psychological: family dysfunction theories of schizophrenia

the schizophrenogenic mother theory

• The schizophrenogenic mother explanation of schizophrenia (Fromm-Reichmann, 1948) suggests that a toxic, negative, dysfunctional mother is a major factor in her child’s development of schizophrenia

• The SM theory depends on the passive, ineffectual nature/behaviour of the father as another key factor

• The SM is a psychodynamic explanation of schizophrenia, as it is based on a patient’s current internal conflict, having its roots in aversive childhood experiences

• The SM is cold, rejecting and controlling and creates a family atmosphere characterised by tension and secrecy

  • This toxic behaviour is theorised to lead to distrust, paranoia, delusions, and ultimately schizophrenia in the child

double-bind theory

• Proposed by Bateson et al. (1956), the double-bind theory describes a situation in which a child receives mixed messages and inconsistent standards are imposed on them

  • E.g. when I didn’t tidy my room, I was yelled at, but when I tidied today, I was told that I was wasting my time

• It is thought that a child caught in a double bind may develop schizophrenic symptoms such as paranoia and disorganised thoughts

• Parents may withdraw their love and approval as a punishment for perceived wrongs, which may result in the child feeling fearful and confused about how to be themselves in what appears to be an unpredictable world

• Double-bind is a risk factor in the development of schizophrenia, not the sole cause

expressed emotion theory

• Expressed emotion refers to how a family member communicates their thoughts and feelings towards the schizophrenic person in their family

• Expressed emotion can include hostility towards the schizophrenic person, criticism of the person, or over-involvement in their life

• High expressed emotion is associated with an increased risk of relapse in the recovering schizophrenic person

• Low expressed emotion is likely to produce an atmosphere of warmth, support and care that will help to facilitate recovery and prevent relapse

research which investigates family dysfunction

• Hartwell (1966)

  • Argues that the SM concept was developed during a time of tension over women’s changing positions and roles in American society as a way of reclaiming psychotherapy as a purely male domain

• Sojit (1971) conducted an observation of the parents of schizophrenics interacting with their children compared with other groups

  • Parents of young offenders supported double-bind theory, as the parents of the schizophrenic were more likely to send mixed messages to their child than other parents

• Amaresha & Venkatasubramanian (2012)

  • Proposed that the theory of expressed emotion undermines positive attitudes towards schizophrenic family members, so it is important that future studies focus on the protective factors as well as risk factors for schizophrenia

strengths of family dysfunction

• Purely biological explanations cannot fully account for the array of factors that contribute to the onset of schizophrenia, so the family dysfunction explanation fills that gap, demonstrating that close-knit relationships can be toxic as well as life-enhancing

• Robust research findings, such as Kavanagh (1992) show that there is a high relapse rate (48% in the case of Kavanagh’s meta-analysis) for schizophrenic patients who live with high expressed emotion families, compared to 21% for those who live with low expressed emotion families

weaknesses of family dysfunction

• The concept of SM is a dangerous stereotype and a product of ‘blame culture’, which has no basis in scientific fact and which may have caused a great deal or harm over the years (Neill, 1990)

• Shuhman (1967) questions the existence of double-bind theory as a risk factor for schizophrenia, as it is almost impossible to differentiate double-bind from ordinary family communication within a specific family dynamic

  • This means that the theory lacks reliability, as it cannot be operationalised

  • This also means it lacks validity, as it cannot offer a complete explanation for the onset of schizophrenia

link of family dysfunction theories of schizophrenia to issues & debates

• The SM theory shows gender bias as it blame women for their child’s schizophrenia, portraying them as cold, controlling and emotionally damaging

• Family dysfunction theories are socially sensitive because they imply that parenting style or family communication can cause schizophrenia

  • This may lead to stigma, guilt or blame being placed on parents without sufficient scientific evidence

  • Researchers and clinicians must handle these theories ethically and sensitively, especially when applying them in real-life therapeutic settings