Structural couplings between individual development and the epigenesis of family relations in schizophrenia: An eight-year follow-up

The aim of this research was to study individual development along with the epigenesis of family relations in an eight-year follow-up of schizophrenia. The five epigenetic phases described by Wynne are attachment/caregiving, communicating, joint problemsolving, mutuality, and intimacy. Results showed that the critical level of epigenesis was the communicating level; its resolution was statistically significantly connected to good prognosis concerning individual parameters. The mother-child dyad was usually epigenetically the most developed dyad in the family. We think this study gives a new paradigm for understanding connecting interconnections between individual and family dynamics in schizophrenia and valuable information for planning the integrated and need-specific treatment of schizophrenia and evaluating the course and prognosis of schizophrenia.This study was carried out at the Clinic of Psychiatry of the University of Turku, Finland, and financially supported by the Academy of Finland. The head of the project was Professor Yrjö O. Alanen. We have also been in cooperation with and received valuable constructive criticism from Professor Lyman C. Wynne, whose theoretical model we applied in this study. Ms. Birgitta Nolvi's secretarial work was greatly appreciated.     

Parental blaming and acquisition of guilt: A developmental task of childhood

Incidents involving the authors' twin 10-year-old daughters illustrate that guilt is well established in normal children of 10. The incidents suggest how the expectation of parental blaming triggers guilt and shame. Guilt and shame are compared. While they may coexist in the 10-year-old, guilt clearly is assuming a dominant position. Mental health professionals have emphasized the psychopathology of guilt and many forget that it is essential for normal socialization in that the guilty person feels a need to repair damage allegedly done. Guilt presumes that at least a primitive mutuality has been established in the person; and mutuality is the hallmark of human maturity. Terms are defined here with some variation from their usage by mental health experts: shame, guilt, blame, and counterblame.     

Teaching symbolic-experiential family therapy: The personhood of the teacher

This article explores issues in teaching symbolic-experiential family therapy to psychiatric residents. Six controversial contextual issues that arise in teaching any school of family therapy in this setting are presented. Then, the author distinguishes between content and process dimensions in teaching symbolic-experiential family therapy. This distinction helps to clarify the muddle often attendant to attempts to teach this particular area. A major point, to paraphrase Whitaker's famous dictum, is that Teaching symbolic experiential family therapy resides in the personhood of the teacher.     

On teaching psychotherapy via consultation and cotherapy

In this article Dr. Whitaker presents his basic assumptions about teaching psychotherapy. He discusses his expectations of himself and his trainees in the teaching relationship and how he attempts to empower the trainee in his/her professional growth. Following this, Dr. Garfield joins Dr. Whitaker in a dialogue about consultation and cotherapy.     

Is valentine still doubtful? A workshop model for children of divorce

We present this eight-session structured workshop format aimed at school-aged children of divorce who are considered psychologically healthy by family and teachers, in which we review the situations most frequently encountered by these families.In the workshop we offer an understanding vision of divorce while providing the children with the experience of working with therapists who are able to deal with highly troublesome issues in a caring atmosphere.Acknowledgements are expressed to Bernardita Cruz, school counselor, and Ilana Meler and Patricia Tahl, child psychologists.     

Working with families on an inpatient psychiatric unit for children: Hospital staff members are family therapists,too

Inpatient psychiatric units for children can be potent agents for family change. The activities of nursing, education, and activity therapy staff are an important addition to a program of formal family therapy in psychiatric hospitals. These modalities must be organized into a family framework so that insights and achievements from one arena may be generalized to another.     

The effects of intrafamily threats on therapy

Family members often threaten one another during the course of therapy. Such intrafamily threats can cause anxiety for the therapist and disrupt treatment. Examples of commonly encountered threats are given and their management discussed.     

Factors governing the effective remediation of negative affect and its cognitive and behavioral consequences

The present experiment tested the hypothesis that the remediation of negative emotion will be most effective when the remedial procedure matches the experience or cognition that induced the negative state--process-specificity hypothesis. Other hypotheses examined were that negative states induced by cognitive reflection related to the self would be resistant to remediation, even by a same-process positive procedure, and that changes in emotional expressions may make it appear that a negative state has been effectively remediated when lingering effects on behavior and cognition indicate that it has not. Negative emotional states were induced in second-grade children by one of four processes, all of which involved social rejection content: cognition that focused on (a) the self (thinking about oneself being rejected by a peer) or (b) another person (thinking about a peer being rejected); or experience that related to (c) oneself (actually being socially rejected) or (d) observing another (vicarious: seeing a peer be socially rejected). These inductions were then followed by a positive, remedial induction whose content was the reverse (social acceptance) and whose process did or did not match that of the negative induction. As predicted, except for negative self-cognitions, it was found that the behavioral (altruism) and cognitive (performance on a block design task) consequences of negative emotion were alleviated when the positive remediation was of the same type as the original induction. Emotional expressions were consistently positive following remediation, regardless of their type. The results are discussed in terms of differing processes for maintaining negative emotion as a function of the character of induction, and the implications for the understanding of clinical depression in children are noted.     

The Impact of Parental Suicide on Child and Adolescent Offspring

Child and adolescent survivors of parental suicide experience two stressful events simultaneously: (1) the loss of a primary caregiver, and (2) suicidal death of a significant person. These youths are thought to be at increased risk for mental health problems, but a systematic review of studies on these survivors has not yet been conducted. A comprehensive search for published literature identified nine studies. The existent studies provided modest yet inconsistent evidence on the impact of parental suicide on offspring psychiatric and psychosocial outcomes. More methodologically rigorous research is needed to inform and guide postvention efforts for these survivors.