Family and Caregiver Schizophrenia Discussion Forum

Do you believe it is possible for someone diagnosed with SZ and has no insight to truly connect with their emotions properly?

My loved one is “high functioning”. He keeps himself well put together, he’s clean and tidy - he has ambitions - he remains drug and alcohol free. But no insight into his behaviours and if you try to bring up something that was a delusion from the past he will deny it and change the subject or make up a reason. His memory on how things transpire is usually now how it went down.

My question is do you think that if someone suffers from complete lack of insight - they are experiencing the reality of their true emotion

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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.

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Hi there!

Thanks for your reply. I guess I didn’t word my question properly. I understand that the emotions my loved one experiences is true to him. That I do understand. I guess what I was trying to say was, if I know he loves his niece for example, but he is convinced he doesn’t - is it true? But I guess I know the answer to my question - his perception of her is not the reality. So when you mentioned perception I answered my own question … he is not experiencing the same reality as before.

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That is so true with my son as well

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A few things I’ll add here, his expressed reality and his actual reality and resulting behavior might not be the same or in direct conflict. And his beliefs may sometimes change on a dime or be logically inconsistent— and he may not question or even notice it.

As you say, his perceptions control his reality, but bear in mind his perceptions may change and thus his reality may change too. I’m sure most caregivers of loved ones with paranoia notice paranoid delusions evolve over time, or get pushed out by a new set of ideas, only to resurface again.

I guess what I’m saying is I wouldn’t necessarily assume what he says or feels is permanent and at a later date his feelings may change or return to “normal” with treatment. Bear in mind though once you have SZ or SZA you are never quite the same person again.

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I think the question is, is it part of a delusion or is it more an actual physical abnormality or damage in the brain that doesn’t allow for ‘crisis’ memories?
Delusions are, by definition, a held belief in something contrary to the factual evidence.
Confabulation, also, is a concoction of that same mind to justify their ‘beliefs’. Their ‘reality’.
Or maybe it’s just excuses…
It’s sick and it’s sad and it hurts us all.
What can we do as the people closest to our our loved ones but take the hits?

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When I was in psychosis, my partner stopped trying to disprove my ideas. Instead, he just ask me to provide proof. Although I still believe in some theories I used to have, I let go of a lot of them. While trying to prove them I found flaws in my own logic. It didn’t help to have people say I was delusional. It just made me angry and I felt a lot of rejection from people who did. Those very people are no longer part of my life. As someone with schizophrenia, I want support. I want people to believe me, I hate having everything I say questioned.

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