Narcissism and Schizophrenia

Hello to all,

I have been posting on here for a few years about my untreated sz brother and the problems we have.

We live in different cities. He lives in my late dad’s house in a far away city. We had parted a long time ago till our roads crossed again in 2015. He was in very bad conditions when we met. Since then I have been trying to support him in all ways. Last year, my husband and I tried to get guardianship for him so that he could have an income of his own through government. ( We are not in US, but in Europe so the laws here allow him to get 1/3 of my late dad’s retirment pension if he is under guardianship) Unfortunately, he refused to
undergo medical inspection and this attempt failed.

Since then, we have been communicating less and when we do, our communication is very brief. We still support him and try to make sure that he has at least minimum living conditions.

He has accused me of several things so far which I always ignore and don’t take personally. In the meantime, I try to learn about the illness as much as I can and educate myself.

I really can’t understand though how a human being can be so irreverent and ungrateful to someone who tries to help him that much. He did smear campaigns against me in the past and so many other negative things. I feel like this is pure narcissism and he has so much hate against me which I have difficulty understanding. Why do they hate the people who cares for them ??? Really confusing !

Last week, I called him and we chatted a bit. I asked for a very small favor from him. I wanted him to contact a very old friend of mine who lives in the same city he does. (My friend’s phone number was changed but she still resides at the same address) And also told him that if he didn’t want to do that, just to say ‘no’. My brother said okey, but next morning I found a message from him telling me that I was trying to use him or I was not in my right mind when I asked for that from him.

I got so mad and did something I was thinking of doing for some time. I wrote back to him. I told him to behave decently. I said ’ Noone owes you anything ! The world doesn’t owe anything to you either. If people support you, that is not because they owe you something. Are you aware of this fact ?? ’ etc. He didn’t reply or may be he had blocked my phone number after writing to me and didn’t get my messages, I don’t know.

What do you do when your loved ones act out? Once I talked to a sz person and he told me not all sczs were like that. He said my brother had some character defects maybe. How do you build up boundaries with your mentally ill loved ones?

And is extreme narcissism a part of schizophrenia?

Thank you.

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SZ is a very isolating disease. I’ve hypothesized that there’s a sort of evolutionary function to this kind of behavior. It “wants” you to be alone and preoccupied with delusions for two reasons. First, to keep you occupied and away from everyone else, and therefore out of trouble in most cases. Second, isolated individuals don’t thrive and don’t live as long as those with social support and resources. The abysmally shortened life spans of people with SZ bear this out. It’s the animal that runs off from the herd to die, or the eldery Eskimos on the ice flow.

Also, when you are in throws of the illness, you get very accustomed to people discounting much of what you say, telling you effectively that your thinking, opinions, feelings, pretty much everything that you value are all wrong, you should just do exactly what they’re told, because they know better than you, and it makes you feel totally worthless. And stepping in to ‘help’ them only further demonstrates to them that you think they are a failure and need help, and they should appreciate everything you do and that further underlines the dynamic and it hurts.

That may not be what you personally project, or think you project, but subliminally that’s what society seems to be telling people with SZ. Caregivers bear the brunt of our anger about this, and I agree it isn’t fair. People with active SZ generally have very few people in their life that will deal or listen to them, so it’s more them lashing out at the only person that’s around and wields power and therefore demonstrates their impotence and failure.

What you consider narcissism may just be an attempt to feel powerful and reclaim self-esteem when others and the disease make you feel worthless again and again. I know it’s tough for caregivers to hear this and put themselves in that person’s place when they are just trying to help, but if you think about it, the person they are caring for feels much the same way and for a much much longer time.

I think this is a paradoxical common ground that makes strategies like Dr. Amador’s LEAP strategy work for some caregivers. Search the forum for people’s experiences with LEAP. It may be a useful tool for you.


Thanks, Maggotbrane. That makes a lot of sense. I really value your perspective and this is very helpful.

I’ve been really trying to understand my loved one’s perspective - he has become totally isolated in the house due to beliefs that others are intending him harm and surveilling him - but I have come to realize that I just have never experienced anything remotely like this, which makes it hard for me to empathize, despite being a naturally empathetic person.

I will reread your response and try to internalize it. My loved one normally sees me as his #1 supporter and from my perspective, I still am, but he has not been feeling this way for a while now, which feels terrible to us both.

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Thank you very much for your reply. It is really valuable to hear your perspective, the perspective of someone who has gone through all this. Family members are usually in the dark when it comes to what the other person is feeling, what is the motivation of some behaviours because of the lack of communication and self expression. But I am not sure if that helps to improve the situation.

I think a lot about my brother’s behaviours. For example, I tried to find answers for the incident. I often think, ’ Is he jelous of me ? Does he want to blame someone for all he has gone through ? What does he want ? Maybe I should stop helping, my help hurts him. But then what will happen ? ’ So many questions, no answers.

As a person who has experienced this illness, how would you want your family members approach you ? In what way ?

There has to be a common ground, somewhere, somehow…though I am not hopeful in our situation much. Everything has been tried and nothing has worked. I am about to give up which means stoping all interaction with him. I have heard about LEAP and as a last chance I’ll read the book and everything about it.

You explain why people with scz behave the way they do, the motivations behind the actions…well, understanding them doesn’t help unfortunately. And…yes, I accept there is an illness, a very complicated illness indeed. But, I am a human being, I have feelings and emotions and when someone is hostile, unkind, like my worst enemy how am I supposed to act ? A professional care giver might cope up with this but a lay person with her own life, own problems ? If he were my child, then, I don’t know maybe one can endure. But as a sibling till when and where a person can be a giver all the time and expect nothing but hostility ? As for a mother/child situation that might be different as I said.

I, myself have attended some 12 step meetings. There they always say " Don’t help people who don’t ask for help, it won’t work and you won’t be doing any good both to yourself and the other part " I wonder if that applies to scz.

This is a tough situation for both sczs and their family members. I pray God to show us all a solution about how we’ll handle it.

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Hello @Venetian, so sorry that you are dealing with this difficult situation for such a long time. Many family members feel angry and frustrated and want to give up.

I do understand how hard this illness is to try and understand and cope with simultaneously. It’s one of the most difficult things for family members do.

I would strongly recommend attending a family education program as that was what helped me and my friends the most. Do you have such a program where you live?

I don’t know your family personally and we are all different but the people I know who live with the symptoms of severe and persistent mental illnesses such as schizophrenia and their family members, dont expect to have the same relationship as they do from a person who does not have the severe and persistent symptoms of this illness. When a person is unmedicated it more than likely is more of a one way relationship.

As in Alzheimer’s, people’s behaviour can be difficult and hard to deal with and it instead of thinking, “they are giving me a hard time” it makes more sense to realize that, “they are having a hard time” and not to expect a give and take relationship.

A psychiatrist once told me that when someone is in a severely psychotic state that one really can’t judge their character.

Hugs to you

I usually try to explain such experiences with little things that most people experience that are normally short-lived, but in people with SZ can persist for a long time.

For example imagine that feeling you get in the middle of the night when you hear a noise and you don’t know what it is: Your mind races… what could it be??? is it an animal? is it the wind? is it a burglar? is it someone with a gun? is the sound coming from within the house? or outside? should you investigate, or will that put you in danger? maybe it’s someone you know just trying to get in?

You have a few options:

1.) wait and hope it goes away, investigate in the morning.
2.) investigate and risk a confrontation.
3.) Get help. Phone a friend or police, ask a spouse or housemate if they hear it. But if you aren’t sure, you risk them saying you are crazy or discounting what you say in the future and maybe not helping you in the future, etc.

And then the noise persists for hours, days, weeks, months. Over time you’ll probably get more anxious, you’ll lose sleep, you’ll start developing more and more hypotheses about what it might be. A ghost, a demon, God trying to tell you something. A neighbor or someone you live with trying to prank you. You might wonder about any enemies and why they might harm you. And so on.

With lack of sleep and anxiety you might start thinking even less clearly. Maybe it’s the FBI (that was my ultimate conclusion) surely they have equipment to do this. But why? And then you might think it’s all a mistake or that time you cheated on your taxes years ago that you thought didn’t matter or you were set up or framed by someone, or maybe you are guilty of something you did in your sleep, etc and so forth.

Does that give you a sense of what might be going on internally? Think pretty much everything strange you see in a horror or ghost story or spy film, but it seems real and you can’t prove it, but it persists and you don’t know how to make it go away.

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I think acknowledging that there are internal factors and reasons for their behavior may be enough. They may not understand them either, or they may not feel safe expressing them out of concern they may be somehow punished or become vulnerable if they do.

Sometimes there are elaborate reasons and sometimes there just aren’t. My first Jewish friend growing up was particular about food and I noticed he always ordered things without tomatoes. Eventually I got curious and asked him if it was a kosher thing, and he said no— He just didn’t like tomatoes. I’d approach someone with SZ as a foreigner who has different customs, or a developing child whose tastes may be developing or changing. You’ll never know if you don’t ask, but they may not have an answer or may be unsure why they do the things they do, but you should respect the culture and the right for tastes to evolve.

This will vary from person to person. In my case I had a story to tell, and I was interested in feeling I was being heard, listened to, acknowledged and respected as an authority on myself— how I felt and how I thought. It didn’t particularly bother me if you disagreed with what I said, as long as you respected that I had opinions and and they might differ from yours. It was important to be included in decisions that affected me, I may not have had an opinion, but I didn’t like surprises.

Understanding motivations doesn’t mean that you have to put up with behaviors, or be devoid of feeling about them. Setting boundaries is important, telling people when you say or do X it makes me feel Y, and that doesn’t work for me, can we change that. I would encourage talking more about how things make both of you feel. Arguing ‘facts’ and opinions often gets you nowhere, but feelings are hard to argue away. But you’ll likely have to choose battles.

In short, yes. Make sure you are helping with something they want help with, and if not don’t martyr yourself or expect your help to be appreciated. It often hurts caregivers to hear this, but honestly sometimes you are actually helping for some internal need, not because anyone asked for or needed it. Even for well people, appreciation won’t reflect the effort required. Sometimes the simplest thing for you to do will be the most appreciated, because it’s what’s most wanted, or much easier for you to do than the recipient.

In a caregiver situations this be can complicated by bureaucratic requirements. The person you are caring for may not grasp or care that whatever requirement is necessary, because it doesn’t directly affect them financially or the requirement is a bridge too far in whatever internal system they work in. I’m talking about situations like reverse Catch-22’s where you have to admit you are ‘crazy’ to get help, but your whole problem is you don’t know you are ‘crazy’.


There are two different issues. First, do you protect yourself from being hurt by his unreasonable behavior? Second, do you hold a grudge against him or blame him for his unreasonable behavior? My answers, “yes” and “no.”

To expand more on the second question and answer, you do have to realize that he has a serious debilitating disease. My wife has schizophrenia, and I find that often times I have to attribute certain unreasonable behaviors to the disease, and not to her. She has a voice inside her head which talks to her a lot. Among other things, it tells her that I am a terrible person. So when she thinks really bad things about me, I have to not take it personally.