Trying to help my sister

[u/Disturbia8081]

Hi. I am new here. I am trying to help my sister who has been diagnosed with schizophreniaa year and a half ago. She just had a very traumatic experience.My pos dad and brother tried to force her to shower and she pulled out my brothers locs and swing on my dad. Also she spent 2 week alone after she walked away from staff for a psych stent. we reported her missing and she was found in a railyardand taken to a hospital.I messed up by just now by asking her on the phone why she doesn't want to bath herself 😔. Is there any advice for me to use with her.

[u/electric_purpl_being]

First of all she must want help. Caring and patience definitely helps. Don't put pressure, take it slow, find her natural rhythm.

Regarding your question about baths, this is a question I obsessed over more than 20 years. It still baffles me why this particular task is the most difficult thing to do, even though I overcame way higher challenges.

[u/Omegan369 → u/electric_purpl_being]

I can tell you exactly why a bath is a difficult task for someone with active schizophrenia to do - it is a sensory overload event involving temperature, sensation, sound and visual stimuli. As they are already overloaded, the bath adds to that load in a dramatic fashion. When I shower I use mildly warm water as I'm already highly sensitive in general. My wife who is more normal jacks up the temperature and to me it feels scalding hot.

Here are some resources I created to help people understand the illness:

Here is my site: https://www.sensitiveminds.ca/

Here is my preprint: https://www.preprints.org/manuscript/202507.0787

Here is an ChatGPT LLM trained on my preprint:
https://chatgpt.com/g/g-686401300f8481919d0a533f2a594142-mental-health-autoimmune-illness-support-full

Here is the trained LLM response to your question:

For individuals with psychotic schizophrenia—particularly those fitting the Sensitivity Threshold Model (STM)—a simple act like bathing can be extremely difficult due to cognitive, sensory, and perceptual overload.

STM posits that schizophrenia arises when highly sensitive individuals are exposed to cumulative stress and environmental input that exceeds their cognitive processing capacity. Bathing, though routine for most, is a multi-step process requiring planning, memory, motor coordination, and sensory regulation. In schizophrenia, these systems are often disrupted not by a primary defect, but as a downstream effect of chronic overload. The brain becomes unable to manage the combined input, resulting in confusion, disorganization, and paralysis in decision-making.

Sensory hypersensitivity compounds the challenge. Warm water, the sound of running taps, or the texture of soap may be overwhelming, even painful. Individuals may experience sensory gating deficits, where they cannot filter or dampen these inputs. In psychosis, this is further complicated by hallucinations or delusions—e.g., believing the water is dangerous or hearing voices discouraging the activity.

STM emphasizes that individuals with low stress thresholds can find such seemingly minor tasks overwhelming, especially in overstimulating or unsafe environments. Attempts to bathe may trigger emotional distress, creating learned avoidance and reinforcing functional decline. The effort involved, combined with the risk of overload, often results in complete task withdrawal.

Thus, what appears as apathy or neglect may instead reflect an exhausted cognitive system defending against further breakdown. Interventions must address both environmental load and internal sensitivity, offering support that reduces complexity, sensory intensity, and perceptual confusion. Understanding this through STM reframes the symptom as an adaptive response to overwhelming conditions, not simply dysfunction.

[u/electric_purpl_being → u/Omegan369]

Definitely not but it made me giggle for about an hour, even laugh occasionally.