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Adult Children of the Mentally Ill (ACMI) as cross cultural workers

June 17, 2014 1 comment

narrow passagewayI knew that I was an ACoA (adult child of an alcoholic) but I did not know I was an ACMI until I read Vicki Hornung Reyes, “A Closer Look at Children of the Mentally Ill in Missions in the April issue of the Evangelical Missions Quarterly.  Apparently California psychotherapist Eva Marian Brown created the term “adult child of the mentally ill” (ACMI) to describe people who had grown up “with a parent suffering from a serious psychological impairment that profoundly affected the functioning of both the parent and the family.” You can read more about Brown and her book, My Parents Keeper on her website.

Reyes asked the following question, “How do adult children of the mentally ill react in cross-cultural settings?” As an ACOA and an ACMI, I would love to see more research done on this topic. As I discovered in my dissertation, we don’t have an overabundance of research on missionaries to begin with.  Again, Reyes says, “Although it takes effort to uncover research about other types of adult children involved in missionary service (such as adult children of alcoholics), it is extremely difficult to find any specific research on adult children of the mentally ill in a cross-cultural situation.”

Reyes provides the following definition of “Mental illness” from the National Alliance on Mental Illness (NAMI),

A mental illness is a medical condition that disrupts a person’s thinking, feeling, mood, ability to relate to others and daily functioning…Serious mental illnesses include major depression, schizophrenia, bipolar disorder, obsessive compulsive disorder (OCD), panic disorder, posttraumatic stress disorder (PTSD) and borderline personality disorder. (2013)

I would classify myself as an ACMI because of major depression episodes in one of my parents. Again Reyes says, “Offspring of the severely depressed also seem to be very prone to depression, as well as other serious mental illnesses, according to a longitudinal study done by Marian Radke Yarrow and fellow researchers (Radke-Yarrow 1998, 192).” And she cited the following, “Those with at least one depressed parent had about a threefold higher risk for developing mood disorders (mostly major depressive disorder) and anxiety disorders (mostly phobias), more than twofold greater risk for alcohol dependence, and sixfold greater risk for drug dependence. (Weissman et al. 2006)”

Healing the blind man by Edy-LegrandReyes provides ten characteristics of Adult Children of the Mentally Ill

  1. They often have painfully low self-esteem and feelings of unworthiness.
  2. They are often victims of abuse.
  3. They have experienced a “lifetime of losses.”
  4. They are often “parentified children” (Brown 1989, 1).
  5. Many have felt alone growing up.
  6. They are usually very compassionate.
  7. They often have a great need for structure and predictability (Brown 1989, 128).
  8. They have probably not been able to share their story with others.
  9. They are generally very hard workers.
  10. They dislike artifice and are usually painfully honest both about themselves and what they observe around them.

According to Reyes, “ACMIs can make very competent workers.”  She lists some of potential positive characteristics

  1. ACMIs who are accepted by mission boards have proven to be very resilient.
  2. They are “copers”—those people described by Agnes Hatfield who make efforts to “master conditions of threat, harm, or challenge when the usual strategies are insufficient”.
  3. They have found the healing love of God, the Perfect Parent, and want to share this love with others.
  4. ACMIs usually have the gift of compassion and can empathize with the many victims of abuse and trauma worldwide.

into-the-caveAs expected, being an adult child of mental illness may lead to struggles on the mission field some of which Reyes suggest.

  1. Because of a lack of normal social experiences, support-raising may be initially awkward
  2. Relatives may not support the ACMI, either financially or emotionally when he or she leaves for the field.
  3. The ACMI may feel guilty for leaving the care of the parent to the spouse or other siblings
  4. The ACMI’s poor self-esteem may plummet when he or she arrives on the field until he or she feels confident using a second language and living in a new culture
  5. The ACMI may feel isolated because he or she is unable to share his or her story with many people.
  6. The ACMI may struggle with the chaos of living and working in certain cultures. •  The ACMI may overreact when there are church splits or mission upheavals because of his or her background of chronic loss and abandonment.

As an ACOA and an ACMI, I wish I had taken the time to process my family of origin issues before becoming a cross-cultural worker.  Perhaps, in 1985, when I became a missionary, missionary organizations were not as aware of mental health issues and member care  was a fledgling field of study.  I suppose in a lot of ways, I have ended up in the area of member care because of my own journey as a missionary processing my family of origin issues.

I do like the way Reyes concludes her article.  May this give hope to other cross-cultural workers who are ACOAs or ACMIs. Reyes writes, “ACMI missionaries can enjoy a successful and joyful ministry, but they may require time to recognize how growing up with a mentally ill parent has affected them. If childhood trauma is recognized before leaving for the mission field, ACMIs can focus on healing and may avoid attrition in the future. With the support of mission leaders and member care providers, these resilient, compassionate gospel-sharers can help bring hope to a hurting world that so desperately needs to know the love of a perfect Father.”