Social Explanations 1: Dysfunctional Families

  • Created by: curt703
  • Created on: 07-12-18 10:01

Double Bind Theory (1)

  • Double bind theory explains the development of schizophrenia as being a consequence of abnormal and inadequate patterns of communication within the families of schizophrenics. Bateson (1956) put forward this theory, according to which the members of families of schizophrenics communicate in a destructively ambiguous fashion.

    • For example, the mother will tell the child that she loves him, but in a tone of voice that does not suggest love.

  • This theory, therefore, states that it is the way the parents or other family interacts with the child that causes the schizophrenia. If a child is repeatedly exposed to this sort of communication, they become unable to respond to others.

  • Parents who often make these double bind statements may not be aware they are doing so. The words that we choose to say are only a part of what we communicate to others. Body language, tone of voice and facial expression can betray an individual's true feelings.

    • These non-verbal cues are known as paralanguage. So the words that a child hears may not match with the paralanguage shown by the parent. For example a mother may say to her child “Do you want mummy to read you a bedtime story?”. The words said by the mother imply that the mother wants to read a story to their child. However, if the mother’s true underlying feeling is “I don’t want to read you a story. I want you to got to bed so I can be alone as I don’t like spending time with you”, this will come across in her paralanguage.

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Double Bind Theory (2)

  • The child is therefore getting two separate messages, and as these two messages contradict each other, it causes a conflict. Whatever the child’s actions, they cannot win. They are in a double bind.

  1. If the child says yes to the bedtime story, the mother may do so, but will be unhappy while doing so, but will be unhappy while doing so, which will be unpleasant for the child.

  2. If the child says no, they are rejecting the mother, which may be punished by the parent for not showing how loving they are.

  • Children who grow up encountering these double bind statements on a regular basis learn that they have no idea how to respond in a reasonable way in conversations. As these interactions are with a role model they will grow up believing that this is how normal relationships work, and in the future will struggle in establishing normal relationships.

  • Bateson argued that these double bind statements could eventually lead to the hallucinations and delusions of schizophrenia. These symptoms arise as a means of escaping the conflict caused by these contradictory double bind statements. These statements can also cause the child to respond with maladaptive thinking patterns to help them navigate social situations such as:

    • “All statements are derogatory towards to me”

    • “All statements are to be taken literally”

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Supporting Studies of Double Bind

  • Beger (1965)- Interviewed schizophrenics, and found that they had a higher recall of double bind statements by their mothers than non-schizophrenic controls.

  • Mischler and Waxler (1968)- Found that mothers talking to their schizophrenic daughters were rather aloof and unresponsive. However, the same mothers behaved in a much more normal and responsive way when talking to their normal daughters.

    • While not specifically investigating the effect of double-bind statements, this does provide support that there are differences in communication between schizophrenics and their family members and non-schizophrenics.

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Expressed Emotion (EE)

While the evidence for double bind theory may be limited, there is some evidence that the interactions within a family can play a key role in maintaining the symptoms of individuals who are already suffering from schizophrenia. Families who engage in expressed emotion (EE) show a high level of criticism, hostility and emotional over protectiveness. Expressed emotion contains a number of different components.

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Evidence Supporting EE

  • Kavanagh (1992) Found that schizophrenics in families with high expressed emotion were four times more likely to relapse compared with those who live in families with low expressed emotion.

  • Brown (1959) Investigated 156 men with schizophrenia after they had been discharged. He found that relapse was strongly connected with the type of home the men were discharged to. Those men discharged to stay with their parents or wives were more likely to relapse than those men who lived in lodgings or with the their siblings.

Vaughn and Leff (1976) Offered clear support for the role of expressed emotion in relapse rates. They found that 53% of those individuals with schizophrenia who had a high EE relatives relapsed within 9 months, whereas only 12% of those with low EE relatives relapsed.

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Evaluation (Double Bind)

  • The double bind theory argues that it is the ambiguous communication from the parents that leads to schizophrenia in their children. However, we must remember, that just because two factors seem to be connected, we can not necessarily state that one causes the other.

    • Another explanation for this is one of cause and effect. It could be the children causing the parents to behave like this.

  • Determining what classes as a double bind statement is very subjective Ringuette and Kennedy (1966) had supposed experts in double bind theory and non-experts make judgements about letters written to schizophrenics. These letters were either written by family members or hospital staff. Interestingly, the results demonstrated that the so called experts were no better at identifying double-bind statements than the non-experts.

Schuman (1967) even argued that the confusion around defining what double bind statements even are has impeded the research and provided little support to the theory. It is fair to argue that the evidence for the influence of double bind is conflicted, at best, and weak or non-existent at worst.

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Evaluation (Expressed Emotion)

  • Unlike double bind, expressed emotion has a lot more evidence to support it. There are many studies that suggest that living in a high EE environment is bad for schizophrenics, and may cause a higher rate of relapse.

    • However, EE cannot provide a complete explanation of schizophrenia as it cannot explain what caused the illness in the first place. There is no evidence that EE can trigger schizophrenia in someone who has never had it before.

  • Perhaps schizophrenics don’t know that they are living in a high EE environment. Due to the nature of their illness, and their disconnect from reality, it could be argued that schizophrenics are not aware of the communication in their family is destructive. If this were the case, then it is unlikely it would have an effect on their illness.

    • However, Cutting et al (2006) found that schizophrenic patients were able to understand the criticisms of others and that it affected their wellbeing by raising their stress levels. However, they were not as perceptive of emotional over involvement. This suggests that not all elements of EE have an impact on schizophrenics.

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Overall Evaluation

  • There a few methodological issues that apply to many of the studies that investigate family communication in which some studies used self report. In these studies, schizophrenics and/or their families are asked about their relationships, or about the type of communication they engage in. They might be asked to report on their current relationships, or asked to recall relationships from childhood.

    • Some issues are their memory might be fragmented, they might perceive conversations different and they might not want to make their parents look bad to the therapist.

  • Other studies avoid the issues raised by self-report by conducting controlled observations. In these studies, schizophrenics are observed communicating with their family members, either in their own home or in a controlled environment such as a lab. Their communication is recorded and analysed. Often these observations may be quite short, perhaps ten minutes or so.

    • An issue that may affect the validity is that the family might change the way they speak as they are aware they’re being observed.      

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