My parents want to contact my sister's psychiatrist (coercive control) - I don't think they're allowed to - thoughts?

[HepburnKNotA]

V briefly, DSis married to man who shows all the hallmarks of coercively controlling her.

He has now arranged (found, booked etc) a psychiatrist for her as he says she is mentally unwell. (they are v wealthy/high status so he has just booked the 'best' and most expensive meantal health professional they can think of; it's entirely possible that a psychiatrist is inappropriate and a therapist/counsellor would be better but hey-ho)

There have been a couple of initial sessions but DSis seems more controlled than ever - she's just taken a big 'decision' to do something that her H wanted her to do that my parents are worried will isolate her more.

I think it's too early for psychaitrist to have begun to get to the bottom of a lot of the issues (eg the coercive control) - DSis is ostensibly seeing shrink because she's unhappy 'at work'.

My parents (understanably extremely worried but with a tendency towards over-involvement, albeit with best (sometimes misplaced) intentions...) are saying they want to contact psychiatrist to give him some info that they are certain DSis won't be revealing (about the way she is bullied/controlled)

I have told them I think psychiatrist will just disregard any email from them (am I right?) as unethical, even though they are not interested in correspondance ie they would never presume to ask psychiatrist for info (and I would hope to God reputable dr wouldn't give it to them).

Or might a shrink read something like this and then either disregard it or put it to use in sessions?

I've told my mum I think she needs to tell Dsis they WANT to write to psychiatrist (she will, I am certain, say no) as if they went behind her back she would feel, if she found out, incredibly betrayed.

I can see how desperate my parents are, there are children involved and the situation is toxic beyond belief, DSis's husband is now telling everyone DSis isn't well etc and I think anyone on the outside can see, without having to take sides, that the essential problem is her husband's treatment of her (and kids too).

But contacting psychiatrist behind her back is a bad plan, right? Has anyone ever done this? Would psychiatrist a) take note of the info b) ignore the info? If DSis was in agreement, would it make a difference? (she won't be, I can almost put my mortgage on it).

Please help if you can! Desperate situation all round, tbh :(

A psychiatrist is a doctor so I would think they can’t break doctor patient confidentiality.

Oh and sorry - I have expressed to my mum that in my view any psychiatrist worth their salt will - even if it takes some TIME - be well able to see through my DSis's outward mask (refusal to admit the way she's treated at home) - no matter that she will be sitting there saying what an amazing supportive H she has, a good shrink would be able to get to the bottom of the situation - right?

Or am I being over-optimistic?! Would have thought any good mental health professional owuld be able to read sub-text?

When my dh had an employee with bdp he was able to contact their crisis team.

The crisis team would not discuss or comment on anything with him, but they would listen to him.

opalfruits, absolutely, I don't think for a minute my mum is wanting dr to tell them anything at all, they literally just want to write to the dr themselves... what I don't know is, is THAT just as unethical? Obv in a sense it's not for my parents to worry about in terms of ethics - they're being 'ethical' parents in their concerns, it's the Dr who needs to either refuse to read/take on board the email. But I worry, of course, that the mere act of sending the email is a betryal for my DSis.

My poor parents are desperate - they fear pushing her away with open criticism of the way her H treats her. But I don't think this is the/a solution to their feelings of helplessness.

Ah ok aussiebean, that's interesting.

Do you know if they were obliged to let the employee know that your dh (his boss?) had contacted them?

Thanks by the way, to both of you!

They cant discuss it with them but they can read it from them

However

If she is going for work stress surely that will be the focus of the conversation not her husband

I can fully understand your parents’ concern. When DD was in an abusive, controlling relationship I was beside myself with worry about her and DGS. I contacted the Police , SW and school. Although they ( rightly) wouldn’t give me information , they listened and took everything I said seriously. They said all information was important . Good luck . 💐

slippery - that's exactly their fear. This whole 'psychiatrist' thing has come about as a result of a month or so of horrendous rows between DSis and her DH - rows that turned quite violent etc with things being thrown (on both sides). Anyone who knows them can see their marriage is toxic, at best - but DH has convinced DSis the ENTIRE problem is work stress.

My parents are worried DSis - who believes everything her H tells her - will just bring up work stress and never mention home life.

My view is a good professional would see through the mask?

My DH talks to FIL's GP because FIL is often misleading about his physical health. Your parents won't get in any trouble for writing to the psychiatrist - though they should emphasise that the info must not be shared with your DSis, to prevent her DP getting wind of it and isolating her further. Also, obviously tell them to keep it as factual and objective as possible. Worst that can happen is the psychiatrist will disregard it, though I think it would be very unprofessional for any MHP to disregard concerns about DA.

Gosh, old, that is helpful thank you so much and I really hope your dd is OK now.

Can I ask, did your DD know you were contacting people 'behind her back'?

Do people like eg schools, police, doctors, have a duty of confidentialty to EVERYONE who contacts them about a patient, or just to the patient themselves?

I'm so torn between thinking it's just not right to go 'behind my sister's back' no matter what, and then sometimes I think, if she DIDN'T KNOW, then, under these particular circumstances, maybe it wouldn't be such a bad thing for my mum/dad to do.

What I would hope would happen is thos wouldmake him aware of a potential issue and would act accordingly

Thank you JesusintheCabbageVan - that's exactly my worst fear, and my parents' too, in fairness - Dsis genuinely believes she has a mental health problem and that her H is a saint :( and any attempt in the past to gently point out any contradictions in this are just met with total shut-down. If she were to find out they had emailed shrink to give their opinion on DH's behaviour, it could well cause her to cut them out (totally or a lot) and/or I wouldn't put it past her to let something slip to her H.

Very good idea indeed to be factual - I think my mum in partuic is so worked up she would be writing the world's longest angry slagging-off email about her Son in law and it would be inflammatory and unhelpful. My dad - if reminded be me - would be more factual.

Not all psychiatrists understand or will pick up on the dynamics of coercive control unfortunately, though some will.

Your parents can email them but they are unlikely to get much of a response.

What are your parents hoping the email will achieve?

If there are children involved in a domestically abusive situation, I wonder if your parents best bet is to email the children's school about their concerns specifically about them?

A psychiatrist has no duty to DO anything unless they're concerned that the patient is likely to harm themselves or someone else pretty imminently. They would take things down the medical route ie contacting GP, suggesting patient goes to A&E, which run the risk of further pathologising your sister, when their are obvious relationship and family problems.

I don't know, just a thought. I can imagine that your parents and you are beside yourself with worry and can understand that their need to do something.

I get the not wanting to 'go behind your sister's back' but their motivation is concern and wanting to help, not create problems.

Lumene - I don't know exactly, to be honest.

Part of me recognises that my mum JUST WANTS TO VENT about her daughter's horrible husband (!) which is probably the main excellent motive for me putting a stop to it.

Mostly I think they're in a panic and see DSis looking ever more trapped/depressed, knowing the main cause (her H) and recognising that he is painting a very very different situation, undermining her belief in herself and her mental state and not for a single minute addressing his own behaviour.

Hadn't thought about alerting the school thehorse, but it's good advice. It's all complicated in so many ways by the fact DSis and her H are very very wealthy, outwardly incredibly 'respectable' iyswim - I think my nephews' (posh) school would fall down if they thought there was a domestically abusive situation at home - people 'like them' just don't have these issues - does that make any sense? DH incredibly confident/popular/alpha so I think school just wouldn't compute it.

Psychiatrist may not be well versed in coercive control. If your sister doesn't yet understand she is being abused she is unlikely to be revealing the kinds of details that would enable the psych to pick up on it. And the psych is very unlikely to be asking questions that would even touch on any of it unless they happen to be hot on this area.

Unfortunately it's very common for abusers to convince the victim she is mentally unwell and that's why she can't meet his thoroughly reasonable demands, overreacts to his perfectly normal behaviour, fails to meet basic housekeeping standards, is too dependent on friends/family, neglects him, is frigid, etc etc. (His POV, obviously)

It's no less common for abusers to enlist unwitting HCPs to back up their narrative that the victim is mentally ill (even getting their victims detained) and by extension undermine any future efforts she may make to seek help, report his abuse or generally be believed by anyone - because he can say "she has a documented history of mental illness (I have been nothing but patient, trying to get her treatment, and now she is psychotic accusing me of terrible things, feel sorry for me sob sob)".

Some MH professionals have a fantastic understanding of the complexities of coercive control and how it affects victims but unfortunately most just don't. Some still don't get it even when it is being explained to them.

My concerns about your parents contacting the psych would be does this put your sister at risk? Is it likely to lead her to become more isolated if they are cut off as a result? Is she likely to feel compelled to double down to protect her abuser (bearing in mind the way abuse affects people)?

Have you read the advice on the Women's Aid website about if you're worried for someone? How telling someone what to do/to leave and being critical of the abuser makes things worse?

At a simplistic level you're just replicating the abuse by trying to control her decisions, so it undermines any argument you try to make about why she should leave because being controlled isn't normal if it is actually what everyone in her life does to her. And criticising him/his behaviour (however justified) is just going to feel like criticism of her for loving him and choosing him, which will lead her to become very defensive of him (and by extension herself). Generally coercive control is not dissimilar in its effects to people who've been brainwashed by cults and it is as difficult to reach people. Ask questions that give her opportunities to think and express concerns rather than telling her what to do/think. Validate if she does ever express distress at something that's happened ( "I think I would be upset if someone did that to me")...

Massively simplifying complex matters. I'm sure you already know how difficult this is.

Your parents won't get in any trouble for writing to the psychiatrist - though they should emphasise that the info must not be shared with your DSis, to prevent her DP getting wind of it and isolating her further

I've been a PA to quite a few psychiatrists over my years in the NHS and often had patient's relatives phoning up wanting to pass on information like this (its pretty common). Whilst the psychiatrist would never speak to the relative directly, they would ask me to tell them 'send me a letter/email with all the details and I will read it'. Your parents must mark the letter as contents not to be disclosed to patient or patient's husband.

Last thought, would it help your parents/you to do the Freedom Programme course online to help you all better understand the dynamics of what's going on, how any interventions by you may be received, how it's affecting her, etc?

Domestic abuse is no less common in wealthy or professional homes. It thrives on secrecy and "keeping up appearances" in every environment. The school staff would be really poorly trained if it shocked them. At most it would be the first family they'd been made aware of, but there's no way your sister's family is the first in that school where domestic abuse is an issue. It's way too common for that to be plausible (unless it's a newly opened school perhaps).

It can and does happen to anybody from any background.

Many a person has been saved by a psychiatrist seeing through abuse. Someone I know 'was put into a spa' and the shrink said 'he should be in here, not you'.

Tell your parents to write, beg confidentiality and be as clear and objective as they can.

This sounds like the storyline of Deadwater Fell!
Have your dps spoken to your BIL? As a parent of adult women, that’s what I’d be doing in the first place. I’d make it very clear that I had concerns and would be prepared to speak to school and the GP regardless of them giving me permission or not. If he’s fabricating her mental health that’s a big safeguarding concern.

If your DPs wanted to discuss their concerns about your DSiS's health without involving her, the HCP shouldn't refuse to listen to their views or concerns on the grounds of confidentiality. However, the HCP should consider whether their patient would consider them listening to the views or concerns of others to be a breach of trust. This would be particularly pertinent if your DSis has asked them not to listen to specific people (she may have requested this if she suspects family involvement). The HCP may need to tell their patient about information they have received from others, so your DPs should be prepared for that.

Thank you so much everyone.

Soontobe, they have had one conversation (monologue) with Their son in law when he phoned them a few weeks ago to tell them DSis was having a nervous breakdown and he was sending her to a psychiatrist.

They are scared of him, not so much scared maybe but worried about him escalating, turning DSis against them if they confront him in any way at all. Even a minor confrontation worries them. They worry about being cut off from their GC.

Really really appreciate all your posts. That’s very helpful nightsky thank you and good to hear it’s not uncommon. User, thank you, that’s all very very helpful info. I possibly am too optimistic about psychiatrist spotting signs of coercive control :(

Really having a bit of a bad day today worrying about this, have had my parents on the phone after they saw DSis yday and were even more worried about her.

It feels impossible to solve; it’s so subtle and I still struggle to get my head around the fact that my v dynamic successful sister can’t seem to see even one iota of the truth. Makes me think I must be imagining it!! But even my own DH who has been a big fan of my sisters husband in the past and is a very i dramatic character himself (unlike eg my mum) can see it full-square.