Family and Caregiver Schizophrenia Discussion Forum

I need help and advice

I have a brother who has paranoid schizophrenia and he is convinced that I’m saying all kinds of bad things to him. How can I prove to him that I didn’t say all these horrible things to him? I don’t know how to make him understand that he’s hearing voices but I am not the one saying any of these things. I begged him to seek help, It must be so hard to hear horrible things all the time but I don’t know how to help him. He is so convinced and calls me a liar. I am scare he will get so angry at me and eventually have enough and hurt me physically. Should I stay away from him for his sake and mine??

Some basics here:

1.) it’s essentially impossible to “prove” this to him using “facts and logic”. The best you can hope for is to use emotional arguments, as he will likely not be thinking purely logically. I wouldn’t recommend trying this approach either, however.
2.) it doesn’t necessarily follow that he will be violent toward you, but arguing with, contradicting and trying to “prove” him wrong likely only serves to increase this likelihood, NOT decrease it. In many cases, people with schizophrenia tend to be passive and avoid conflict, but can lash out when they feel threatened or provoked. While limiting contact with him can limit this possibility for yourself, it has the downside of further isolating him and may increase the likelihood he may harm himself and others. It can be a difficult decision, but some caregivers have few other options.
3.). There is another approach to this problem called LEAP, developed by a psychologist Dr. Amador, which is described in his book: “I’m Not Sick, I Don’t Need Help!” The book teaches communication skills to help combat anasognosia (lack of insight into disease). While there’s a definite learning curve to the process, and his strategies may seem counterintuitive compared to reasoning with “normal” people, they have proved helpful to many people.

Watch the following video for an introduction to anasognosia and LEAP strategies to help people with serious mental illnesses:

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Thank you so much for this!! I will try this approach hopefully it works. An other question I have is this: He does get an injection once a month and it was helpful for about a year but he admitted that he started hearing voices again. Does this happen? Maybe the dosage needs to be increase?

Good to hear your brother is on medication, but unfortunate that it doesn’t seem to be working as well as you’d like. Injectable medications are often used for people with schizophrenia who have anasognosia to help deal with lack of compliance due to lack of awareness that they need medication. Many caregivers struggle with getting the people under their care to agree to medication at all, so this is often the focus of their battles. Many people here wish that their loved ones would take medication, so your brother shows promise despite your concerns.

Yes, antipsychotic medications can lose effectiveness over time. It’s also possible that your brother was concealing symptoms, or they had lessened naturally as psychotic symptoms can ebb and flow depending on sufferers level of stress. Hospitalization often removes outside stressors that may have exacerbated symptoms, and psychosis can return gradually as they are reintroduced. There can be powerful incentives to hide symptoms to gain additional freedoms, but over time these coping mechanisms break down and suffers start exhibiting them again.

Changes in medication by adjusting dosage, adding additional medications or replacement are common over the course of treatment. Your brother should be receiving regular care in addition to his shots being administered. This feedback is necessary to adjust medications and, your brother may be withholding this information due to distrust or lack of understanding of the necessity. You may have heard of HIPAA restrictions related to psychiatric care, but these restrictions are one-way. You should be able to contact his doctor and report concerns of his symptoms and he/she will take your input under advisement.

Be aware these drugs are not perfect and in practical terms the goal of drug and other therapies are to manage the illness and not completely obliterate symptoms or “cure” the illness. Most outcomes are not as favorable as mine, but through well managed medication and other therapies it’s possible for people with schizophrenia and related diseases to live better lives.

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There’s a group called the Hearing Voices Network - USA. They might have a group in your area. I’d love it if my son was motivated to go to such a group and make contact with other people who hear voices and compare notes.

Disputing the voices has zero effect. It’s easy to demonstrate what they say is false, e.g. as in showing that the opposite of what they predicted actually happened. It’s all for naught. They are simply too compelling.

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Thank you for the information. I will try to contact his Dr.

Bluebear,

I’m so sorry to hear you are struggling with your brother hearing voices and thinking you in particular are sending out negative messaging. You must be very worried. If you feel threatened, by all means remove yourself from the situation. Take care of yourself first.

My brother was diagnosed with the brain disease schizophrenia decades ago and I have had my share of listening to his voices and the thoughts, many of which have been incomprehensible to me, as well as disturbing at times. Only you can decide in your situation whether he is on the brink of something dangerous or not. But: if it just feels like chatter, for lack of a better word, one technique I found useful is to verbally repeat out loud the full sentence(s) he has just spoken, without commentary or argument. Really, sometimes, he will not let the thought go until it is repeated back to him, as if he mostly needs to know that someone heard him. I’ve noticed he often drops the thought and moves on when I do this. I know this is easier said than done, so feel free to ignore this if it seems unhelpful to what you’re going through. You can always show up another day–he most likely will have forgotten the conversation–and say or do something that directly refutes his accusations and builds trust in whatever area he seems stuck on.
So hard. Good luck.