My brother was diagnosed with schizoaffective disorder about 10 years ago. He’s 35, lives with our father, he’s dependent, unemployed, doesn’t really leave the house at all unless to go to therapy because he has a lot of issues with social anxiety, all his groceries and meds are brought to him. I know it’s not an ideal situation but I have no control over his treatment. He’s pretty well enabled to just watch movies and smoke cigarettes all day.
That said, my question is about his state of mind. He lives in the past. I don’t mean he dwells on the past exclusively. I mean that he lives like no time has passed since he was diagnosed and now. He still treats me like I’m his 20 year old little sister who doesn’t know anything and isn’t independent, married, employed, experienced, mature etc. Not just me, he talks down to everyone. He was always very intelligent, he finished a degree in philosophy before he was diagnosed. But today he won’t take in new information. He acts like he knows all there is to know about something. He won’t update his knowledge. Is there a name for this? What’s going on?
I found this online but it’s about PTSD: “PTSD appears to involve a number of problems with the hippocampus which, if you recall, is devoted to moving short-term memories into long-term storage. First, intensely emotional events lead to intense memories called flashbulb memories. It seems that these memories may actually be partially stored in the amygdala, which accounts for the fearfulness involved. In addition, the prolonged stress of experiences such as war or childhood abuse actually begins to destroy tissue in the hippocampus, making it more difficult to create new long term memories. Studies show that people who have suffered long-term trauma have anywhere from 8 to 12% less hippocampus. The net result could be that they are, in a sense, stuck in their traumatic past.”
We were both severely abused physically and emotionally by our father when we were kids. But my brother doesn’t acknowledge those facts since the onset of his illness. He still believes many of his paranoid delusions that friends and neighbors have plotted against him and sabotaged his life and “that’s much worse than anything Dad ever did,” he’s said.
You might be misinterpreting your brother’s behavior. It may not be PTSD but rather cognitive impairment associated with his disorder. A core feature of schizoaffective disorder, and related disorders, is cognitive impairment. These impairments can range in severity and affect virtually all areas of an individual’s life, including attention, memory, IQ, language deficits, and executive functioning. Studies consistently show that to be the case.
You mentioned that you brother doesn’t acknowledge the severity of the abuse he suffered. The majority of people with schizoaffective and related disorders have abuse histories. It’s possible that he does not remember it well because those memories have been repressed (i.e. unconsciously blocked from his mind) or he is in denial. It’s also possible that those memories are so painful that he is avoiding the topic for the sake of self-preservation.
You also said that he is living with his father, the perpetrator of the abuse. Perhaps acknowledging the severity of the abuse would mean that your brother would have to move and cut ties with your father. People with psychotic disorders often have difficulty with change. In fact, even minor changes can trigger psychotic episodes. If your brother doesn’t want to talk about the abuse, that is okay. He might talk about it when (and if) he’s ready and no one should push him to do it any sooner. People with psychotic disorders are more stable, and less prone to psychotic episodes, when they live in calm, stress-free environments, where there is structure and routine. You and your family should try to avoid anything that might trigger a psychotic episode.
If he’s willing, he should inform his treating professionals about his on-going paranoid delusions. His medication might need adjusted.
Finally, you might want to research cognitive impairment and schizoaffective disorder. It might help you to better understand your brother’s illness and explain his behavior. If you have any other questions, don’t hesitate to write again. Please take care.
Dr. Kristina Randle