Ask Dr. Conte: Do You Have Any Advice for Coping with My Mother’s Schizophrenia?

How can I deal with my mother's schizophrenia?

(Names have been changed for privacy.)

Dr. Conte,

I need advice on how to deal with my mom, who has schizophrenia, and my sister, who has anger issues or is a narcissist.  I have anger issues as well, but I am the quiet one and learned to repress a lot of emotions because I hate fighting and screaming. I think that even when I try to tell my mom or sister how I feel… they don’t get it. I’m always caught in the middle of their battles, and it doesn’t seem like they see how it affects me. 

Somehow it became my responsibility to find help for my mom when her psychiatrist stopped her medication. I’ve called so many places in my state to find help for my mom, and it’s difficult since she never thinks anything is wrong with her. 

I go to therapy, and most likely I will be going for the rest of my life. I would appreciate advice from you on how to deal with mental illness. I think that I tried so many resources and it doesn’t lead to much. Your videos resonate with me, and I remember them and try to practice your advice as much as possible 

I know there are a lot of people dealing with schizophrenia who cannot find proper resources. It would be helpful if you could do a video targeting this disease specifically 

Thank you for your time 


Hi Abigail,

Powerful question. Schizophrenia is an extraordinarily difficult mental disorder for people to deal with, and it certainly isn’t easy for loved ones to interact effectively with family members who are suffering with schizophrenia; so first and foremost, please know my heart goes out to you for the obstacles you’re encountering. I do have some advice for you that I hope can be helpful, and it centers on the phrase I always say: Align your expectations with reality.

In other words, you would not go outside and expect that a tree in your front yard would magically turn into an elephant one day. And just as much as you wouldn’t expect something that out-of-the-norm to occur, it is equally important to not expect that your mother or sister will suddenly be open to genuinely listening to the struggles you’re expressing. If your sister truly struggles with clinical narcissism, then she does not have the same mental capacity for focusing on others that you do. Instead, her brain is so locked into her seeing only her own story, that she has an inability to care about anyone who is not currently serving her direct needs. It is very important that you hear me say “if she is struggling with clinical narcissism,” because oftentimes, people throw around the word “narcissism” on those who disagree with them or don’t care about them as much as they would like (I’m not saying you are or are not, but I just want to be clear since all that I know about you is what you wrote in this question). The difference is, and I think this is important for people to understand, in true narcissism, the entire idea is that the person does not have the mental capacity or ability to focus on others in the way that those without narcissism can. 

In terms of actual schizophrenia, it’s also really important to understand that there is a world of hurt and confusion going on inside someone’s head when they are struggling with schizophrenia. From delusions of grandeur (e.g., “I am perfect and there is nothing wrong with me”), to auditory (and sometimes visual) hallucinations, those who have actual schizophrenia are dealing with an entire extra world in their minds in addition to the one they are experiencing physically. So again, expecting that your mother can somehow just change that when she’s not even willing to admit that she has any issues whatsoever is as unrealistic as expecting that tree in the front yard to magically turn into an elephant. 

Because schizophrenia and narcissism are such serious mental health issues, I think it’s important to really understand the full meaning behind the phrase, “Align your expectations with reality.” When you can expect that you will not change your mom or sister, and you will not be heard by them, then you will likely stop putting effort and energy into trying to do either one of those things; and when you stop putting in effort and energy to do those things, you will not be let down when you don’t get them. In other words, if I don’t buy a lottery ticket, I won’t be as disappointed if I don’t win as if I would have been had I actually bought a lottery ticket, because I wouldn’t have expected to win (considering that I didn’t even play). This doesn’t mean that you don’t try to have a relationship with your mom and sister; it just means that you allow yourself to see what that relationship honestly is.

From what you wrote, to me, it sounds like your biggest challenge lies in letting go of trying to change either one of them in any way. When you let go of trying to change them, you can let go of getting caught in the middle of them anymore, as well. You can also let go of trying to have them hear you, because as history has taught you, neither one of them will hear you. 

Coming to terms with those ideas is a whole lot, and you will definitely benefit from having someone to talk to, so I’m glad you have a therapist you can trust. When you align your expectations with the reality of what your mom and sister’s past behaviors have taught you about how they will likely respond to things in the present, you can free yourself from constantly trying to change them (especially considering that it seems from what you wrote that neither one of them is likely working on changing herself). In the end, none of us changes anyone anyway. All we can ever do is give others our best, and then let go. If people decide to change or not to change, well, that is 100% on them. 

Sending you and your family much peace. 

Dr. Christian Conte