Schizophrenia – Psychological Explanations 1 Family Theories

Schizophrenia – Family Theories Blames S on abnormal and inadequate patterns of communication in the Family environment Several theories have looked at the role of the family etc but not always that much evidence

Schizophrenia – Family Theories Fromm-Reichmann (1948): The Schizophrenogenic Mother Here’s the theory: A cold, domineering, manipulative and conflict- causing mother causes her child to become schizophrenic The distrust and resentfulness that the child feels makes them psychotic This theory has not been supported by the results of controlled scientific investigation

Schizophrenia – Family Theories Fromm-Reichmann (1948): The Schizophrenogenic Mother AO2: For example, Mischler (1968) did various observations and found that mothers talking to their daughters who had S were rather aloof and unresponsive BUT the same mothers were normal and responsive when talking to healthy daughters So it might be the presence of S in a family that results in poor communication patterns, not the other way round. ie effect, not cause.

Schizophrenia – Family Theories Bateson et al (1956): The Double-Bind Theory Family members of individuals with S communicate in a destructively ambiguous manner, eg. someone says ‘I love you’ but in a hateful way Bateson et al argued child’s ability to respond is incapacitated by the contradictions, Prolonged exposure to these interactions prevents the development of a coherent construction of reality In the long run this manifests itself as schizophrenic symptoms, e.g. flattened effect, delusions, hallucinations, incoherent thinking and speaking and some cases paranoia

Schizophrenia – Family Theories Bateson et al (1956): The Double-Bind Theory AO2: little evidence supports it eg. Kennedy (1966) asked medics to analyse letters written from parents to children in hospital. Double binds present to same extent whether child had S or not SO our parents don’t always talk to us nicely BUT we don’t all get S AO2: Could in part account for the confused thinking of patients with S AO2: There is some evidence of inadequate comms in families of those with S (Gisson, 1978)

Schizophrenia – Family Theories Lidz et al (1956): Schism & Skew in the Family Lidz descibed a family in which parents could be blamed for causing S in their offspring by Schism: one parent over-dominant, the other submissive Skew: causing emotional disturbances in the family He spoke of the folie a deux, a delusion of the parents thinking themselves normal when in fact the dysfuntion that they presided over was causing psychosis in their children No evidence of Theodore Lidz’s theory exists

Schizophrenia – Family Theories AO2… Lirem (1974) compared communications in familys with S and those without. Found same dysfunctional exchanges in all families Other theories exist which also cite familial issues as a cause for S: Scheff’s (1966) Labelling Theory suggested that an oft-punished child may become quiet to avoid further beatings. The child may be labelled as deviant, this then becomes self-fulfilling when the child learns to conform to this label to get attention & sympathy etc (a behaviourist view), and they become psychotic

Schizophrenia – Family Theories AO1: Other research focuses on expressed emotion: hostility, critical comments & over-emotional involvement in the family environment AO2: Kavanagh (1992) found when a family engages in high expressed emotion children are four times more likely to suffer from schizophrenia, this shows the importance of family factors Eg. A study in Iran by Kalafi & Torabi found the high EE in Iranian culture (overprotective mothers, rejecting fathers) was one of main causes of relapse from schizophrenia

Schizophrenia – Family Theories AO2… The EE explanation enjoys more universal support than double bind, though critics note that many schizophrenics are estranged or have minimal contact with their family, and there is no evidence that such people are less prone to relapse just because they are not with their family Mustn’t ignore the EE model since society/friends could have high or low EE just as the family does, and in this way it is a less family-blaming model than theories such as Double-Bind or The Schizophrenogenic Mother

Schizophrenia – Family Theories AO2… Brown et al (1966) – Examined progress of discharged patients who had schizophrenia back to their families. Classed families as either high E.E or low E.E Results – 58% of patients returned to high E.E families had a relapse compared to 10% in low E.E Could be the schizophrenia that produces a dysfunctional family or the dysfunctional family leads to onset of schizophrenia Theory has become accepted → treatment for schizophrenics now includes education and training for family members.

Schizophrenia – Family Theories AO2… There is a higher incidence of S relapse in developed countries, it has been theorised that this could be due to cultural differences in expressed emotion (Leff, 1990) BUT it is hard to establish causality in EE studies, eg Patterson (2000) found that EE is the gradual result of a family trying to come to terms with a member who has S