechanisms.
Your brother's behavior towards your father, particularly his disrespectful remarks, could be a manifestation of his internal struggles. He may be projecting his frustrations onto your father, who, despite his efforts to maintain a light-hearted atmosphere, may inadvertently trigger your brother's feelings of inadequacy or anger. This cycle of conflict can create a tense home environment, which can further impact everyone's mental health, including your parents'.
As for your concerns about your mother's emotional well-being, it's understandable that she might be feeling overwhelmed. The stress of managing a family member's mental health crisis can take a toll on caregivers. It's crucial for her to have support as well, whether through friends, family, or professional counseling.
Here are some steps you might consider taking as a family:
1. Open Communication: Encourage open and honest discussions about feelings and concerns within the family. It might help to have a family meeting where everyone can express their thoughts in a safe space.
2. Professional Support: If your brother is resistant to individual counseling, consider family therapy. This can help address the dynamics within the family and provide a platform for everyone to express their feelings and work towards understanding each other better.
3. Encourage Healthy Activities: Encourage your brother to engage in activities that promote mental well-being, such as physical exercise, hobbies, or social interactions, even if they are small steps.
4. Set Boundaries: While it's important to support your brother, it's also crucial to establish boundaries regarding his behavior. This can help him understand that while he is loved and supported, there are expectations for respectful communication and engagement.
5. Seek Support for Parents: Your parents may benefit from their own counseling or support groups to help them cope with the stress of the situation and learn effective strategies for managing their son's behavior.
6. Monitor Changes: Keep an eye on any changes in your brother's behavior or mood, and be proactive in seeking help if his condition worsens.
In conclusion, navigating mental health issues within a family can be incredibly complex and emotionally taxing. It's essential to approach the situation with empathy, understanding, and a willingness to seek help. By fostering open communication and encouraging professional support, your family can work towards healing and improving the overall dynamic.
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