Family and Caregiver Schizophrenia Discussion Forum

What do you do when boundary enforcement necessitates reality checking?

Hi everyone. I’m having trouble figuring out how to interact with my unmedicated loved one who has lack of insight. I’ll call them E.

I have learned I’m not supposed to argue about their delusions or give reality checks, but lately a lot of their delusions have centered around concerns for my safety (and their own). To the point of banging on my door in the middle of the night, waking me up, yelling at me through the door to stop hurting myself, stop trying to kill myself. (I’m not suicidal and this stuff comes out of nowhere.) This is just the tip of the iceberg of their bizarre behaviors lately.

My own boundaries are extremely important to me due to my history with abusive people I successfully escaped from. But E keeps violating my boundaries (or attempting to violate them) in the name of their delusions.

I can’t live like this. I can’t sleep well, I’m not functioning well, I feel profoundly emotionally unsafe, on edge, my anxiety levels are through the roof, every sound I hear in the house triggers more anxiety and worry that E is going to come to my door spouting nonsense again or trying to bang my door down. E does the same thing to my sister who lives with us, even calling 911 recently in their belief my sister was being assaulted – even though she presented herself to E to show that she was fine. I even caught E trying to pick my sister’s lock to get in, believing she needed protection. I didn’t know how else to respond but to try to stop E and try to reassure E that we are all safe. But is that a form of unwelcome reality checking?

Even in the middle of typing this post just now I had to go break up a physical fight between them caused by another boundary violation. My sister and I are both stressed to the max and pushed to the edge so my sister ended up screaming and crying before I was able to get E out of her room. I told E in no uncertain terms (again) they cannot do this, they MUST respect other people’s boundaries.

But I don’t know what I’m doing and I feel like I’m probably handling everything hopelessly wrong. What can I do better? Is enforcing boundaries a bad idea? Is it a lost cause?

There’s a difference between having delusions and acting on them. In my case I had delusions about the FBI surveilling me, but I resisted turning myself in because I knew there were consequences. Although it may seem drastic, I’d consider trying to get restraining orders related to proximity or disturbance or trespass or attempted lock picking etc. And make it clear that when inappropriate boundaries are crossed, the police will be called and there will be consequences. It’s important to distinguish between having thoughts and initiating behaviors. I wouldn’t argue or invalidate these thoughts, but say the behaviors that follow from them are the problem. It’s a form of impulse control.

You may be able to find a cognitive behavior therapist (CBT) who can provide tools to extinguish these behaviors without resorting to legal measures or involving the police. My mother ended up getting a restraining order against my brother when he attempted to choke her. We ended up getting him his own house, and he is allowed to visit, but he is not allowed to drink or be drunk on the premises. We haven’t had these sorts of issues since, and since he has been jailed in the past and he didn’t care for it, he takes the deterrent seriously. Physically distancing, where possible, is probably the surest way to deter or limit these behaviors.

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.

@NeedAnswers the best thing I can suggest is to address how their behavior makes you feel (banging on the door, picking locks etc).

How long has E been off medication? Do you have to continue living with E? If you have influence maybe you can suggest for E to see a doctor and hopefully start on medication maybe a antipsychotic to help with sleep but will also help with the delusion thoughts as well.

@Maggotbrane I like how you point out the delusions are one thing and acting on them is another thing. My family member has a lack of respect for other people’s boundaries.

Thank you for pointing out the difference between thought and action. Unfortunately this week E’s delusions have generated distressing actions many times a day, every day and almost every night.

E lives with me and my sister and all our names are on the lease so I don’t think we can call it trespassing.

I have tried to focus on the behaviors and how they were making me and my sister feel unsafe. Unfortunately E had not slept for days and communication became progressively more disjointed and ineffectual. E’s mental state and invasive behaviors deteriorated even more yesterday to the point where we had to call 911 multiple times to protect ourselves from E.

E is now experiencing consequences, at the hospital on a 72 hr hold. I feel horrible about everything that has happened.

I also know E left us no choice.

E broke the mirror on the back of my bedroom door when they busted through my lock. I have bruises and I ache all over from trying to protect my sister and keep E from stealing her phone when she was calling 911. I thought I would sleep forever after E was taken to the hospital but instead I slept for 3 hours before my worry and anxiety awakened me again.

Sorry if this reply is a bit aimless, I’m trying to come down from days on end of extraordinarily high stress levels. Thank you for listening.

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Than you for your suggestions and questions. I posted another reply that addresses some of this. Also, E has been off meds since they left their former state across the country and moved in with us 2 years ago. We aren’t sure what was prescribed but we know it was an injection of some kind.

I am hoping the 72 hr hold will produce some medication and a treatment plan. And I am praying it will not also require treatment for covid picked up as a result of their inpatient stay.

But step one is getting E to sleep for the first time in days.

I feel that I have to continue living here. I can’t abandon my sister to deal with this by herself. And E quit their job about six weeks ago due to what I now recognize as a persecutory delusion. So E has no income and nowhere else to go.

I am dreading trying to manage this situation after their release from the hospital. I don’t know if they will be properly medicated, I don’t know how long it takes for it to start working, and I have no doubt E will feel betrayed and freshly traumatized. We are all traumatized.