Family and Caregiver Schizophrenia Discussion Forum

How to break through lack of insight barrier?


First off, I have to say that this forum is a total Godsend. I thank all of you who share your knowledge and experiences.

My wife was diagnosed with sza after being first diagnosed with post partum psychosis after child birth. She had late onset in her late 30’s and her case is very rare. Her diagnosis was changed after an almost 2 month stay in the hospital (discharged twice for about 5 days each time but went back in). She never believed her diagnosis, after hospitalization her family and I thought we had a breakthrough and that she now knows she must stay on meds.

Well, you know this story, she stopped taking meds (resperidone) for 8 months, relapsed but started again, but on very low dose of 1 mg per day. Now she is completely defiant in her delusions and will not accept the fact that she has a psychotic illness (words from her pdoc).

She has postive symptoms, she believes that my ex g/f who i lived with before marrying wife is coming in our home and damaging her things, and that I’m allowing it to happen as I’m sleeping with her (which I am not).

So my question is how do can we break through the anosognosia? Will it take her hitting rock bottom? The big problem as far as me trying to help is that our relationship is deteriorating as she is very hostile towards me. She says she’s going to file for divorce. In the end, there may be nothing that I can do, I love my wife and I don’t want divorce. But I would love to get feedback from the forum…I’m learning everyday from this forum and the recommended books.

Thank you all again for your wisdom…

  1. Get a copy of this book and read it and have your family read it, as well. (Torrey can be a bit totalistic and unwilling to see exceptions to his “rules” at times, but most of the book is really worth the effort to plough through.)

2) Get properly diagnosed by a board-certified psychopharmacologist who specializes in the psychotic disorders. One can find them at… and
3) Work with that “psychiatrist” (or “p-doc”) to develop a medication formula that stabilizes their symptoms sufficiently so that they can tackle the psychotherapy that will disentangle their thinking.
4) The best of the psychotherapies for that currently include…
10 StEP –
5) the even newer somatic psychotherapies like…
6) or standard CBTs, like…
Schematherapy –
Learned Optimism –
Standard CBT – & scroll down
7) If you/she/he needs a professional intervention to get through treatment resistance, tell me where you live, and I will get back to you with leads to those services.
8) Look into the RAISE Project at
9) Look for mental illness clubhouses in your area (which can be hugely helpful… but may also pose risks). Dig through the many articles at to locate and investigate them.


Be patient, talk to her and tell her straight forward that you’re not doing that stuff, not that she’s crazy or anything, just that she can trust you. Even if she doesn’t believe it, when she’ll get better she will treasure the fact that you were understanding of her condition.

I think patience is my only advice here… Sorry you’re going through all of this.

Best of luck.



Medication and taking it is a key. America is pretty backwards in that you can’t force people to take medications. Over here in Australia they can give treatment orders and give them depot injections.

Fighting delusional thought is a bit like taking a knife to a gun fight. I wouldn’t recommend it. Often you become tied up in the delusion and that doesn’t help. Try " I’m not sick, I don’t need help " by Xavier Amodor ?/ check the spelling it’s been a while since I’ve recommend it and my brain is mush these days.

One thing about medications is that sometimes the medications don’t work after you stop them. They just aren’t as efficient. Work with the treatment team and anything you can do to help your partner take the medications the better. Reward systems would help I’d assume. Medication and acceptance of taking the pill ( helps you sleep…whatever works!) is the key!

Tough situation. Hope this helps a little,

A friend in the struggle,



So thank you to all that responded… I know that it’s been 12 days but work got very busy.

I have read some of the books mentioned…and I think that my wife’s case doesn’t really fit the mold. It’s not that she just has sza, but she probably has a sprinkle of paranoia on top of that. Is it possible to have all available “options” if you will of mental illness in one person?

Beside the anosognosia, the real issue is that she’s extremely hostile towards me and believes that I’m involved with my ex in harming her things and her life.

I believe that at this point the only options we have left are either getting her committed (which her doctor won’t do), or doing an intervention. Short of that, we play the waiting game and see if she’ll deteriorate.

Rogueone, thank you for your insight. I will file that away when and or if I have to deal with the county mental health officers. I’ve felt that I’ve brought a knife fight to this gun fight for 5 years. My wife’s case is sort of similar to a case that Dr Amador highlights in his seminars, Margaret Mary Ray. I know that everyone’s illness is different just like snowflakes are different…but I can see that the illness has so many bad consequences.

Sz is one brutal bitch of a disease…but this forum has been a Godsend and I appreciate all your insights and encouragement!!



Yeah. You have a broken leg and people seek help cause it hurts like shite.

You have a broken brain your the last to seek help because you know nothing else and often the symptoms are masking your insight!

Hang in there. There’s a broad spectrum to mental illness. Most of us have floated through various diagnosis’ depending on the medical team who are treating you. It’s not rocket science…but as my shrink says…it’s definitely an art! Good you read Amador…gives you a leg up!

Peace and good luck,

A friend in the struggle,