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When Madness Comes Home

When Madness Comes Home

Growing up can occasionally be challenging, regardless of family. However, there are frequently significant issues when a family member has a mental illness. These families frequently experience volatility or unpredictability for their members. Families are commonly affected by the “ripple effect” of mental illness, which can lead to conflict, ambiguity, stress, and occasionally dramatic changes in how they live their lives (Ahmed & Ghaith, 2018). The paper provides a summary and reaction to Victoria Secunda’s work in the book “When Madness Comes Home” and highlights the impact of treatment on a therapeutic relationship.

“When Madness Comes Home” Summary

The book “When Madness Comes Home” offers emotional support and direction for friends and family of the mentally ill by giving a personal account of the effects of mental illness on families and friends. The author focuses on the effects of mental illnesses on families and incorporates her experience growing up with a mentally ill sister.

Additionally, the author narrates research findings on mental illness-related topics, using anecdotal facts she learned by speaking with people whose relatives have similar conditions. The book exemplifies the role of biological, social, and environmental factors in the etiology, maintenance, and management of mental conditions.

Having a broken mind has short to long–term effects affecting the patient and the lives of those around them. Although she acknowledges the genetic component of mental illness, Secunda advocates for better prevention and treatment and concentrates on assisting families in learning coping mechanisms. Among the pharmacotherapy and the non-pharmacotherapeutic interventions, she emphasizes the critical value of families teaching families during psychoeducation.

The author also points out the role of medical professionals in providing a diagnosis in a manner that leads to its acceptance. She emphasizes the value of support networks and the necessity of acknowledging the helplessness that can often come with cohabiting with a mentally ill person (Secunda, 1997). The result is a wealth of information that can help anyone who currently or in the past has lived with a spouse, sibling, parent, or offspring who has a mental illness

Implications of Therapeutic Relationships Treatment

A therapeutic relationship is vital for patients receiving psychopharmacological therapy for a wide range of mental health conditions. Taking drugs outside of treatment sessions is necessary for psychopharmacological treatment to be effective, and the therapeutic alliance may play a crucial role. Many psychiatric drugs have side effects, some of which take time to manifest a therapeutic effect (Totura et al., 2018).

Alliance formation is relevant for balancing effectiveness expectations and side effects that could reduce adherence because adult patients are typically accountable for their drug compliance. Despite unfavorable side effects or the absence of an early therapeutic benefit, patients who have a strong therapeutic relationship are more likely to continue taking their medications.

An individual in therapy may be more likely to open up emotionally and elaborate on their issues once the therapeutic relationship has been established. As a result, the therapist can better understand the patient’s viewpoint, emotions, and motivations. The therapist is better positioned to offer the most appropriate care and use the most efficient methods to deal with the problem since they are fully aware of the circumstances.


When Madness Comes Home” by Secunda V, 1997, is an incredible book highlighting personal accounts of people whose family members have a mental illness, “A broken Brain.” The work expresses the continual fear of being next in the pathological lineage and shattered families due to mental illnesses. The author suggests therapeutic intervention for patients’ and families’ recovery. A therapeutic relationship is a crucial first step, and trust is essential for that alliance to be fruitful.


Ahmed, H. A. A. E., & Ghaith, R. F. . (2018). Effect of psycho-educational program on families’ perception of burden and attitudes toward mental illness among caregivers of patients with schizophrenia. Egyptian Nursing Journal, 15(3), 331. https://www.enj.eg.net/text.asp?2018/15/3/331/248967

Secunda, V. (1997). When Madness Comes Home: Help and Hope for Families of the Mentally Ill. Hyperion.

Totura, C. M. W., Fields, S. A., & Karver, M. S. (2018). The role of the therapeutic relationship in psychopharmacological treatment outcomes: a meta-analytic review. Psychiatric Services, 69(1), 41-47. https://doi.org/10.1176/appi.ps.201700114

When Madness Comes Homes (Secuna, V. 1997)
Read the entire book, summarize and give your reaction.
What are the implications for treatment in a therapeutic relationship?

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