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The question: It's clear to our entire family that my adult sister has big emotional issues, but she won't recognize this fact. How do I deal with her mood swings in a loving way, but also not promote further outbursts that seem to only be brought on for attention?

The answer: Speaking to anyone who is in denial about their personal issues is difficult in the best of times. But the challenges become particularly amplified when a relationship with an immediate family member is potentially at stake.

A sibling bond is unique and special in so many ways, given the shared experiences – after all, no one better understands parents and family issues better than someone who was raised in the same environment. Yet our sibling relationships are often the most complex as well, particularly when elements such as competition, jealousy or insecurity play a role.

You care about your sister and want to be supportive, yet seem to be struggling with being available as a support for her, but also establishing boundaries for what behaviours of hers you will tolerate.

The first thing you want to do is offer to provide support to your sister, if you haven't already done this. ("I'm concerned about you, and want to help however I can.") When communicating with her, ensure that she doesn't feel ganged-up on by the family. Speaking to her one-on-one, without others there, is the most respectful way to approach this. Don't be blaming or accusatory, and stick to the facts of what you observe, as well as the impact on you. ("I felt extremely hurt when you yelled at me last week for disagreeing with your opinion on what we should do for dinner.") Ask her what you can do differently to help improve the relationship.

Ask yourself what your contribution to her outbursts may be. When there is a long history of problematic behaviour in a relationship, friends and family members often, without even realizing it, react in sarcastic or passive-aggressive ways, given their understandably pent-up frustration. Be mindful of patterns that trigger her. Are there certain topics that push her buttons which you can simply avoid (say, talking about careers or relationships)?

Identify your hard and fast boundaries in the relationship. For example, you may decide that you will no longer tolerate her yelling or using profanity in disagreements. Figure out what your response will be (for example, ending the visit). Verbalize what you are doing and why. ("I find myself getting very upset when you swear at me, and I'm choosing not to be around you if that's how the conversation is going to go, so I am leaving.") Then, consistently stick to this.

Often, emotional outbursts get reinforced because the family doesn't implement consequences to the behaviour. Your establishment of clear and consistent boundaries may serve as a catalyst for her to change.

Finally, realize that the only actions you can control are those of your own. We are stuck with the family we have for the long haul, but remember that we can maintain love for them – without always having to like them.

Dr. Joti Samra, R.Psych., is a clinical psychologist and organizational & media consultant. She is the host of OWN: Oprah Winfrey Network's Million Dollar Neighbourhood and is the psychological consultant to CITY-TV's The Bachelor Canada. Her website is www.drjotisamra.com and she can be followed @drjotisamra .

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