Psychological: Family Dysfunction Theories of Schizophrenia (AQA A Level Psychology): Revision Note

The schizophrenogenic mother

• The schizophrenogenic mother (SM) explanation of schizophrenia (Fromm-Reichmann, 1948) suggests 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 experiences

• 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

Double-bind theory

• Proposed by Bateson et al. (1956), double-bind theory describes a situation in which a child receives 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

• 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 judgmental 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 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

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, as the parents of the schizophrenic were more likely to send mixed 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 those 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)

Limitations

• 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

Issues & Debates

• The schizophrenogenic mother theory shows gender bias, as it blames women (specifically mothers) for their child’s schizophrenia, portraying them as cold, controlling, and emotionally damaging

  • This reflects outdated, sexist assumptions and ignores the role of fathers or other family dynamics, making it an unbalanced and biased explanation

  • It contributes to a blame culture, which can cause guilt and distress for mothers and families

• 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—especially mothers—without sufficient scientific evidence

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