Speaking as someone with a SZA diagnosis with insight, I’m not sure I or anyone else aside from the person in question can answer this. You also add a value judgement of how anyone “should” properly feel or express emotions where there isn’t one. You also appear to want to arbitrate what and what isn’t a “true” emotion. I often say to caregivers to talk about feelings rather than facts when faced with delusions and anasognosia, because you can’t argue with someone about how they feel. Was I wrong about this?
Perhaps are you confusing thoughts and emotions which coincidentally is a feature of schizophrenia. In fact the so-called splitting of the mind of schizophrenia was a reference to a split between thought and emotion— not a splitting of personality. In my early days of recovery, I had trouble experiencing emotions in-the-moment. I might think about an incident and then later experience an emotion, but it took practice to cut down on the lag. I took up acting as a safe environment to practice integrating thought and emotion through character work.
Emotions are often tied in with perception and point of view, and most caregivers would say they don’t always agree with sufferer’s perceptions of events. But those perceptions are quite real to the person suffering them, so it can be demeaning and hurtful to contradict and invalidate those emotions. Dr. Amador’s LEAP method is an approach to bridge this gap.
I think you ask the wrong question as a caregiver. Do I believe it’s possible for the caregiver and diagnosed with anasognosia (lack of insight) to communicate thoughts and feelings and improve their relationship? Yes, with work largely on the caregivers part through the LEAP process. Will they agree completely on those thoughts and feelings? No, this isn’t a realistic goal in any relationship. I suggest you search the forum for info on LEAP, and/or read Dr. Amador’s book, “ I’m Not Sick, I Don’t Need Help”.
Disclaimer: While I am a part-time caregiver of my brother and father with SMI, I was diagnosed with SZA over thirty years ago. I’m an advocate of appropriate drug treatments for SMI, but I feel they are incomplete treatments and additional CBT, supportive talk and psychosocial therapies are helpful where feasible. Any drug advice is from personal experience or research and not a substitute for qualified Psychiatric care.