Schizophrenia
RECAP – Psychodynamic
approach

 What is the main assumption of this approach?
 How is the personality explained in the
psychodynamic approach?
 What are defence mechanisms? Examples
Different explanations

 Using the hand-outs, each of you focus on one –
either:
 Regression/defence mechanisms,
 Schizophrenogenic mother/Double bind
hypothesis or
 Expressed Emotion
 Provide a summary of your explanation
Regression

Schizophrenogenic Mother

Expressed Emotion (EE)

REGRESSION

 Schizophrenia (SZ) may reflect regression and a
poorly developed ego – issues in childhood
 The ego may be overwhelmed by the demands from
the Id or by feelings of guilt from the superego & so
the individual regresses to the safety and security of
the oral stage.
 In the 1st stage the ego has not yet properly
developed & the child can’t distinguish between
itself & its fantasies & the external world.
CHILDHOOD EVENTS

 According to the psychodynamic approach, family
relationships dramatically influence the way a
growing child perceives reality.
 If trauma carries on into adulthood, then
schizophrenia could result. There are several family
problems which are thought to contribute to the
formation of schizophrenia:
 Schizophrenogenic Mother
 Double-bind Hypothesis
 Expressed Emotion
Schizophrenogenic Mother

 A schizophrenogenic has actions that are often
contradictory – verbally accepting yet behaviourally
rejecting.
 This can set up faulty communication between both
mother and child and can lead to the onset of
schizophrenia.
Double-Bind Hypothesis

 ‘Double-bind’ communication is witnessed in the
schizophrenogenic mother.
 Double-bind communication is contradictory
communication. For example, a mother will ask for a
hug and then pull away – the child is placed in a ‘no
win’ scenario.
 The child cannot avoid displeasing the parent, thus
can become confused and suspicious – this can
contribute to the onset of schizophrenia.
Study: Schofield and Balian (1959)

 This study used 178 schizophrenic patients and 150
non-sufferers, comparing their childhood
experiences to see whether schizophrenics really did
have more difficult childhood relationships.
 It was found that with the quality of relationships
between the parents there was no difference found
between the two samples.
 However there were significant differences in the
reported quality of mothering with patients'
mothers being less likely to be affectionate and more
likely to be domineering and overprotective.
Conclusion

 The results are thus consistent with the theory of the
schizophrenogenic mother – the only childhood
circumstances that appeared to increase the risk of
schizophrenia in adulthood were related to the
quality of the maternal relationship.
 Though the study was able to produce qualitative data, it was
restricted to America, thus it is hard to generalise the findings
to the wider public without being ethnocentric.
Expressed Emotion

 Expressed Emotion (EE) refers to hostility,
criticalness and concern in the family environment
after someone has been diagnosed. It therefore
examines the development of schizophrenia as
opposed to the onset.
 Brown et al (1966) examined progression of
schizophrenia when patients were discharged from
hospital and lived with their families.
 Families were either high EE or low EE. 58% of
patients who returned to high EE families relapsed,
compared to only 10% of those who returned to low
EE families.
Projective Identification

 EE is linked to the psychodynamic concept of PI.
 This is when the person without Sz projects emotions
onto the person with Sz.
 So, in some families, the pressure caused by the
diagnosis of Sz on the people around the patient can
lead them to act in a way that perpetuates the Sz.
 What will this cause?
Diathesis Stress and
Schizophrenia

 The confusion from these contradictory messages could lead to
self doubt and withdrawal – but is this enough to lead to
schizophrenia?
 How could the Diathesis Stress model explain Schizophrenia
using this family life theory?
 What study have you already got that supports this theory?
 That no cause is readily apparent for Sz gives ammunition to
those who doubt the validity of the diagnosis. Sz seems to need a
specific set of circumstances before it begins to change behaviour.
A fractured family background alone is not a sufficient trigger.
Evaluation

 Reductionist?
 Deterministic?
 Is it fair to blame parenting?
 Is it scientific/objective?
 BUT
 Research support
 Different perspective into the human mind unconscious

 Psychodynamic theory is not adequate to explain Sz
because its approach to childhood developmental
problems is too simplistic. Sz appears to be a multifaceted disorder with many factors contributing to
its onset. You can take something from most of the
major perspectives and apply it to Sz but one
approach alone is not sufficient.
Weaknesses of the
Psychodynamic Approach

 One weakness of the psychodynamic approach is that it’s
deterministic. This suggests that all thoughts, behaviours
and emotions are determined by our childhood
experiences and unconscious mental processes.
This is a weakness because it suggests we have no
conscious free will over our behaviour.
 Another weakness of the psychodynamic approach is that
it is reductionist. This reduces the main reason for our
thoughts, emotions and behaviour down to childhood
experiences and unconscious mental processes.
This is a weakness because it does not take into account
the influence of our biology and genetics.
Continued...

 But the data is retrospective –
the memory may not always be accurate. They
are memories of people with SZ so may be distorted as a consequence of their illness. There’s not
much data for support of F-R’s views. Research suggests that most people with SZ don’t come from
this type of family. Also some people with SZ will suffer a relapse even if they’ve been moved from
their families entirely.
 Leads to parents being blamed for their children’s
problems – In the early part of the 20 century the wide spread belief of this theory led to
th
many parents feeling guilty because of the implication of it being their fault. It’s now recognised as
unjust since its excepted that biological problems probably influence the disorder.
 People with SZ don’t really behave like children – they don’t
behave as a child would as children don’t normally have hallucinations.
 The theory is unscientific (behaviourists would argue) – it
refers to structures like the Id, Ego and unconscious which are not observable, empirical evidence.
Strengths of the
Psychodynamic Approach

 One strength of the psychodynamic approach is that it
acknowledges the impact of the early childhood
experiences on the adult personality and behaviour.
This is a strength because it provides a level of insight
that other approaches lack and also gives adults a
reason for their irrational behaviour that can lead them
to realise that the behaviour is not their fault.
Strengths of the
Psychodynamic Approach

 Another strength of the psychodynamic approach is
the focus on the role of the unconscious mind in
determining thoughts, behaviour and emotions.
Using the role of unconscious mental processes can
explain why we think and behave irrationally. We
are driven by unconscious conflicts that we have no
conscious answer of.
This is a strength because it provides a different
perspective into the human mind.
Task

 If high rates of EE within families is a contributory
factor in developing Sz, what should treatments be
targeting?
HW – Due Weds 24/09

 Plan and write an essay for the following question:
Discuss one psychological explanation of
schizophrenia (12 marks)
 Need to outline as well as evaluate the explanation –
use research!