Schizophrenia and the Family: II. Adverse Effects of Family Therapy

Theoretical formulations of the past thirty years have championed the hypothesis that family interaction contributes heavily to the etiology of schizophrenia, a position that has dominated contemporary family therapy even in the absence of solid empirical confirmation. The possibility that sociogenic modeling of schizophrenia is not only incorrect but even harmful to families, and to the relationship between families and clinicians, has never been taken seriously, despite its implications for the practice of family therapy. The author describes untoward effects of the sociogenic hypothesis in his own ten-year experience with families of chronic schizophrenics and examines pertinent reports in the family therapy literature, offering the reinterpretation that many communicational aberrations are adaptations to two therapist attributes: (a) failure to absolve the family of initial causal responsibility, and (b) failure to inform the family about the nature of the illness.     

McCandless's Response to “Soul Healing: A Model of Feminist Therapy”

The term soul healing captures the reader's imagination by intimating that therapy may do more than just focus on the healing of emotional pain. The author of “Soul Healing: A Model of Feminist Therapy,” Patricia M. Berliner, a psychologist, therapist, and sister of St. Joseph (Brentwood, New York) is to be applauded for recognizing the need for a model of therapy that consciously intends to address the concerns of women “who value the spiritual dimension in their lives” (p. 2).     

On “Naturalistic” Family Research

Much is made of the desirability of “naturalistic” research on the family. Indeed, experimental research is often rejected for not being “naturalistic.” The purpose of the present article is to draw out and to examine some of the assumptions underlying such a position. The assumptions behind criteria such as “real,”“relevant,” and “typical” for research topics and settings are held to be questionable, not least because they are inconsistent with a communicational, context-oriented approach to the family. Alternative assumptions more consistent with this approach are described.     

Effects of visual familiarity on “same” and “different” decision processes

An experiment was conducted in which subjects matched upper and lower case versions of well-known abbreviations, such as BBC and etc, and meaningless controls. “Same” RT showed a familiarity effect for upper case versions of abbreviations such as BBC and GPO, but not for the lower case versions bbc and gpo. The converse did not occur for abbreviations such as etc, which were thought to occur most frequently in lower case. The “different” RT was inhibited by familiarity, with pairs such as IBM GPO being classified less rapidly than their lower case versions or controls. These effects occurred for subjects instructed to report “No” for “same” displays and “Yes” for “different” displays as well as for subjects given a conventional decision-report assignment. Some implications of these results for an account of the manner in which familiarity affects graphemic comparison processes are considered.     

Intrusiveness and Closeness-Caregiving: Rethinking the Concept of Family “Enmeshment”

This article analyzes the concepts of “enmeshment” and “cohesion” and their entanglement in the field of family therapy. Early theories in this area were concerned primarily with processes of self/other differentiation. More recent theories have favored spatial metaphors that emphasize closeness-distance. We contend that self/other differentiation and closeness-distance are different classes of behavior and that their linkage in the literature has obscured useful distinctions. Our analysis reveals two separate dimensions that clinicians and researchers should consider: Intrusiveness (including coercive control, separation anxiety, possessiveness/jealousy, emotional reactivity, and projective mystification); and Closeness-Caregiving (including warmth, time together, nurturance, physical intimacy, and consistency). We give definitions of these constructs and briefly examine their clinical and gender-related implications.