Family and Caregiver Schizophrenia Discussion Forum

Suggestions for building empathy

I am really struggling with empathy for my ill sister-in-law and her parents. I would very much appreciate any advice from caregivers on how I can change my thinking - any book recommendations, groups, mantras that you’ve found useful or that you wish extended family who doesn’t live the reality of mental illness daily would do/read. With each negative, unkind, boundary stomping or stressful interaction I find myself growing more resentful and just wanting to completely cut ties with my inlaws. Logically I know she is sick and her actions are outside of her control, but I can’t get my feelings to match. I have paused all contact with her and my in-laws for the remainder of my pregnancy and will continue it through my postpartum period for my own well-being. However, I don’t think that is a fair or kind long-term solution. I’m hoping during this “quiet” time so can work on myself and my empathy and get to a better place so at least my in-laws can be part of my baby’s life

To be honest, this is partly an issue from my own family. I grew up with a parent that suffered from serious depression, was frequently verbally abusive for many years, and refused to address it for 14 years. It left scars for me and my siblings that followed us into adulthood in different ways. I am deadset against my child ever being exposed to someone with untreated mental illness, especially someone who is not an immediate family member and with whom I have no relationship.

As background, I never knew her before she was ill and my interactions with her over the last 9 years have either been non-existent or negative despite my best efforts. When the interactions became negative I stopped interacting beyond basic pleasantries and small talks about topics that were safe (her dog, the beach, the weather, etc.). She has been very cruel/verbally abusive to her parents and her other sister-in-law. Things like yelling that God made SIL barren on purpose because she’s too awful to have kids while poor SIL was unsuccessfully undergoing fertility treatment. This was completely unprompted, as are most of her abusive outbursts. For the last 2 years the voices are telling her that I am laughing at her, think she’s fat, etc.

Plus as I’ve mentioned on another thread, her behavior and that of her parents have been very stressful and unreasonable during an already difficult pregnancy.

Thank you in advance.

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I found this advice in a book about schizophrenia in teenagers, but I think that they can be applied for all ages…
•choose your moment to communicate carefully
•don’t expect clarity from someone who is mentally ill
•pay attention to the emotion they are expressing rather get caught up in the delusional remarks
•don’t take their delusions personally
•don’t expect rationality
•sometimes the mentally ill talk in metaphors - the delusional remarks may somehow be related to something going on in their lives

My brother gave similar advice as above when we first became aware of my daughter’s illness.

I am just now starting to read I Am Not Sick I Don’t Need Help by Xavier Amador focusing on how often the mentally ill do not realize they are ill and how to relate by listening, empathy, finding area of agreement and partnering in some solution.


These are good tips, Windyhill63. The toughest one for me is “don’t take their delusions personally.” I am super-sensitive in the first place, and to have the person I love insult me and tell me my life is worthless is difficult to hear repeatedly. I am getting better at letting it roll off my back, but it has taken years. It doesn’t seem to matter what age the afflicted person is; it is always difficult to communicate with them when they are delusional. We are taking good steps by educating ourselves that will help both us and our loved ones.


Thank you, that is very helpful. I will read the book. Does it address what to do when the person is verbally abusive?

I haven’t got real far in the book, but maybe other who have read the book might be able to say…

That is the hardest for me too… I do tend to take things personally… even at times when the comment had nothing to do with me… maybe with some ideas of reference slightly… I have noticed a tendency to think people are talking about when I hear people whispering whether they are not…

A few other tips in communication form the adolescents with sz book:

•speak clearly and directly
•watch for things you say to be taken literally
•it’s ok to set clear straight forward realistic rules
•treat with respect as much as possible even if you don’t get what they are saying
•try to be supportive and positive as you possibly can

What I am currently struggling with is that I wouldn’t tolerate this treatment from a stranger who was ill - I would avoid the person and not feel guilty about it all all. And that’s really what she is to me, a strangee - we have never had a relationship and the only interactions I’ve gotten from her have been unkind. If this was a loved one that had gotten sick I think I would struggle less with empathy and be able to handle more. But she’s not and the only link I have to her is that she’s my husband’s sister. Which makes it hard for me to want to expose myself to her abuse and the bad memories it brings up and makes me just want to say I’m not going to see this person or have this person in my home. Especially now with a kid on the way who I don’t want exposed to the verbal abuse and other issues that come with her untreated illness.

What type of relationship does your husband have with his sister? How well do they get along with each other?

I grew up in a family that was closely knit…I get along pretty well with my siblings. I now live in a different state so I don’t see them as often.
Both my oldest brother and my sister had verbally abusive spouses… both of which seemed nice and friendly before marriage. It wasn’t until after marriage their true colors showed. I have no idea what their mental state were… but most of the time I had to force myself to be civil at family gatherings… My brother ended up as an alcoholic, so bad to the point of being hospitalized for substance abuse. Both my sister and brother are divorced now.

He was close to her growing up but her illness is so severe that there isn’t much of a relationship left. She is rarely able to respond to him (or anyone) and only for a word or two before slipping away. He is the only family member who she is not verbally abusive to, however. My husband recognizes that she is not safe to have around a baby or young child (per our doctors’ instructions) so he doesn’t plan to have her in our home. My only solution is that he can go visit her alone and make sure to address the contagious/infection issues before coming home, again as recommended by our doctors’. I think he is mourning the loss of his sister and trying not to be angry at his elderly parents for not doing much of anything to get her care.

BDinVA, you have to forgive yourself for your less than stellar level of empathy and you have to constantly remind yourself that this illness is not your fault, you didn’t cause it, and you can’t fix it.

This illness can turn people into very unlikable, unkind, and socially inappropriate human beings. Yes, this fact is not your fault, but it’s also not the fault of the ill person. They’re sick.

Nobody is perfect. You’ll have periods of time when you’ll have greater patience and empathy, and you’ll have times when you have nothing left to offer. You might even feel hatred. It is what it is.

Take care of your health, both physical and mental, and do the same for your baby. Be very careful not to let this horrible illness ruin your relationship with the father of your child. You have to fight this.

Boundaries have to be set. Don’t interact with your in-laws and your ill SIL unless you’re in a good mental place, with a bucket full of patience. Know when you’re feeling like you need to walk away. Don’t wait until you have steam and resentment coming out of your ears.

Again, don’t let this horrible illness impact your relationship with the father of your child. It happens all too often.


Thank you for the kind advice. I want to learn the tools to be able to do what you suggest - recognize when and how to engage. I also want to learn to be more empathetic for my husband’s sake - I can’t imagine losing a sibling to this horrible disease. We are going to therapy to learn how to set good boundaries to protect our nuclear family and communicate about his family in healthy ways. Right now I am stuck in a phase of feeling resentful and very disconnected.

Regarding the “when and how to engage”, I think you both have to keep interactions at a minimum, so you can focus on your newborn, without stress. Don’t miss out on this beautiful opportunity. Once it’s gone, it’s gone.

I’m sure your husband is grieving for the loss of his sister, just as my daughter is grieving for the loss of her brother. No doubt, it’s tragic and painful.

You’ll figure out how to set and stick with the boundaries. You’re not living with your SIL and her parents, so it’s much easier to do this.

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Good advice. Thank u. Going to print it out.

Try thinking about your future and the odds you might have to deal with someone close to you…even in your own family that might fall victim to Alzheimer’s, a stroke, brain trauma from a accident…etc.

We have had family…close and extended that have fallen victim to these medical maladies. How would you treat those people? Those folks will and do exhibit same/similar behaviors as some who suffers from a mental illness.

How would you want to be treated if you were to fall victim to such an illness?

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Thank you, that is helpful advice. I will try to look at it from that perspective.

Meta meditation…
I would download insight tuner on the Apple app

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Thank you, I will look into it!