Threads of Struggle: Navigating Family Dynamics and Mental Health

Copyright © 2025 by Susana E. Méndez, MD.

All rights reserved. No part of this book may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopying, recording, or by any information storage and retrieval system, without permission in writing from the copyright owner.

Drawing by: Inés Bosso Bacarreza

Rev. date: 02/03/2025

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CONTENTS

1     Roots of Understanding

2     Inheritance of Pain

3     Silent Battles

4     Ties That Bind

5     Carrying the Load

6     Interweaving Bonds

7     Embracing Renewal

8     Thriving Beyond Adversity

9     Breaking the Chains

10   Educating Hearts and Minds

11   An Ancient Treatment for this New Century.

Acknowledgments

I want to acknowledge all the families that during my forty years working in the USA, gave me the foundation of the words used here. I saw their struggles to set boundaries, the pain of losing a spouse or a child as well as the joy of having their loved ones stable again and reunited by love, patience, and understanding.

I want to acknowledge my own family,

My father, Dr. Mendez, whose crazy hours of work offered others solutions for their physical and emotional pain, and my mother, who was the force behind my father, supporting all his dreams as well as mine.

Elena and Carmen, my grandmothers, both had their struggles in life. I learned from them the strength needed to face adversities, to speak the truth, unconditional love, and a sense of service to others. Overall, they molded me to be who I am today.

Alberto, my brother who was always present in my life, like there wasn’t a long physical distance between us, through our phone calls, his prayer for me, or just BS, every time we saw each other, the encounter filled me with new life lessons, unconditional love, and awareness. His logic and wisdom helped me to clarify my path in times of sorrow, and Sandra, his wife, for showing me that forgiveness is a treat that not many is willing to offer.

To my first deep love in my twenties, Culi Culi T, you came into my life when less expected and, for many, many, many years, even today, taught me acceptance. To all who crossed my path and provided invaluable lessons—you know who you are! And the sisters related by love and not blood—Viviana, Alicia, and Stella—the three of you witnessed my happiness, my fears, and my success.

Last but not least, my adoptive family in the US, Alan, Kaye, and Ashley Gold, their unconditional presence in my life made my days easy to manage in a new country and when facing discrimination.

This book is for all of you.

Thank you!

Preface

In the pursuit of destigmatizing mental health and addiction, Threads of Struggle: Navigating Family Dynamics and Mental Health embarks on a journey that not only covers the intricacies of the development of mental illness but also delves deep into the interconnectedness of human experiences and healing. Dr. Susana Méndez has spent her career and much of her personal life walking through the darkness and into the light with people suffering from addiction and mental illness. Not only has she studied, trained, and mastered multiple modalities of healing, including Eastern and Western medicines, she has decades of experience helping people achieve the rare victory of reaching sobriety and remaining in recovery.

She is well-known in the field as someone to send the most challenging cases to, the people who have multiple relapses or inpatient stays, or as someone’s last hope for help. She is fearless, unwavering in her commitment to helping someone survive, and incredibly successful with this specific population.

Dr. Susana Méndez was my first boss in the field of counseling. At the time, she was the assistant executive director at a drug and alcohol treatment center, and she hired me as a therapist on the detox unit. It was very clear in the interview and even more evident after working for her that the clients come first. Her unstated message to the employees at the facility was they had the gift of being honored enough to be a part of the client’s healing journey, and she would accept nothing less than excellence, the highest ethical standards, and success.

As I reflect on the invaluable guidance from Dr. Méndez, I wonder how many therapists she has trained and how many clients she has assisted to seek solace amidst the shadows of stigma and misconception. In a world where silence often reigns over suffering, it is imperative to shatter the barriers of shame and ignorance that enshroud mental health and addiction. Through candid and empathetic conversations, we can dismantle these walls, paving the way for healing and acceptance.

This book is a testament to the unwavering commitment of my mentor, Dr. Susana Méndez, to advocate for the holistic well-being of individuals grappling with mental health challenges and addiction. By emphasizing the integral role of family dynamics in the recovery process, she acknowledges that healing extends beyond individual work, including the collective support and understanding of loved ones. Within these pages lie the blueprints of evidence-based treatments, meticulously curated to offer a beacon of hope.

From cognitive-behavioral therapies to pharmacological interventions, each modality is a testament to the resilience of the human spirit and the power of perseverance. Her message is as clear as her commitment to her patients—may we stand united in our quest to foster compassion, dispel stigma, and champion the cause of mental health and addiction awareness.

For it is only through collective action and unwavering solidarity that we can light up the path toward a brighter, more inclusive future for all.

Ashley G. Kuehne, LPC-S, LCDC

Certified Clinical Trauma Professional

Dr. Méndez offers hope and healing in this overview of causes and treatment modalities driving home to patients that even if nothing in their family system ever changes, they still can. When one person in a relationship changes, the relationship inevitably changes. This is a powerful mind shift for individuals and families living with severe and persistent substance abuse disorders and/or mental illnesses. Dr. Méndez turns powerful statements into purposeful practices.

Treatment of the underlying cause feels attainable as she breaks down the barriers and digs into the systems at play before the onset of substance and mental health challenges. Dr. Méndez provides extensive research backed by years of personal experience in treating some of the most difficult cases tied to substance abuse and mental illness. Taking this from treatment to textbook, she has provided a frame of reference for practitioners and professionals to provide better informed care.

Dr. Méndez connects the dots by merging modalities and educating us on each of them to create an educational pathway to success.

The bottom line, in a world that stigmatizes substance abuse and mental illness, she makes it all make sense. She provides a true holistic approach to understanding the whole person and treating them as such.

Summer Butler, MA

Author, Blended: Aligning the Hierarchy of Heart + Home

Stepfamily Dynamics Coach

1

Roots of Understanding

Introducing the Complexities of Family

Dynamics and Mental Illness

Would like to start with the intricate web of family dynamics and the often-overlooked intersection with mental illness. How