The Burden of Sympathy: How Families Cope with Mental Illness

A careful and current look at the frustration and the pain when someone you love is mentally ill. I enjoyed the depth of the analysis, which at times moved me profoundly. The author is non-judgmental and non-prescriptive, and yet unafraid to tackle what lies below the surface. He waded into the waters of male and female differences in caregiving, along with the reality of inadequate and sometimes non-existent societal supports. He concludes with compassion that we who caretake are really given an impossible task, and that society must begin to support both us and our loved one.

This is the first book I've read that describes my experiences of living with mentally ill family members so precisely. It is a must read for anyone living with or caring for a mentally ill loved one. David Karp has tapped into a secret well of pain and love and compassion that needs to be brought to the collective consciousness of our society.

Reading this book was such a relief. Dealing with a mentally ill family member is so hard to explain to someone who doesn't share the experience. People would tell me, "You look like you have the weight of the world on your shoulders." I just couldn't find the words to express what it was like to care for a family member who was severely depressed and psychotic until I read this book. Rereading it helped me see that it was not only OK but necessary to set boundaries to preserve my own mental health. Fortunately for my family, once I set boundaries, things changed dramatically for the better. The ill person in my family saw that I was serious about maintaining my own boundaries and actually started to get better. I realize that we might be the exception, and not the rule. I recommend this book highly, as it provides deep insight and a bit of comfort to those who are grappling with the devastating financial, physical, and emotional effects of caring for a mentally ill family member.

To write this book Karp, a sociologist, performed three-years' worth of in-depth interviewing of family members of mentally ill patients and attended support groups among these family members at McLean's Hospital in Belmont, MA. He also read extensively on mental illness and living with mental illness, mostly from sociological literature and some from medical books and a few medical journal articles. When I first looked at the book at the library, I noticed the chapter called "The Four C's." Looking at this chapter was what caused me to take the book home. I ended up reading almost the entire book carefully.Throughout the book, Karp discusses and quotes 60 caregivers (by "caregivers," I mean someone with a close relative with mental illness) talking about their relatives and about their own feelings, always focusing on the caregivers' reactions to the events surrounding the illnesses. Karp's main concern is with the obligation family members feel toward their mentally ill relative(s) and with how these family members cope with fulfilling their obligations toward the ill person(s) while trying to live their own lives. One theme that reappears often is that many mentally ill persons refuse to acknowledge their illness at one level or another, thus making their familial caregiver's role more difficult. This includes elderly parents who refuse to get help as well as young spouses with manic episodes who place blame on their healthy spouses. Another theme is the evolution of family caregiver emotions, from those of surprise and pain and hope at first to resentment and even severing of relations in some cases.Karp notes that parental care and obligation is the strongest of the familial ties with the mentally ill. He also covers numerous siblings, spouses, and children of people with mental illness. Some of the interviewees have both a parent and a sibling with an illness; some of these people are living with the fear of suffering the development of the illness themselves. Many wrestle with depression, seemingly as a result of their problems with their sick relative.Most of the patients related to Karp's interviewees have depression, mania, schizophrenia, or some combination such as bipolar disorder or schizoaffective disease. Most or all have had hospitalizations. Karp manages to cover a wide range of family relationship and ages with most of the concepts he introduces, thus emphasizing the similarities among those involved with mental illness in the family. The level of illness discussed is generally major.This book is not for the faint of heart. It is powerful and brutally honest, with no happy ending or false hopes. Another strong theme in this book that is visited over and over again is the chronicity and incurability of much mental illness. Quote after quote from the family members discusses early hopes of cure that are dashed by later episodes of illness, medications that work for a while and then stop working or never work at all or cost too muc

David Karp promises no easy answers, but he is unquestionably our most eloquent chronicler of mental illness. I had to take a lot of deep breaths as I read this book. It is full of gripping stories about the daily crises and terrible contradictions faced by anyone living with a mentally ill family member. The book moves between personal narratives and cultural analysis to explore what we owe the people we love. If you are a caregiver, or simply a reader who is puzzling through the question of commitment and moral obligation in your own relationships, you simply must buy and read this book.