Family Dysfunction

• The schizophrenogenic mother (SM) explanation of schizophrenia (Fromm-Reichmann, 1948) has at its basis (you guessed it) the idea that a toxic, negative, dysfunctional mother is a major (if not the) factor in her child’s development of schizophrenia
• The SM theory depends as well 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 experience
• The SM is cold,rejecting and controlling and creates a family atmosphere which is characterised by tension and secrecy
• This toxic behaviour from the SM is theorised to lead to distrust, paranoia delusions and ultimately to the development of schizophrenia in the child

The schizophrenogenic mother: just another example of a misogynistic stereotype?

• Proposed by Bateson et al. (1956), double-bind theory describes a situation in which no matter what a child does, they can't win as they receive mixed messages and unpredictable/inconsistent standards are imposed on them  e.g. When I didn’t tidy my room last time I was yelled at, but when I tidied it 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 e.g. Am I doing the right thing? Is someone going to tell me I’m wrong? Do I even know what’s right and what’s wrong?
• 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, Bateson did not claim that it was the sole reason behind a child becoming schizophrenic

• Expressed emotion (EE) refers to how a family member communicates their thoughts and feelings towards the schizophrenic person in their family
• There are several elements to EE, some of which are:
  • Hostility towards the schizophrenic person e.g. showing anger and resentment
  • Criticism of the schizophrenic person e.g. being openly judgemental of them
  • Over-involvement in the life of the schizophrenic person e.g. playing the ‘martyr’ in their presence
• High EE is associated with an increased risk of relapse in the recovering schizophrenic person
• Low EE is more likely to produce an atmosphere of of warmth, support and care that will help to facilitate recovery and prevent relapse
• EE could be one of the reasons that a vulnerable person develops schizophrenia i.e. it is another risk factor

People with schizophrenia walk a fine line between what they perceive as reality and what is fantasy - their family situation can help or hinder them in this struggle.

Research which investigates family dysfunction

• Hartwell (1996) argues that the schizophrenogenic mother concept was developed during a time of tension over women's changing position and roles in American society as a way of reclaiming psychotherapy as a purely male domain
• Sojit (1971) - An observation of the parents of schizophrenics interacting with their children compared with other groups e.g. parents of young offenders, supported double-bind theory i.e. the parents of the schizophrenic were more likely to send messages to their child than the other parents
• Amaresha & Venkatasubramanian (2012) - the theory of EE undermines positive attitudes towards schizophrenic family members so it is important that future studies should focus on the protective factors as well as risk factors for schizophrenia 

Evaluation of family dysfunction

Strengths

• 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 that by Kavanagh (1992) show that there is a high relapse rate (48% in the case of Kavanagh’s meta-analytical study) for schizophrenic patients who live with high EE families (compared to 21% for those who live with low EE families)

Weaknesses

• The concept of the 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 of harm over the years (Neill, 1990)
• Shuhman (1967) questions the very existence of double-bind theory as a risk factor for schizophrenia as it is almost impossible to differentiate double-bind from more ordinary, everyday forms of family communication within a specific family dynamic which means that the theory lacks reliability as it cannot be operationalised and validity as it cannot offer a complete explanation for the onset of schizophrenia

Link to Issues & Debates:

The schizophrenogenic mother theory clearly shows acute gender bias as it suggests that women/mothers play a key, destructive role in the onset of schizophrenia in a child (alpha bias as it assumes key differences based on gender).

This topic is socially sensitive which means that there are ethical implications as to how the findings of research in this field should be presented so as to avoid further bias, prejudice and discrimination