Expressed emotion in families : its significance for mental illness / Julian Leff, Christine Vaughn.

  • Julian Leff
Date:
[1985]
Catalogue details

Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Expressed emotion in families : its significance for mental illness / Julian Leff, Christine Vaughn. Source: Wellcome Collection.

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    Introduction The great majority of people throughout the world live in families, and so do most individuals who develop psychiatric illnesses, at least at the time of the first episode. It is universally recognized that the family not only provides a supportive environment, but is also a potent source of psychological ten¬ sions. It is hardly surprising that theorists have put two and two together and have implicated psychological pressures from family members in the etiology of most psychiatric conditions. Although this may appear to be no more than common sense, there are many obstacles in the way of determining the truth of this assertion. Many of the theoretical and practical contributions to this endeavor have focused on schizophrenia, one of the most severe and enigmatic of mental illnesses. A major problem in studying family influences on the origin of schizophrenia, and indeed of virtually all other psychiatric condi¬ tions, is that there is no way of identifying precisely those individuals who are susceptible to the illness prior to the development of symptoms. Hence nearly every study in this area has been either retrospective in nature, start¬ ing from the point of illness and looking backward in time, or cross-sectional. Both approaches involve the assumption that relationships assessed after the onset of the illness are indicative of those that existed beforehand. The fal¬ lacies and biases that are implicit in these strategies have been fully explored by Hirsch and Leff (1975). In reviewing a large number of relevant studies, these authors identified a handful that avoided such biases by drawing on child guidance clinic and school records. The findings from these are presented at an appropriate point in this book (see Chapter 15). In addition, there are a few ongoing studies in which cohorts of children identified as being at high risk for developing schizophrenia are followed up prospectively. However, it will be some years before these far-sighted projects begin to yield definitive findings. It is perhaps surprising that the theories of the family's role in the origin of schizophrenia that have been most influential either are based on cross- sectional studies (R. W. Lidz & Lidz, 1949; Singer & Wynne, 1963) or are supported by little or no scientific evidence (Bateson, Jackson, Haley, & Weakand, 1956; Laing & Esterson, 1964). Despite these handicaps, such theories have led to the development of therapeutic methods of working with 1
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