Psychological explanations for schizophrenia
Family dysfunction A01
The schizophrenogenic mother
Psychologists have attempted to link schizophrenia to childhood and adult experiences of living in a
dysfunctional family. The psychiatrist Fromm-Reichmann (1948) proposed a psychodynamic
explanation for schizophrenia based on the accounts she heard from her patients about their
childhoods. Fromm-Reichmann noted that many of her parents spoke of a particular type of parent,
which is called the schizophrenogenic mother. “Schizophrenogenic” literally means “schizophrenia-
causing.” According to Fromm-Reichmann the schizophrenogenic mother is cold, rejecting and
controlling, and tends to create a family climate characterised by tension and secrecy. This leads to
distrust that later develops into paranoid delusions and ultimately schizophrenia, which is defined as
the loss of contact with reality.
Double-bind theory
Bateson et al (1972) agreed that family climate is important in the development of schizophrenia but
emphasised the role of communication style within the family. The developing child regularly finds
themselves trapped in situations where they fear doing the wrong thing, but receive mixed
messages about what this is, and feel unable to comment on the unfairness of this situation or seek
clarification. When they “get it wrong”, which is often, the child is punished by withdrawal of love.
This leaves them with an understanding of the world as confusing and dangerous, and this is
reflected in symptoms like disorganised thinking and paranoid delusions. Bateson was clear that this
was neither the main type of communication in the family of someone with schizophrenia nor the
only factor in developing schizophrenia, just a risk/contributory factor.
Expressed emotion
Expressed emotion is the level of emotion, in particular negative emotion, expressed towards a
person with schizophrenia by their carers who are often family members. Expressed emotion
contains several elements such as verbal criticism of the person, occasionally accompanied by
violence, hostility (aggressive behaviour) towards the person, including anger and rejection, and
emotional overinvolvement in the life of the person, including needless self-sacrifice. These high
levels of expressed emotion directed towards the individual are a serious source of stress for them.
This is primarily an explanation for relapse in people with schizophrenia. However, it had also been
suggested that it may be a source of stress that can trigger the onset of schizophrenia in a person
who is already vulnerable, for example due to their genetic makeup, known as the diathesis stress
model.
One strength of these explanations is evidence linking family dysfunction to schizophrenia.
Indicators of family dysfunction include insecure attachment and exposure to child trauma, in
particular abuse. According to a review from Read et al (2005) adults with schizophrenia are
disproportionately likely to have insecure attachment, particular type C or type D. Read et al also
reported that 69% of women and 59% of men with schizophrenia have a history of physical and/or
sexual abuse. Morkved et al (2017) reported that most adults with schizophrenia had at least one
childhood trauma, mostly abuse. This is a strength of the family dysfunction explanation for
schizophrenia because strongly suggests a family dysfunction makes people more vulnerable to
schizophrenia.
However, one limitation is that these findings rely on self report techniques from schizophrenic
patients. This is a problem as it may compromise the validity of the reportings due to their loss of
contact with reality.
Family dysfunction A01
The schizophrenogenic mother
Psychologists have attempted to link schizophrenia to childhood and adult experiences of living in a
dysfunctional family. The psychiatrist Fromm-Reichmann (1948) proposed a psychodynamic
explanation for schizophrenia based on the accounts she heard from her patients about their
childhoods. Fromm-Reichmann noted that many of her parents spoke of a particular type of parent,
which is called the schizophrenogenic mother. “Schizophrenogenic” literally means “schizophrenia-
causing.” According to Fromm-Reichmann the schizophrenogenic mother is cold, rejecting and
controlling, and tends to create a family climate characterised by tension and secrecy. This leads to
distrust that later develops into paranoid delusions and ultimately schizophrenia, which is defined as
the loss of contact with reality.
Double-bind theory
Bateson et al (1972) agreed that family climate is important in the development of schizophrenia but
emphasised the role of communication style within the family. The developing child regularly finds
themselves trapped in situations where they fear doing the wrong thing, but receive mixed
messages about what this is, and feel unable to comment on the unfairness of this situation or seek
clarification. When they “get it wrong”, which is often, the child is punished by withdrawal of love.
This leaves them with an understanding of the world as confusing and dangerous, and this is
reflected in symptoms like disorganised thinking and paranoid delusions. Bateson was clear that this
was neither the main type of communication in the family of someone with schizophrenia nor the
only factor in developing schizophrenia, just a risk/contributory factor.
Expressed emotion
Expressed emotion is the level of emotion, in particular negative emotion, expressed towards a
person with schizophrenia by their carers who are often family members. Expressed emotion
contains several elements such as verbal criticism of the person, occasionally accompanied by
violence, hostility (aggressive behaviour) towards the person, including anger and rejection, and
emotional overinvolvement in the life of the person, including needless self-sacrifice. These high
levels of expressed emotion directed towards the individual are a serious source of stress for them.
This is primarily an explanation for relapse in people with schizophrenia. However, it had also been
suggested that it may be a source of stress that can trigger the onset of schizophrenia in a person
who is already vulnerable, for example due to their genetic makeup, known as the diathesis stress
model.
One strength of these explanations is evidence linking family dysfunction to schizophrenia.
Indicators of family dysfunction include insecure attachment and exposure to child trauma, in
particular abuse. According to a review from Read et al (2005) adults with schizophrenia are
disproportionately likely to have insecure attachment, particular type C or type D. Read et al also
reported that 69% of women and 59% of men with schizophrenia have a history of physical and/or
sexual abuse. Morkved et al (2017) reported that most adults with schizophrenia had at least one
childhood trauma, mostly abuse. This is a strength of the family dysfunction explanation for
schizophrenia because strongly suggests a family dysfunction makes people more vulnerable to
schizophrenia.
However, one limitation is that these findings rely on self report techniques from schizophrenic
patients. This is a problem as it may compromise the validity of the reportings due to their loss of
contact with reality.
