[costello]

Hoping for some insight into what's going on with my son and if it's part of sz.

My son seems to have little insight into the fact that other people have needs and desires. I would say he acts like a 3 year old in this matter, but actually I think a 3 year old would have more sensitivity. One example is that I have asked him repeatedly not to turn on the lights at night because it wakes me up. I need regular sleep or I fall into a depression. I'm willing to tolerate a lot as long as he seems to be making an effort to recover, but sleep is simply non-negotiable. If I can't get enough sleep, he has to live elsewhere.

Anyway this is the kind of thing I'm talking about. Underwear on the floor. Trash never making it to the trash can. Toilet seat up. Whiskers and globs of tooth paste in the sink. I know all of this sounds incredibly petty, and friends tell me this is a male thing not a sz thing. But I find it exhausting. And I worry about the lack of insight into why others might find these things irritating. He seems genuinely puzzled. I know in the past these same behaviors have made it impossible for him to live with other people - both family members and non-family members. So it seems the behavior must be more extreme than typical.

Another example is gift-giving. In our family we draw names for Christmas gift giving. He got my name. He's been living off me, eating my food and not compensating me for utilities, etc. and spending his disability money on jewelry. Meantime I don't think I would have got a gift at all if my sister hadn't intervened and forced him to go out and get me something. I find it hurtful. And if I find it hurtful, then so will friends and girlfriends. People expect you to give as well as take.

We'll be arranging for him to have a payee (knock wood!) and I'll be getting money for rent and food starting in February (he still owes money for one last month at his old apartment), so I don't need advice on that issue, but any thoughts on the whole selfishness thing would be helpful. Do I let it slide for now? What's it about?

[FooZe]

It sounds as if from your point of view, there are lots of good reasons why he should want to please you. He, meanwhile, doesn't sound like he cares all that much if he pleases you or not, and all the reasons why he should want to seem mostly lost on him.

There might even be a vicious circle going on here. If he already had a self-esteem problem which was made that much worse by his having a history of schizophrenia, he might be seeing your taking care of him as one more reminder that he couldn't make it on his own. Resentment of his own situation might be driving him not to cooperate much with you. Understandably, that would be a problem for you but the more you leaned on him to act differently, the more he'd resent you and dig in his heels.

I don't know what a good solution would be but I'm thinking, find a way to get him out of your space. He might even come to miss you after a while but he can't as long as you're always there to remind him of whatever he's doing wrong.

[costello]

Part of me wants to get him out of my space. Part of me knows he can't make it on his own right now. And those are the only two choices. Me or alone. There's nowhere else to go where he's sheltered.

Last night I introduced the idea of his moving out, and he said it wouldn't work, he wouldn't be able to handle it. And he's right. He's doing far better after less than two months in my home. He simply can't live alone, and there's no supervised housing available - particularly as he wishes to stay off medication for now.

Edited to add: Also he needs to learn not to transgress others' boundaries and how to get along with others. Otherwise he'll have a lonely life.

Last night I told him that I need sleep and that to sleep I need darkness. He replied, "I don't understand what you need." I told him, "You don't have to understand what I need. I just told you what I need. I need sleep and I need darkness." We had to have that conversation several times before he finally accepted it.

Come to think of it, I often don't understand why he needs what he says he needs. We're like two creatures from different planets trying to share a house.

[spiritual_emergency]

Hello costello,
Some of what you describe reminds me a bit of my own child. They could also leave a trail behind them and weren't always good about respecting other people's boundaries. There were times I attributed this to the abundance of energy that comes with mania and other times I thought it might be related to those fragmented ego barriers wherein, it can be difficult to determine where you end and the rest of the world begins.

I also found, because our child was in their young adulthood as well, that there could be periods of what was probably healthy resentment that I experienced as challenging, sometimes unhealthy behavior. It's difficult to strike a balance. This is one area where peers and other people can be helpful. They can say something and you can say something and it might be the exact same thing, but your child may be more open to hearing it when it isn't coming from someone who is a parent.

Living with someone who is in an early stage of recovery can be very challenging for all parties. You noted that you can't take him out of the house, but can you bring others in? In the link I shared from Windhorse Communities, they talk about creating a care team. This is beneficial to the caregiver because it helps to prevent burn-out but it's also beneficial to the individual in recovery because it helps maintain and restore social relationships and provide structure. It's possible you might be able to create your own care team drawing on local resources.

Admittedly, in the early stages of my own recovery I preferred to be left to my own devices. I was not keen to socialize widely and often found it quite draining when I did. I mostly kept to myself for the first few years and I think this was healthy for me. Maybe you could talk this over with your son and see how he feels about interacting with others right now.

Other things you could consider are:

- Declutter his personal spaces. It will make tidying efforts easier for him to tend to.

- If he makes a mess in the kitchen, perhaps spend some time on the weekends preparing meals that can be eaten, reheated through the week.

- Baskets for holding personal care items in the bathroom and some disposable cleaning cloths might help streamline tidying efforts.

[costello]

Originally Posted by spiritual_emergency

Living with someone who is in an early stage of recovery can be very challenging for all parties. You noted that you can't take him out of the house, but can you bring others in? In the link I shared from Windhorse Communities, they talk about creating a care team. This is beneficial to the caregiver because it helps to prevent burn-out but it's also beneficial to the individual in recovery because it helps maintain and restore social relationships and provide structure. It's possible you might be able to create your own care team drawing on local resources.

I do hope he's in recovery. I'm very fearful right now that he's just vegetating on my couch.

I've read the stuff at the Windhorse site, and I'm reading Recovering Sanity right now. I wish I could have such a team for my son, but I don't see it happening. Except for the case manager, the local mhc is hell-bent on medication. My family is negative. They think he's manipulating and/or that he needs to be medicated. I can't afford to hire people outside of the mhc - except for one therapist I'm seeing for myself because he doesn't want psychotherapy. And I can only afford to see her once or twice a month. (She's pretty much anti-medication.)

He does seem to be making some efforts at recovery which I mentioned in other posts this evening.

But he's told me he isn't going to sleep tonight. He says he has nothing to do tomorrow so why sleep? I fear it will only escalate his psychosis. He's been around that block enough times that he must know he's just courting these extreme states of consciousness.

I was talking to a friend with sz tonight who is very pro-medication. He thinks my son is dangerous, and I should call the police and have him hospitalized tonight. Of course, I could create/escalate a crisis right now, but why? To what end? He wouldn't end up hospitalized tonight because he's not a danger to self or others and he has no intention of going voluntarily.

On the other hand this is the third time in a little over a week that he's acted out in an aggressive manner. Do I let him stay here?

I think he's mad as hell, and I'd like him to learn to deal with his anger appropriately. I don't think that's what will happen if he goes the medical route. He'll just be medicated. On the other hand, if I'm not safe, he'll go that route anyway, because he's not going to be able to maintain out in the world without help. He'll end up in jail or the hospital.

What do I do?

[spiritual_emergency]

costello: I've read the stuff at the Windhorse site, and I'm reading Recovering Sanity right now. I wish I could have such a team for my son, but I don't see it happening. Except for the case manager, the local mhc is hell-bent on medication. My family is negative. They think he's manipulating and/or that he needs to be medicated. I can't afford to hire people outside of the mhc - except for one therapist I'm seeing for myself because he doesn't want psychotherapy. And I can only afford to see her once or twice a month. (She's pretty much anti-medication.)

I don't think anyone could afford the same kind of team Windhorse offers. However, you may be able to find volunteers:

- Friends (Yours or His)
- Family (Not the ones that don't fit well.)
- Other people in the community who have experienced mental illness and are in recovery, or family members of the same
- Students in Psychology or Social Work programs at any local colleges
- Volunteers from local spiritual or religious communities (in keeping with your own beliefs)
- Local professionals who might be willing to cover a three hour shift once a week, or once a month.
- Anyone else you can think of.

You may also be able to fill some of those shifts with activities outside of the home. Time at the pool or a gym; an animal shelter; walking trails, etc.

But he's told me he isn't going to sleep tonight. He says he has nothing to do tomorrow so why sleep? I fear it will only escalate his psychosis. He's been around that block enough times that he must know he's just courting these extreme states of consciousness.

Is he there at home with you because that's where he wants to be as opposed to a hospital setting? If so, can he accept that he has to work to stay out of the hospital too? If he's not going to sleep, can he quietly busy himself reading, watching television, working/playing on the computer?

It sounds as if there's no one there who can spell you off when you need to get some sleep and this is part of the reason you need him to sleep in a pattern similar to your own. Yes?

I was talking to a friend with sz tonight who is very pro-medication. He thinks my son is dangerous, and I should call the police and have him hospitalized tonight. Of course, I could create/escalate a crisis right now, but why? To what end? He wouldn't end up hospitalized tonight because he's not a danger to self or others and he has no intention of going voluntarily.

Sounds like you wouldn't get that sleep you're after either.

Meantime, is your son opposed to making use of sleeping aids such as teas or melatonin? Is he open to channelling any anger or frustration into physical activity such as exercise, dance, etc.

Overall, I think you and your son need to sit down and figure out an arrangement that's going to work. Unfortunately, a great deal of it may be determined by what he's willing and capable of contributing.

Also, what was it about his medications that he was opposed to and was his opposition to all classes? Sometimes people who are opposed to things like long-term use of anti-psychotics are open to things like occasional and short-term use of anti-depressants or anti-anxiety agents. It can be helpful to have a small supply on hand to be used in situations like this. That may be a useful discussion to have... sometime over the next few days.

Something else I suspect it will become very necessary for you to do is to bring some help in for you even if it's just someone who can keep your son company for an hour while you grab a nap or tend to some errands.

If you've not already done so, I would also encourage you to thoroughly scout out resources within the local community. See what kind of support programs there are for you and for him, therapists, free programs, etc.