Please remember, this column is designed to help the consumer seeking behavioral-health information, and not intended to be any form of psychotherapy or a replacement for professional, individualized services. Opinions expressed in the column are those of the columnist and do not represent the position of other SelfhelpMagazine.com staff.

Question

My brother is 21 years old and was dumped by his girlfriend. He liked her a lot more than she liked him. He took this rejection very badly. He has gotten drunk and injured himself several times with a knife. He has gotten beat up by a gang. This behavior is completely out of character for him. He does not seem to be able to forgive himself for what he has done. He blames himself for the breakup with his girlfriend; he is very angry. He does not sleep for more than four or five hours a night. He is exercising and keeping busy, but doesn't feel better about things. It has been three months since the break up and he does not feel that he is getting over it. He refuses to seek professional help. How do I help him help himself?

Answer

Apparently your brother had a lot invested in this relationship. He views the break-up as a reflection of some personal flaw and believes that had he behaved differently with her, the break up would not have occurred. So now he is obsessing about the outcome, believing that the responsibility for the break-up was totally his fault. Your brother cannot tolerate the thought that this girl was not as attracted to him as he was to her. He wants to believe that he had more control over the situation and her feelings than is possible. Her reasons for rejecting him may have had little or nothing to do with anything he did or did not do. People's feelings change, especially when it comes to affairs of the heart, and even more particularly when one is young.

You state that your brother's behavior is out of character. I assume that refers to the drinking, self-mutilation, and fighting. The magnitude and duration of your brother's reaction to the break-up leads me to wonder whether this event triggered a deeper, underlying issue that needs professional attention.

Self-mutilation is dangerous. People can do serious damage to themselves, especially when under the influence of alcohol. I wonder whether this incident might have touched off some feelings of low self-esteem, powerlessness, or underlying depression. You might encourage him to seek out a consultation with a professional psychologist. It is unfortunate that people have a bias against seeking a professional for their mental health concerns, while even professional athletes will seek a professional consultation for their physical health concerns. Just as one can wait too long to seek medical help, one can wait too long to seek psychological help.

The issue of trying to help someone help themselves, as you put it, is difficult. The short version is, no matter how much you want to help someone, unless they want to be helped there is little you can do other than be supportive, empathic, and understanding. Sometimes you can give information. That's about it.

3/5/98

Dr. Edward A. Dreyfus is a Clinical Psychologist, Marriage, Family, Child Therapist, and Sex Therapist. Dr. Dreyfus has been providing psychological services in the Los Angeles-Santa Monica area for over 30 years. He offers individual psychotherapy to adolescents and adults, divorce mediation, couples counseling, group therapy, and career and vocational counseling and assessment.His book, Someone Right For You, is available in the Amazing Bookstore Catalog.

Dr. Dreyfus can be reached at: (310) 208-5700.