The Blame Game

Is it my fault? Did I cause it?

Angela Inglis, MSc, and Jehannine Austin, PhD

Reprinted from "Families" issue of Visions Journal, 2013, 8 (3), pp. 10-11

When someone develops a psychiatric disorder, one of the first things they and their loved ones wonder is: Did I cause this? Could I have prevented it? Is this somehow my fault?

Those who have the psychiatric disorder often wonder whether they are somehow to blame for their illness—because, for example, they used street drugs, drank alcohol or didn’t sleep properly.

Parents of people who have been diagnosed with psychiatric disorders can feel guilty for a lot of different reasons. The parents often wonder if their child developed a psychiatric disorder because, for example, they got divorced or because the mother had the flu while she was pregnant. And society, unfortunately, sometimes reinforces parental feelings of guilt. “I was told it was because I was a weak parent…” These sentiments imply to parents that if they had been more strict or a ‘better’ parent,’ perhaps their child wouldn’t be ill. Also, if a parent has a family history of psychiatric illness, they can feel guilty for causing mental illness by “passing on bad genes” to their affected child.

Siblings and children of people with psychiatric disorders can also feel guilty and wonder if it was their fault. Siblings may wonder, for instance: Is it because I teased him too much when we were growing up? Children might wonder if their parent developed mental illness because they were “difficult” children when they were young.

These feelings of guilt about whether or not mental illness is someone’s “fault” are very common. They are also deeply uncomfortable. In fact, they are so uncomfortable that people often find it hard to talk about them. These are feelings that cause families much suffering.

So is it anyone’s fault?

There is a lot of research data that clearly shows psychiatric disorders are caused by combinations of various experiential or “environmental” vulnerability factors (such as life events) and genetic vulnerability factors. None of the individual contributing factors are sufficient on their own to cause mental illness. In most cases, it is the combined effects of both these factors, with many different little contributions that ultimately lead to mental illness.1

Feeling guilty about passing on “bad genes”
First, and most importantly, remember that genes alone don’t usually cause mental illness—and so, typically, we do not inherit mental illness. We can inherit a vulnerability to mental illness, but this is an importantly different concept. Further, research is indicating that everyone has some genetic vulnerability to mental illness—not just those who have mental illness.1

Second, we cannot control the genes that we pass on to our children.

If we consider all of this together, it’s clear that even if a parent has a family history of mental illness, their child’s mental illness cannot be attributed entirely to having received “bad genes” from a parent.

Feeling guilty about life experiences
It’s very important to remember that any given life experience on its own typically doesn’t cause mental illness. Often it’s a combination of events that might contribute to the development of mental illness, usually together with an underlying genetic vulnerability.

It’s also important to realize that experiences don’t have to be dramatically negative—such as experiences of trauma—to contribute to the development of a mental illness. Some life events are not necessarily perceived as negative but can be stressful—planning a wedding or a vacation, for example. These kinds of stressful events may potentially contribute to vulnerability to mental illness.

One life experience people often feel guilty about is street drug use. While drug use can contribute to the development of mental illness, it is not typically the only cause. There are many people who use street drugs and don’t develop a mental illness, and vice versa.

Parents often feel guilty about their child’s mental illness and wonder if they could have prevented it by being “better” parents. We also know that even “perfect parenting” cannot prevent mental illness. It’s important to recognize that we have limited control over many of the things that happen to us throughout our lives and that happen in our loved ones’ lives.

So, do we have any control?

You need to know and feel that your family member’s or your mental illness is not your fault. And while there can certainly be a sense of relief in letting go of blame, it can also make us feel frighteningly out of control or helpless. It can lead people to feel that everything is just a result of chance, and that perhaps there isn’t anything we can do to help with recovery or protect mental health.

Because the development of mental illness is not all genetic, there are things we can do to try to protect our mental health and help with our recovery. Healthy habits to do with sleep, exercise, diet and social support can be very beneficial. It can be a challenge to keep up these healthy habits all of the time—no one is perfect at this.

But when we have periods where we are not taking care of ourselves as well as we’d like to, it’s important to try to accept that we are doing the best we can, so as not to feel guilty. It’s important, always, to be kind to ourselves. Family members and loved ones of individuals with mental illness can also try to encourage and model these healthy habits.

 
About the authors

Angela is a genetic counsellor* who specializes in psychiatric disorders. She helps people understand the causes of mental illness, explaining in lay language what is known from research, and making that information relevant to each person. Angela provides this service to people who have mental illness and to their families Jehannine is an Associate Professor in the departments of Psychiatry and Medical Genetics at UBC, where she holds the Canada Research Chair in Translational Psychiatric Genomics. Jehannine led the development and implementation of the first and only specialist psychiatric genetic counselling service in the world, here in BC

Jehannine is an Associate Professor in the departments of Psychiatry and Medical Genetics at UBC, where she holds the Canada Research Chair in Translational Psychiatric Genomics. Jehannine led the development and implementation of the first and only specialist psychiatric genetic counselling service in the world, here in BC

Footnote:
  1. Peay, H.L. & Austin, J.C. (2011). How to talk with families about genetics and psychiatric illness. New York: W.W. Norton & Company
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