Who is a “schizophrenogenic mother”, or what does suppressive overprotection lead to?

The views expressed in the book “Madness: Family Roots” by R. D. Lang and A. Esterson aroused considerable interest in the professional community and a wide response, since they are radical and contradict the generally accepted point of view on such a well-known disease as schizophrenia. Meanwhile, the ideas are supported by research that was conducted by the authors in 1956.

“Understand, friends, I know nothing about who I am and where I came from into the dark world. I remember myself only at the court of my beautiful queen. I think she saved me from some evil spell and brought me here out of generosity... Even now I am under a spell from which only she can free me. Every night there comes an hour when my mind betrays me, and after my mind, my body. I get so mad that I could attack my best friend and kill him if I weren't tied up. And then I turn into a monster, into a huge snake, hungry, vile and evil... That’s what everyone tells me, and this, of course, is true, for she says the same thing.” Clive S. Lewis "The Silver Throne" The Chronicles of Narnia".

Revolutionary ideas in psychiatry

The main idea covered in the book is the connection between mental illnesses, primarily schizophrenia, and the patient’s family, and more precisely, their origin from there.

The authors of the book make a revolutionary statement for their time: schizophrenia, in fact, is not an existing disease, it is a set of symptoms, probably partially or completely socially determined. They essentially completely deny schizophrenia as a diagnosis, proposing something else instead.

“We use the expression “schizophrenic” to mean a person whose experiences or behavior are clinically considered to be manifestations of “schizophrenia.” In other words, a person with such a diagnosis is assigned experiences and behavior that are not simply human, but are the result of some pathological process, processes of mental and/or physical origin. It is clear that “schizophrenia” is a social phenomenon, since at least one percent of the population can be diagnosed as “schizophrenic” if these people live long enough” [1, p. 11].

In support of their theory, Lang and Esterson cite the first works on the study of schizophrenia from the times when this disease was just described and the professional community had not yet accepted this diagnosis as a given; many authors expressed justified doubts that such a disease was worth highlighting. Among them is E. Bleuler with his monograph “Daementia praecox oder Gruppe der Schizophrenien”, 1910 (“Dementia praecox, or group of schizophrenias”, Dementia praecox from Latin - Previously dementia).

Research by R. D. Lang and A. Esterson

The study recruited 11 women who had been formally diagnosed with schizophrenia. To the authors of the book, this number seems quite sufficient to confirm their theory.

Throughout the book, the idea is developed that the behavior of the subjects, defined by doctors as manifestations of schizophrenia, is actually caused by the dysfunctional relationships that have developed in their families. This behavior was natural and the only possible for them in this situation, because, in fact, they were left with no other choice. Having reviewed the cases presented in the following chapters, we can conclude that this is indeed the case or very close to it.

It is worth saying a few words about the sample: all subjects are young (under 30 years old) women who grew up in two-parent families with average and high incomes. They did not have any organic disorders, they did not undergo neurosurgical operations. For some of them, the first signs of schizophrenia appeared in childhood, for others - in adolescence and older. All of them were officially diagnosed with schizophrenia based on the following symptoms:

• hallucinations;
• delusions of influence, persecution, paranoid delusions, etc.;
• incoherence of thinking;
• cognitive disorders;
• catatonia;
• disorders of the affective-volitional sphere;
• behavioral disorders.

All patients were hospitalized for treatment in a psychiatric hospital. The list of drugs prescribed to them is not provided in detail, but it is indicated that some were prescribed electric shocks.

Interviews were conducted with patients and their families, together or separately. For each case, a list is provided, the composition and number of hours of interviews, as well as the most interesting parts of them, which allow us to reveal the essence of the patients’ relationship with their relatives.

Attachment: the main condition for development

For 9 months, two people are connected, eat the same, breathe the same air. They have the same flesh and the same experiences. Then the child separates from the mother and is born. For the first time in his life, he sees the face of a person who will determine his entire future fate: to maintain or destroy his inner world, to populate it with good spirits or evil monsters. This is how attachment is formed.

Babies are born immature and defenseless. This is how nature solved the problem facing it of giving birth to an upright creature (which should have narrow pelvic bones) with a large brain (which means it should also have a large skull). Human children are born according to an improved plan that was originally invented for the marsupial species. Female kangaroos give birth to small cubs, which “mature” in the pouch for a long time. If the cub is outside this shelter, it will soon die.

Children are born in a similar way. They unconsciously know the cruel rules of the game of this world: if they are not close to adults who are ready to feed and warm them, their attempt to live will not succeed. The need to have a parent or adult nearby who is ready to care is vital for an infant. If a child loses sight of an adult, he instinctively begins to fight for his survival - and he can only do this by screaming. If he does not see his mother, he will scream for help - after all, she is a vital object for him, and in the struggle for life, as we know, it is not appropriate to stand on ceremony.

The cry of a child has a special effect on the emotional background of an adult. Usually people are surrounded by a large number of different sounds: car horns, the noise of a train in the subway, the roar of a construction site. But the cry of children is always noticeable. It makes you want to caress a child, even if it is not your own child - the instinct of caring for the offspring is manifested. Sometimes this natural feeling turns out to be broken - a child’s crying is either completely ignored or causes aggression. This happens if a person’s emotional and personal development was filled with traumatic experiences, as well as when the brain is influenced by intoxicating substances - drugs, alcohol.

Clinical cases: similarities and examples

After reading the book, it becomes clear that the 11 families described have some similar characteristics. They are repeated in all or several cases from the selected group. Among these signs are the following:

1. Difficult communications between daughter and mother or both parents, consisting in the ambiguity of the transmitted messages. This is denial or devaluation of existing facts, false interpretation, double messages that contradict each other, so-called gaslighting.

For example, the first case described is a patient named Maya:

“As Maya said, her father “... often laughed at what I said to him, and I could not understand what he was laughing at. I thought this was very offensive... I told my dad about school, and he laughed at my words. If I told him about my dreams, he laughed and told me not to take them seriously...” [1, p. 33].

The case of another girl, Claire Church:

“Mrs. Church only managed with great difficulty to maintain the impression that they were “very similar... To see the resemblance approaching identification, Mrs. Church had to deny her own perceptions, encourage Claire to deny her feelings and so change her words, gestures, movements so that they did not very much contradicted the image of the daughter drawn by the mother” [1, p. 83].

Sarah Danzig's family:

“We first had to explain why this girl is so naive. One could assume... that the attempts of family members to mystify her, to deceive her, were a consequence of this naivety. This was partly true. But our data suggests that her very naivety is the result of previous deceptions and hoaxes. Thus, the family was drawn into a vicious circle. The more Sarah was mystified, the more naive she became, and the more naive she was, the more clearly it became necessary for family members to protect themselves from this naivety by deceiving the girl” [1, p. 124].

In the family of another patient, Ruby Eden, there was even confusion about who was who and who was related to whom: she had to call her biological mother “mom” and her aunt “mother”, her father “uncle”, and her uncle “dad”.

“Ruby and her mother lived with her mother’s married sister, that sister’s husband (father or uncle), and their son (cousin). Her father (uncle) was married, lived with another family somewhere else and visited them only occasionally. There were furious arguments in the family over whether Ruby knew who she really was” [1, p. 140].

This attitude undoubtedly greatly disorientated the patients, so that they sometimes could not distinguish the objective reality from the one created in such dysfunctional communication.

1. Family as a closed system. In some of the described cases, patients were prohibited from leading a social life and communicating with people outside the family, as this was declared dangerous.

The case of Lucy Blair described:

“Mrs. Blair said that her husband watched Lucy’s every move, demanded that she account for every minute she spent outside the house, told her that if she left the house she would be kidnapped, raped or killed... He (and his brother , mother, sister and sister-in-law) terrorized Lucy with stories of what would happen if she left the "safety" of home. He believed that it would be useful for her to “toughen up” in this way” [1, p. 54].

In some cases, patients, when removed from their families and placed in a different environment, began to feel significantly better. As in the case of patient June Field:

“Having returned from the camp, she for the first time began to express her true attitude towards herself, towards her mother, towards school activities, towards God, towards other people and so on... Only her mother saw in this a manifestation of the disease...” [1, P. 160].

1. Strict boundaries and restrictions. Some families (like the patients themselves) were very religious, others had strict moral principles and rules that were extremely difficult to follow.

An example from the case of patient Sarah Danzig, whose parents were Orthodox Jews:

“Sarah... had to direct her thoughts and actions in strict accordance with Mr. Danzig's obsessive interpretation of religious orthodoxy. Taking advantage of Sarah's social naivety, the family demanded complete obedience only from her. And she could not compare the praxis of her parents with the praxis of other people, since all her contacts, besides her family, were cut off” [1, p. 129].

Another patient, Jean Head, had parents who were zealous fundamentalist nonconformists. Their views and beliefs are so contrary to the needs and behavior of a living person that Jean develops two personalities: one for the house and one for herself. And when the pressure becomes unbearable, she has a delusional idea that her parents are dead:

“There is probably no other group in society whose members expect more of themselves in some respects. By forming families and thereby leading a sexual life... people like the Heads and their parents consider any sexual fantasy a sin, even in relation to their marriage partner. Expressing sexual thoughts towards any person is strictly prohibited. (...) They claim that they never quarrel or get angry. (...) The main goal of life is to glorify the Lord, but children need to be taught in secular schools and they need to acquire “base” technological knowledge in order to win... in a competitive society” [1, P. 192].

1. The parents' negative attitude towards the patients' sexuality was emphasized: it was either denied, condemned, or declared to be something abnormal.

An example from Lucy's case:

“Evidently Mr. Blair did not consider his anxiety about his wife and daughter to be excessive, and it was clear to us what he wanted his daughter to be - a pure, virginal, single lady. Rare instances of physical and frequent manifestations of verbal violence against her were justified by his view of her as a sexually promiscuous woman... Her daughter betrayed him with her sexuality” [1, p. 67].

Another patient, Maya, also spoke in an interview about her sexual thoughts regarding her father and mother. The parents denied everything: “It didn’t happen.”

In the case of patient Ruby Eden, her family reacted to her pregnancy in a very unique way:

“As soon as they heard about this from Ruby, her mother and mother sat her down on the sofa in the living room and, trying to pour soapy water into her womb, with tears in their eyes, reproachfully, pitifully and vindictively began to explain to her what a fool she was, what a whore she was. , what a loser she is... what a pig this guy is, what a shame..." [1, P. 142].

1. Increased attention to the patient’s personality and actions, discussion of her, the desire to take part in all her affairs, “live her life.” Blurred, unclear personal boundaries, total control, even delusional ideas of direct or indirect influence on thoughts and personality. This, in turn, could cause delusions of influence.

Example from Maya's case:

“My mother complained to us that Maya did not want to understand her, my father felt the same, and both were very offended that Maya did not tell them anything about herself. Their reaction to this is curious: it began to seem to them that Maya had some special insight. They were convinced that she was able to read their thoughts” [1, p. 33].

The following describes the “experiments in mind reading” that Maya’s parents regularly conducted without telling her anything about it, and she herself did the same with them. The family supported the idea that family members could penetrate each other's thoughts. The consequences were predictable:

“Clinically, she suffered from the idea of ​​influence.” She repeatedly repeated that, contrary to her wishes, she had an unfavorable influence on those around her, and they also had a detrimental effect on her - despite her resistance" [1, p. 34].

Total control of actions is clearly visible in the case of patient June Field:

“My parents didn’t give June pocket money, but they said they would if June told her what it was for... She had to give an account of her smallest acquisitions. One day... June found a shilling at the cinema, and her parents forced her to give the shilling to the management. June said that this was absurd, that it was “going too far in honesty, that if she herself had lost a shilling, she would not expect it to be returned to her. But her parents talked about it the whole next day, and in the evening her father came to her room to continue admonishing her” [1, p. 167].

Many patients really constantly felt under close attention and control, and noticed these attempts to influence them. But since they were very disoriented and much of what was actually being done was denied by their parents, all this was perceived as delirium, confusion of thinking, etc.

Another example from the case of Lucy Blair, illustrating the patient’s perception of the world:

“I don't believe what I see. This has no backing. Nothing confirms this in any way - everything just happens in front of me. I think that's my problem. Everything I can say is not backed up... I don't think I understand my actual situation... I'm not sure what people are saying, or if they are saying anything at all. I don’t know what exactly is bad, if there is something bad” [1, p. 57].

Schizophrenogenic mother or both parents?

The idea of ​​a schizophrenogenic mother arose around the same years when this book was written - it was first expressed by Frieda Fromm-Reichmann in 1948. Such a mother, as described by Fromm-Reichman, is cold and dominant, selfish, striving for complete control over the child’s behavior. Its behavior involves a special pattern called double bind, which means two statements that contradict each other. In the above cases, it is clear that such patterns occurred quite often in the families of patients, for example, when they were required to be independent and at the same time limited in everything, allowed to meet boys and at the same time condemned any sexual manifestations, etc.

However, Fromm-Reichman's theory has not received scientific confirmation. In the cases cited in the book, moreover, we are not talking about the behavior of the mother alone: ​​all relatives participate in shaping the attitude of the sick. So, rather, we can talk about a schizophrenogenic family, dysfunctional relationships and the environment that provokes the disease.

Siblings. Sibling rivalry

Siblings are children who have a common father and mother - that is, full-blooded brothers and sisters. The first researcher who studied the emotional and personal development of siblings was the English scientist Francis Galton. He noted that a large number of outstanding composers, scientists, and scientists were the first-born children of their parents. Galton expressed several reasons why the first child in the family more often ends up in the category of successful adults:

• According to the scientist, older children have a greater chance of taking advantage of the family's financial resources. They are the first to have access to education;
• Older children are forced to take on more responsibility from childhood;
• Parents always pay more attention to their first child.

The emotional and personal development of siblings was also of interest to Alfred Adler, who separated children by birth order:

• Older children are always more obedient to adults and more organized. They value their position and try not to lose it. The goal of the older child is achievements, improvement in life;
• Middle children most often feel like outsiders in their own family. They feel repressed, and in the future they try with all their might to be different from other brothers and sisters;
• The youngest child often turns into the parents' favorite. His abilities are often underestimated.

The average family in Russia consists of parents and 1-2 children. Older children experience the appearance of brothers and sisters in the family very painfully, especially when they are between 3 and 5 years old. The firstborn may exhibit aggressive or regressive behavior. In the first case, he sucks his finger, asks for a bottle, and begins to crawl. This is a serious sign for parents. With its help, the child shows that he is in dire need of love and attention. The aggressive type manifests itself in the uncontrollable behavior of the older child.

He throws tantrums and breaks things. The older child most often does not realize why he suffers from aggression towards his mother and brother or sister. The mother's attention no longer belongs to him - she now devotes almost all her time to another child (or children). It often happens that the children's room becomes shared - the eldest has to share his favorite toys with his competitor.

Schizophrenia and heredity: modern research

Schizophrenia is considered a hereditary disease: if one of your close or distant relatives had schizophrenia, then the patient has a predisposition. The closer the relatives have had schizophrenia, the more likely it is that the symptoms of the disease will reappear in that family. However, there is a very subtle and ambiguous point here: is schizophrenia transmitted genetically or are there still certain behavioral patterns? The authors of the book develop the second version.

The question of the emergence and heterogeneity of manifestations of schizophrenia has occupied the minds of scientists around the world for many years. The main areas of research are the etiology of schizophrenia, the study of the genesis of clinical polymorphism and pharmacological studies. That is, to put it in simpler terms, scientists are interested in the following: where does schizophrenia come from, why do its symptoms vary so much from case to case, and how can it be cured?

To date, the following facts are reliably known:

• children with two sick parents have a risk of developing the disease of 41-46%, this risk is even more pronounced in identical twins: 47-48%;
• parents of children with schizophrenia have pronounced schizoid personality traits, their cognitive characteristics are very similar to those of patients, and approximately 20-30% of relatives of diagnosed schizophrenics have so-called “spectrum disorders”, which are weakened symptoms of schizophrenia or sharpened personality traits;
• Children with schizophrenia and their parents exhibit the same biochemical and immunological abnormalities [5].

All this may indicate that the disease does indeed run in the family, and perhaps has a genetic origin, but until recently the schizophrenia gene had not been identified. However, everything changed last year, after publication in the journal Nature, where it was reported that the schizophrenia gene was finally discovered by scientists: it was the C4 protein, localized in neuronal processes, synapses and cell bodies. In mice, C4 indirectly affected the elimination of synapses during the postnatal period of development.

“Structurally diverse alleles of the C4 complement component genes generate different levels of C4A and C4B expression in the brain, with each common C4 allele being associated with schizophrenia in proportion to its tendency to generate greater expression of C4A,” reports a team of US scientists led by Stephen McCarroll of the Broad Institute at Harvard University and the Massachusetts Institute of Technology [2]. This study aims to explain why the number of neural connections is reduced in patients with schizophrenia.

However, not everything is so simple: the discovery of the C4 gene only brought scientists a little closer to understanding the biological mechanisms of the disease, but is not clear evidence of the genetic origin of schizophrenia. Since the manifestations of the disease are very diverse, there are also many genetic abnormalities that are present in some cases and absent in others.

How to prevent quarrels between children?

The most important rule when raising several children is this: never compare them with each other. If a child constantly hears that he should study as well as his brother or sister, he automatically begins to play the role of the “bad child”. After all, there is already a good one in the family. In addition, such a mask allows you to attract the attention of the parent. Both boys and girls are very vulnerable to comparison. If there is already someone in the house whom they “need to look up to,” they begin to behave like “troublemakers,” “clowns,” “fools.” Remarks made by parents with the best intentions later serve as a serious bone of contention between siblings.

If children constantly quarrel among themselves, the first thing to do is to teach them how to maintain peace. To do this, you can use the “carrot and stick” principle. Anyone who begins to show aggression towards a brother or sister must firmly remember: such behavior is fraught with serious consequences. If children's domestic quarrels turn into a brawl, the one who fights - regardless of whether the child started first or not - must be punished immediately.

For example, children can be sent to different parts of the apartment. The person who hit the brother or sister must apologize, and do so sincerely. If the child does not show repentance, he should be left alone again for a while. There is no need to use the children's room for punishment. There the child is in his refuge, among his favorite toys.

You need to choose a more strict, ascetic room.

To avoid quarrels between children, it is necessary to prevent in advance some of the reasons why they may arise. For example, children may quarrel over a place at the table. This reason may seem ridiculous to an adult, but for a child who is competing with a brother or sister, it is a serious reason for quarrels. To prevent conflicts, assign seats in advance. The distribution you set should give the impression of legitimacy. For example, children sit on one side of the table, and parents sit on the opposite side, since the mother and father who form a married couple should sit next to each other.

Research prospects

Currently, many researchers of schizophrenia, as well as advocates for the interests of patients, are still inclined to believe that this is not a general disease, but only a set of specific symptoms. Many even refuse the definition of “schizophrenia,” believing that such a diagnosis stigmatizes the patient and does not reveal anything about his personality [3].

Many front-line physicians recommend increasing funding for non-medical approaches such as family therapy and cognitive behavioral therapy. Also, many have expressed doubts about the correctness of the idea of ​​​​inheritance of the disease, which appeared mainly due to family and twin studies. These scientists and doctors are inclined to believe that the development of schizophrenia is predominantly influenced by the environment, personal and family circumstances, experienced stress and mental trauma, especially those received in childhood.