Dysfunctional families

• What is the double bind theory ?

  Bateson (1956) proposed symptoms seen in scz people were result of communication difficulties within family- especially between parents and children.
• What are conflicting messages?

  Scz may develop where child repeatedly exposed to social interactions in which there’s 2 conflicting messages and child doesn’t have opportunity to ignore them or to adequately respond to them.
• What is an example of a conflicting message?

  Father tells kid he’d love to hear what she did today, whilst focusing on TV and not listening to what she’s saying.
• How do conflicting messages affect the child?

  Communication contradictions incapacitate child‘s ability to respond effectively, as verbal and nonverbal messages cancel each other out. Child is reliant on parent so they’re unable to metacommunicate ( can’t comment on fact that contradictory messages have been used).
• What are the components of EE ?

  Critical comments, hostility, emotional over-involvement (EOI), warmth and positive regard.
• Brown (1959)?


  Investigated 156 men with scz after they’d been discharged. Found relapse strongly connected with type of home men were discharged to. Men discharged to stay with parents or wives more likely to relapse than those who lived in lodgings or with siblings. Conducted many interviews later with wives and parents of scz people and found relationship between amount of expressed emotion (EE) and likelihood of relapse.
• What are critical comments?

  Critical comments about behaviour of scz person were counted by Brown. Comments e.g, 'They're so lazy' were made by high EE caregivers. Low EE caregivers tended to acknowledge these behaviours were due to their illness.
• Hostility findings?

  Generally present in interviews with high EE caregivers. Thought to be result of unmanageable anger, irritation and ultimately rejection of the patient.
• What is Emotional over-involvement (EOI)?

  Manifests itself in high levels of both happiness and sadness, excessive self-sacrifice and extreme overprotective behaviour of caregiver toward scz person. Especially evident in parent caregivers, as they frequently reported feeling guilty for child's illness and this guilt led them to excessive reparative efforts and ultimately the emotional over-involvement.
• What is warmth?

  Measured by vocal qualities, smiling and empathy expressed when caregiver was talking about scz person. Warmth generally evident in low EE caregivers.
• What is positive regard?

  Number of reinforcing statements in which caregiver expresses support and appreciation of scz person. Evident in low EE caregivers.
• What happened when Brown joined MRCSP unit in London in 1956?

  Antipsychotic drug chlorpromazine was widely used to treat scz. After being stabilised with meds in hospital, patients were released, but many soon readmitted due to symptom relapse.
• What does long-term exposure to communication contradictions do to the child?

  Child learns to perceive world in terms of contradictory input from their environment and they're unable to discriminate between contradictory messages as they have internalised double bind situation. Leads to manifestation of scz symptoms, e.g, hallucinations and delusions, as means of escaping contradictory demands of double bind situation.