Psychological Explanations and Treatment

• Schizophrenogenic Mother


  Fromm-Reichmann proposed a psychodynamic explanation for schizophrenia based on her patients childhoods.

  The mother's characteristics were:

  • Cold, rejecting and controlling
  • Tension and secrecy
  • Leads to distrust
• Double-Bind Theory


  Bateson et al - emphasised role of communication within a family

  • Child receives mixed messages so worries about doing wrong
  • Feel unable to comment on situation or ask for clarification
  • Getting in wrong results in withdrawal of love
  • Child thinks world is a confusing and dangerous place
• Expressed Emotion


  Level of negative emotion expressed towards patient by their carers who are often family members:

  • verbal criticism
  • hostility, anger, rejection
  • emotional over-involvement

  It's a serious source of stress for the patient and is the main explanation for relapse
• Cognitive Explanations


  Focuses on the role of mental processes where schizophrenia is associated with dysfunctional thought processing. A lower level of information processing suggests that cognition is likely to be impaired
• Metarepresentation


  Firth identified it as the cognitive ability to reflect on thoughts and behaviour, allowing insight into goals and intentions to interpret the actions of others.

  • if dysfunctional - disrupts our ability to recognise our actions and thoughts are being carried out by us not someone else
  • Explains auditory hallucinations and delusions
• Central Control


  Firth identified it as the cognitive ability to suppress automatic responses while we perform deliberate actions.

  • if dysfunctional - we cannot suppress automatic thoughts and speech, resulting in speech poverty
• Eval : Strength


  Tienari et al found that genetic vulnerability alone wasn't sufficient in causing schizophrenia, as the children were only more likely if their adopted family was rated as disturbed. Shows that psychological factors make people more vulnerable to developing the condition.
• Eval : Weakness


  The idea of family dysfunction leads to parent-blaming, where the parents undergo further trauma by receiving the blame for their child's condition. Also information about childhood experiences is gathered after symptoms develop, so recall may be distorted.
• Eval : Strength


  Stirling et al compared 30 patients with schizophrenia with 18 non-patients on a range of cognitive tasks. He found the patients took over twice as long to complete tasks than the control group. Supports the cognitive explanation.
• Eval : Weakness


  Psychological explanations don't clarify what causes what, if cognitive factors are a cause or result of genetic factors. This reduces the overall validity of both explanations.
• Cognitive Behavioural Therapy


  Usually takes place for a series of sessions, aiming to help identify irrational thoughts and change them. Will not get rid of symptoms but can help the patient understand and cope. Reduces anxiety, reality testing, normalisation.
• Family Therapy


  Takes place with the family and patient, to improve the quality of communication between family members. Concerned with reducing stress that could contribute to relapse and reduce the levels of expressed emotion.

  Pharoah et al:

  • reduce anger and guilt
  • balance between caring and maintaining own lives
  • forming alliances with family members
• Burbach's 7 phase model:


  1. Sharing basic info and providing emotional and practical support
  2. Identifying resources and what family can offer
  3. Encourage mutual understanding and a safe space
  4. Identify unhelpful patterns
  5. Skills training
  6. Relapse prevention planning
  7. Maintenance for the future
• Eval : Strength


  Jauhar et al reviewed 34 studies using CBT with schizophrenia, finding small but significant effects on positive and negative symptoms. Support benefits of CBT.
• Eval : Weakness


  Thomas said that different studies use different CBT techniques and people with positive or negative symptoms. It is hard to say how effective CBT will be for a particular person.
• Eval : Weakness


  Both CBT and Family Therapy help the patient, but they don't cure schizophrenia or significantly reduce symptoms.