How to help my schizophrenic mother when my stepdad is enabling her to remain ill

[xyzzy]

Apologies for the length of this message, but it’s a complex problem to explain.

I’m a middle-aged man whose mother was diagnosed with schizophrenia when I was a child. During my childhood and my teenage years, my mum was in and out of hospital, but did the best she could in bringing me up. For most of my adult life, my mum’s mental health has been stable and I’ve had a good relationship with my mum and stepdad, but over the last few years her mental health has slowly deteriorated. Her behaviour became increasingly difficult for me to cope with, while my stepdad insisted that her behaviour was OK and expected me to accept it too.

Three years ago things became so bad that I felt I had no choice but to cut off contact with them both, as I was worried that if I kept in contact I risked having a nervous breakdown myself. I feel I’ve done the best I could in very difficult circumstances, but still feel guilty for cutting off contact when my mum has done so much for me in the past, and feel that there must be something more I can do to help. I’m looking for any suggestions of what I can do, as I’ve tried various things and none of them have worked.

For many years, my mum’s mental health problems were kept under control through a combination of medication (Risperidone) and counselling provided by a Community Psychiatric Nurse (CPN). Unfortunately the counselling was withdrawn a few years ago due to funding cuts. Since then, her mental health has slowly worsened despite continuing to take her medication, and she has become increasingly paranoid. She would regularly warn me about different types of people who were not to be trusted, and about dangers in situations that others would perceive to be safe. She would get angry with me if I questioned or disagreed with any of her paranoid thoughts, and my stepdad would take my mum’s side in any argument.

Over time, my stepdad came round to my mum’s way of thinking, and started bombarding me with text messages, echoing my mum’s paranoid thoughts. I coped with this by reducing contact with them both, so I would ignore any paranoid texts, only phone them once or twice a month, and only visit them occasionally (they live hundreds of miles away). The phone calls normally lasted about two hours and left me feeling emotionally drained. The circle of people who my mum trusted gradually shrank, until she came to distrust my girlfriend and her family, and eventually to distrust me too.

Because I had reduced contact, my mum got angry at me and accused me of deserting her in her old age. I explained that my girlfriend and I were finding it extremely difficult to cope with her behaviour, especially as she kept forcing me to relive traumatic experiences from my own childhood. When I explained how upsetting I found this, she belittled it, saying that as a man I should easily be able to cope, and that listening to her problems was nothing compared to the stresses of bringing up children. My stepdad supported her point of view, saying that I need to be prepared to make sacrifices for my mum because she did a lot for me when I was growing up.

This all ended in a phone call where my mum got angry and put the phone down on me, at which point I cut off contact, blocking their phone numbers and diverting their text messages to a ‘spam’ folder, which I checked periodically in case of any important news about my mum’s health. My stepdad continued to bombard me with text messages for another year, mostly echoing my mum’s paranoid thoughts, interspersed with a few texts blaming me and/or the medical profession for everything that had happened. After that, the texts suddenly stopped and I haven’t heard from them since.

All through this time, my mum insisted that she was mentally well and that everyone else’s behaviour was at fault. Because of her paranoia, she now completely distrusts the medical profession. She has been diagnosed with diabetes, but refuses to accept the diagnosis or take any treatment because she doesn’t have the ‘classic’ symptoms of constant thirst and frequent urination. She was shown the NHS Direct webpages about diabetes, but my mum and stepdad dismissed them as being fundamentally flawed and insisted that the doctors wanted to kill her with diabetes medication.

After I cut off contact, I wrote to my mum’s GP explaining the situation. I received no reply, but it was decided that she would now have to undergo a Mental Health Act Assessment every few months. Each time she has an assessment, she and my stepdad work together to persuade the panel that no change is needed to her treatment. Therefore, she remains ill, while my stepdad continues to support her, and all the rest of their family and friends have now cut off contact with them.

I have also written to my MP about the cuts to the CPN service and the impact on my mum’s health. My MP advised me to write to my mum’s local Clinical Commissioning Group, which I did, but again I received no reply.

I am trying to work out if there is anything else I can do to help. I can’t speak to my stepdad about it privately, as he shares a mobile phone and landline with my mum, they read each other’s texts and open each other’s letters. I could write them a letter explaining that I still love them but that their behaviour has been unacceptable and explaining why I have cut off contact, but I think this will only inflame the situation. They already see me as being entirely to blame for the estrangement, and writing a letter will only reinforce this idea.

I could try writing to them with practical advice, such as details of mental health charities’ helplines, but I fear that this will only rekindle my mum’s anger, as she is adamant that she is mentally well and kept getting angry at me if I questioned any of her delusional thoughts. It is unlikely that she would contact a mental health charity, as she deeply distrusts mental health professionals and all other health workers, and my stepdad supports her in her view that these people are not to be trusted.

To summarise: I can’t see how I can help my mum when part of her illness is that she refuses to believe that she’s ill, and when my stepdad is enabling her to remain ill by agreeing with everything she says. From what I can see, the only way she’ll get treatment is if her health becomes even worse so she’s sectioned, or if my stepdad takes ill so he’s no longer available to look after her.

Does anyone have any suggestions as to how I can help my mum and stepdad, apart from waiting and hoping that one day things will improve? As my mum’s son, I feel it’s my duty to help but I feel powerless to do so. I’m an only child and don’t have a close extended family, so there are no other family members who would be able to help.

[PureFrustr8d]

Hello xyzzy and welcome to the forum.

I'm just going to get to the point - would you trust the same system that withdrew your support and caused your health to deteriorate?

I can imagine it being somewhat distressing hearing your mother say 'xyz' but why are you invalidating her when you know she is unwell? What does it serve to try to prove your mother wrong?

Personally I'm not surprised she's lost trust in you. Sorry if that is harsh but you do seem more against her than with her. Thank god she has your stepdad, he seems to be the only one she trust and why do you think that is? because he isn't trying to prove her wrong, he isn't contradicting her, he isn't adding to her distress etc. When my sister was suffering with psychosis we were told not to question, argue or make her analyse the bizarre and paranoid things she was saying/thinking because all that does is add to the persons distress.

You should really have sough out support for yourself to cope instead of wanting your mother to stop the way she is behaving in order for you to feel better because that's what this comes down to...how you feel. Surely you can listen to your mum without feeling the need to agree or disagree with her?

I'm pleased you've reached out now. I don't feel you understand your mother. Try to put yourself in her shoes. The fact she has become so isolated only makes it easier for her thoughts to take over. Can't you afford a private therapist for her? That's one way you can show your support.

You haven't mentioned anything about how your poor mother feels, imagine being mentally ill, losing your CPN, struggling to cope (therefore becoming more symptomatic) and the son you've raised abandons you because of the absurdities that you come out with. You need support which is perfectly normal and then you wouldn't put so much pressure on your mother. I'm pretty sure she's doing the best she can living with schizophrenia.

Maybe if you find a way to cope better, you'll build up the trust and hopefully be able to help her make sense of her diabetes diagnosis. It's probably her medication that's behind her diabetes. Do a search for 'Risperidone and diabetes' and you'll see what I mean.

All the best,
Peace

[xyzzy]

Thanks for the quick response, PureFrustr8d. I now realise that my partner and I will need to seek counselling for ourselves before we can make any attempt to reconcile with my mum and stepdad. Much of my mum’s recent behaviour towards me amounted to bullying and emotional abuse – I know that my mum is in great distress and was only behaving this way because of her illness, but it didn’t make it any easier to cope with. I felt that I had no escape from her difficult behaviour because my stepdad was bombarding me with text messages on my mum’s behalf, though I realise that things are even more difficult for my stepdad and he needs support too. Unfortunately when my stepdad was offered support for himself, my mum refused to allow it because of her deep distrust of professionals.

I have offered to pay for a private therapist for my mum in the past, but she got angry at me for suggesting that she’s ill, and because she says the medical profession don’t know what they’re talking about (her distrust extends to private practitioners and even medical researchers, not just the NHS which has badly let her down). She dismisses any private doctor or therapist as “fat cats” who are only in it for the money.

From my point of view, the most distressing part of my mum’s recent behaviour was regularly talking at great length about upsetting things that happened to me at school as a child, but painting them as being even worse than they actually were. All through school I was badly bullied; I even received death threats from one of the other pupils for reporting their bullying to the teachers. My mum kept insisting that I was sexually assaulted at boarding school (which I wasn’t), and that I had blanked it out because it was so traumatic. This became a major topic of conversation in every visit and every phone call. I realise that my school days were a traumatic time for my mum too, but this was like having an old wound constantly re-opened, and my mum refused point blank to stop talking about it when I explained how upsetting it was.

Since her illness worsened, her personality changed completely. She would take control of every conversation, and most conversations would consist of her expressing strong opinions very forcefully on a wide range of matters. I didn't set out to challenge her views or prove her wrong; I tried to just calmly listen even though I found many of her opinions offensive. However, I quickly found that the only way to keep the situation calm was to actively agree with her. If I listened calmly but didn’t offer an opinion of my own, she got angry at me, saying that I never argue and that she “hates the strong silent type of men”. If I acknowledged how she felt about something but didn’t actively agree, she would continue on the same topic until I eventually agreed with her. If I disagreed or questioned anything (which I very rarely did), she would shout angrily that I was young and naïve and didn’t have enough life experience to see how things really are. If anyone tried to change the topic of conversation, she would talk over them and immediately change it back.

Some of her strongly-held views were as follows. She expressed all of these views many times:
• Insisting that my partner is anorexic (which she’s not).
• Insisting that because I’ve been sexually assaulted (which I haven’t been) and because my partner is anorexic, we’ve both done a lot of damage to our bodies, so we must never have children as they would be born with serious deformities.
• She warned us not to use any toilets when out and about, because they all have hidden cameras so voyeurs can spy on people. This included public toilets and those in cafes and restaurants. If my partner and I disobeyed her warnings, she shouted angrily at us for putting ourselves in danger.
• She warned us not to go into certain Italian restaurants because they’ve been infiltrated by the Mafia, and not to walk down a certain street because they make IRA bombs there. This is in a part of the UK where there’s been no IRA involvement since the height of the Troubles.
• She insisted that many of the people we know are paedophiles and we should avoid them at all costs. She also said that nobody should be trusted to have internet access at home because it can be misused by paedophiles.
• She insisted that my partner’s parents hate her, and that I’m keeping secrets by refusing to tell her why they hate her. In fact, my partner’s parents haven’t met my mum; they understand that she is ill but have no reason to hate her.
• Years ago, I was once mugged by two masked men and suffered minor injuries. More recently, my mum kept bringing this up again and saying it served me right for not doing enough to defend myself.
• She started making frequent offensive comments about entire nationalities, religions and professions of people, as well as people with bipolar disorder and people with learning difficulties. Before her illness worsened, she was much more open-minded and accepting of differences between people.
• When my partner was diagnosed with anaemia, my mum demanded that my partner should start drinking tea with every meal to give her more energy. When I mentioned that I’d read that drinking tea reduces the absorption of iron from food, my mum got angry at me saying that scientists don’t know what they’re talking about and that common sense tells you that tea will have a reviving effect.

As you can see, my mum’s behaviour has been extremely difficult for me and my partner to cope with. I realise that breaking off contact was not the right thing to do, but my partner and I will need to seek counselling (particularly to deal with my mum's angry outbursts) if there’s to be any hope of giving my mum and stepdad the support that they desperately need.

[PureFrustr8d]

Hello xyzzy,

I have no doubt it's been difficult for you and even without contact you are struggling to overcome the effects of your mothers behaviour and your past problems she has inadvertently triggered. That's why it's important YOU have support.

When the time comes it's imperative you set boundaries with your mother, for her well-being and your own. For example, 30 minute conversation maximum (on fixed days), your right to end the call should you wish, your right to not discuss certain subjects, to not have your feelings invalidated etc. I think you've been out of your depth trying to cope without support.

Here are links you might find helpful:

http://www.schizophrenia.com/family/60tip.html

https://www.helpguide.org/articles/ment ... hrenia.htm

I hope you weren't triggered writing that last post, you have nothing to prove. I was really just trying to stress the importance of you needing support. The priority is you, if you are not ok you're not going to manage to support your mother and stepfather.

Having distance helps short-term but it's not a long-term solution if you're hoping to have them back in your life.

That's really kind of you to offer to pay for a private therapist. I can understand your mothers concerns. I too opted to go private some years ago and it was a disaster. I think she's afraid of taking the risk with a new one (understandably). When you validated the feelings of others this really helps. Rather than a discourse about her lack of trust and them being 'fat cats', you could validate her betrayal and hurt and the risk she needs to take etc.

Read up on the benefits of setting boundaries. I don't think I'd repeat all the issues to her, I'd just try to focus on what type of contact I want and what realistic expectations are possible. It does concern me that she has become so isolated, the sooner you can work through your issues the better.

If I were in your shoes I'd probably send a card, just a 'thinking of you' type. I wouldn't get into the nitty gritty of things.

Wishing yous the best of luck. Don't let mental illness destroy your relationships. Pour your love and light into your intentions.

Peace

[xyzzy]

Thanks for your kind words and advice - those links contain a lot of helpful information.

I'll definitely need to seek professional support before attempting to get back in contact with my mum and stepdad. I've read several books and websites giving advice on coping with relatives with schizophrenia, but am finding it difficult to apply it to our situation, as all the coping strategies I have tried failed. It's made worse by the fact that my stepdad is unable to get any proper support for himself because my mum won't allow him to.

Before cutting off contact, I tried to set boundaries but failed, as my attempts were met with further angry outbursts from my mum. When I suggested limiting the length or frequency of phone calls, this was met with "so you're going to desert me in my old age after all I've done for you over the years?" When I explained that I wasn't happy to keep discussing certain topics (such as bullying at school), my mum accused me of being "a typical weak selfish man" for not being able to cope with listening to her problems. My mum knows that she has schizophrenia but wrongly believes that it is still being well controlled by the medication - as far as she's concerned, her health and behaviour haven't changed so there should be no reason for me to want to reduce or restrict contact. My stepdad also didn't support the idea of setting boundaries - he thought this was selfish of me and that I should be prepared to make sacrifices by increasing the amount of contact with my mum. So we ended up in an impasse - I couldn't cope emotionally with the level of contact that I had, but my mum and stepdad both demanded that I increase it.

The standard advice for dealing with delusional thoughts - listening non-judgementally and trying to avoid agreeing or disagreeing with these thoughts - didn't work in my case as my mum forced me to express an opinion on every topic by having an angry outburst if I didn't. In some cases she even got angry at me for staying calm and for not being angry like she was. Because I was forced to agree with all her views, this probably further reinforced her delusional beliefs. My stepdad was similarly being pressured into agreeing with all my mum's views.

Thanks again for your support - I'll definitely seek professional advice about this situation, as it's horrible for everyone involved and there's clearly no easy solution.

[PureFrustr8d]

Hey xyzzy,

This popped up in my FB feed and I thought of you.

https://www.madinamerica.com/2018/04/me ... delusions/

Peace

[xyzzy]

Hi Peace,

Thanks for the link, I hope this type of therapy becomes more widely available in the UK, instead of the NHS's current reliance on medication as the main (or only) type of treatment.