What Is an Identified Patient (IP)?
Family dynamics can become complex when a family member has a mental health diagnosis, such as autism, a personality disorder, or a substance use disorder. In some families, this person may become the Identified Patient (IP)—the individual who receives the majority of attention, resources, and focus. As a result, other family members may feel overlooked, resentful, or misunderstood. These reactions are common and valid, even though many family members may feel shame or guilt for experiencing them.
High-conflict family systems often involve persistent patterns of tension, escalation, and instability. These dynamics may include:
A parent with an alcohol or substance use disorder
A family member on the autism spectrum
A sibling or partner with a personality disorder, such as Borderline Personality Disorder (BPD) or Narcissistic Personality Disorder (NPD)
These situations can create ongoing stress and conflict, making it challenging for family members to establish stability, peace, or emotional safety.
Treatment with Cognitive Behavior Therapy
In high-conflict family systems, it is important for family members—whether siblings, children, parents, or partners—to express their frustrations and process their experiences in a safe, therapeutic environment. In therapy, I encourage clients to focus on their own emotional needs rather than solely on the needs of the Identified Patient. Through Cognitive Behavioral Therapy (CBT), I support clients in distinguishing between caregiving and codependency, and in developing healthy, sustainable boundaries. This work helps individuals navigate challenging family dynamics while prioritizing their own well-being and emotional stability.