I would be especially interested in ideas you may have about the section on parental communication deviance. How it would fit into Bowen Theory.
James E. Jones, Ph.D.
February 5, 2021
Outline
1. Reasoning for focusing on self and its development
2. The variety of conditions and system behaviors known to be associated with schizophrenia and spectrum disorders.
3. Family communication and emotional environment.
Development of No-self
In the 1950s through the 1980s, there was an abundance of family research, both quantitative and clinical, which followed the efforts of the pioneers of family therapy. A great deal of this research dealt with families of schizophrenics. This focus expanded to the family, after having been more narrowly targeted on mothers of schizophrenics.
I have come to believe that it is time to revisit all this old family research, and look at it through the lens of Bowen family systems theory. The family research was dismissed and buried with the advent of biological psychiatry in the late 1970s and the concomitant rise in genetics research on the study of schizophrenia.
Bowen’s view of schizophrenia expands its perspective to consider schizophrenia to be one form of no-self in addition to the no-selfs seen in severe emotional illness, severe social disorders, and severe physical illness. This thinking has led me to begin considering whether we should be studying more broadly what are the family system conditions which would be associated with the development of the extreme no-self in children who develop any of the severe disorders and conversely the family conditions supporting development of solid self.
Past research has shown individual risk factors, family environment variables, and a variety of kinds of early stressors to be associated with schizophrenia.
Conditions associated with schizophrenia
Let me briefly review some of what is known to be associated with schizophrenia and schizophrenia spectrum disorders.
1. Individual risk factors – relatives of schizophrenics are more often schizophrenic or spectrum disorders(Kety et al. 1994); over 100 genes are known to occur more often among schizophrenics(CNV and Schizophrenia Working Groups of the Psychiatric Genomics Consortium 2017); certain physiological deficits are known to occur more often in schizophrenics(ETD(eye tracking disturbance)(Holzman et al. 1973)) and sensory gating disturbance(Freedman et al. 2020)); movement abnormalities occur more often early in the lives of those who later develop schizophrenia. Obstetric complications(Dalman et al. 1999).
2. Family interaction and communication. Parental Expressed Emotion(hostility, severe criticism, and over-involvement)(Doane et al. 1981)(Goldstein 1987) and the Communication Deviance complex(parental communication deviance(Singer and Wynne 1966)(Jones 1977)(Goldstein 1987)(De Sousa et al. 2012), lack of acknowledgement(Mishler and Waxler 1968)(Herman and Jones 1976), disconfirmatory feedback(Holte and Wichstrom 1987), pseudomutuality(Wynne et al. 1958), double bind(Bateson et al. 1956), mystification(Laing and Esterson 1964)).
3. Environmental factors. Adverse childhood experiences(Varese et al. 2012)(Vallejos et al. 2017). Early grandparent death(Walsh 1978)(Yates et al. 1989), early parent loss(Watt and Nicholi 1979), low SES(Link et al. 1987), immigrant status, frequent geographic moves in childhood.
And then there are the Bowen risk factors for no-self. Individual and system low differentiation, intense chronic anxiety, and parent-child symbiosis parental triangle.
Family interaction and family environment
For this paper, I will review the quantitative and clinical research on families of schizophrenics. That is what I know best, but I will keep in mind that this is only one kind of no-self. The findings about families of schizophrenics might apply to some degree to families of the other forms of no self and vice versa. I have observed this phenomenon in other forms of no-self like severe emotional problems, severe dissociative disorders, and severe chronic physical conditions.
Family communication and emotional environment is one of the several areas of family functioning which have been reliably shown to be associated with schizophrenia and its intensity.
Two variables have appeared repeatedly as associates of schizophrenia: the parental communication deviance(CD) complex of variables and parental Expressed Emotion(EE).
EE is identified as styles of emotional expression toward the patient which express hostility, criticism, or over-involvement. Parental EE predicts relapse and poor functioning in schizophrenic patients(Kavanagh 1992)(Goldstein 1987). EE is not specific to schizophrenics, it has also predicted poor functioning in other serious disorders, both emotional and physical.
It is plausible to me that the negative attributions of hostility, criticism, and over involvement directed at the patient act to undermine the viability of the self of the patient, no matter the specific diagnosis. Parental EE would also be consistent with Bowen family projection process.
The parental communication deviance complex of variables identify styles of family interaction which either actively attack the ability of a child to slowly build up stable habits of attention or fail to support the development of stable attention. Singer and Wynne(1966) described CD as a variety of specific communication behaviors which interfere with the ability of two individuals to share a common focus of attention. Ambiguous language, peculiar language, illogical reasoning, denying a failure to complete their part of a shared task, odd word usage presented as if perfectly coherent.
Communication is a shared exercise between at least two people. Any behavior that interferes with the ability of the two people to share a common understanding of what they’re talking about will undermine that joint exercise. The communication will be frustratingly ineffective at best and confusingly crazy-making at worst. Parental CD has been repeatedly found to be present, both cross-sectionally and prospectively, in families with a schizophrenic offspring(Jones 1977)(Goldstein 1987).
Lack of acknowledgment( Mishler and Waxler 1968)(Mishler and Waxler 1970)(Herman and Jones 1976) and disconfirmatory feedback (Wichstrom et al. 1987) fail to complete the communication reciprocity between two people. One person treats the other person’s words and thoughts as if they had never been uttered, without ever directly and openly admitting that they were ignoring the other’s words.
Pseudo mutuality (Lynne et al. 1958) is a family style that presumes and acts out as if everything is positive among family members, despite explicit words and behavior that demonstrate clear differences between the members.
Double bind (Bateson et al. 1956) is a parental style of communication which issues two requests or commands which are contradictory. That is, if the child follows one command, he automatically violates the other command.
Laingian mystification (Laing and Esterson 1964) is a kind of self-system complementarity where the child reciprocally adapts to confusing and conflicting messages from the family.
These various styles of family communication which undermine the ability of the child to develop self have been found to be associated with later schizophrenia in the child more than in comparison groups.
REFERENCES
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Jim Edd, re your question about parental communicational deviance. I wonder if they fit into the patterns of the nuclear emotional process – is it accurate that these behaviors seem to be a way of avoiding responsibility, dominating the child, distancing from the child, ganging up on the child, putting the child down, or fighting with the child and passing anxiety onto the child and the child is occupied with these relationship maneuvers as opposed to any particular task at hand?
Laura,
For the life of me, I can’t figure out how parental CD might fit into the pattern of nuclear family emotional process. In contrast to parental EE, which seems to easily fit the pattern of intense family projection process.
Parental CD could aid some of the parental behaviors you suggested, but it’s not a direct reasoned conclusion. e.g. distancing from the child, dominating the child(by not considering the child worthy of acknowledging their very presence in a reciprocal communication process.
But there is no necessary connection with any of those parent behaviors you mentioned.
Look at parental EE. It has no necessary connection to parental CD. You can have parental CD with or without parental EE. And vice versa. You can have parental EE, with or without parental CD.
Goldstein (1987) summarizes both in the UCLA Family Project. Nothing necessary about either variable alone, but the combination of parental EE and parental CD can be a killer. From personal experience at UCLA, working with a family that has both is true crazy making, even when neither parent has an extreme psychiatric diagnosis.
Thanks for giving me something to chew on.
Jim Edd
Very interesting about the interaction of EE and CD! It seems like Bowen did some CD in an effort to exit the emotional system – like detriangling can seem a little CD – I may be way off here. But with high EE – that emotional involvement that underlies reactivity “it’s a killer”. High EE without CD – well maybe there’s no emotional trap there – its just mom going off again.
Jim Edd,
This is interesting and worthwhile for learning. These communication patterns that you state–I look forward to more development of each one, including examples. Examples help me to grasp complex ideas. For instance, it was Bowen’s examples in his book that helped me to see.
Thinking about how a family communicates a view of itself or the world that doesn’t line up with reality–would that be one pattern? Parents sometimes give an idealized view of themselves to a child, based on a need to be admired. They may also idealize the child (or the opposite).
Lastly, I would see the patterns you describe as being on a continuum. You are describing the more intense versions, but we should all be able to see ourselves and our families in them, even though in less intense versions.
Thanks for your work on this important subject,
Laurie
Laurie,
Good suggestion. I’ll put in some examples, but I can’t come close to including the 40 or so categories of CD in the scoring manual.
Yes, communicating a view of the family itself that doesn’t line up with reality could be one kind of CD. Also a form of mystification.
What do I believe? What you say reality is or what I see and hear with my own eyes and ears? Some good examples in Laing and Esterson (1964).
Absolutely, I agree that these communication patterns exist on a continuum. Less intense versions exist all around us and in families with no schizophrenic offspring.
I have come to believe that families which nurture differentiation of self are ones which do not get in the way of differentiating efforts of the individuals in the family.
Thanks, Jim Edd
In reference to family communication patterns – I would guess the parental patterns with the child who develops schizophrenia could be different than communication patterns with the other siblings…..or the other siblings respond differently to those communication patterns and are not undermined by them as the more sensitive child would be. If you think of the child who develops schizophrenia as the one who is used to strengthen the group, (unintentionally of course) then all family members are participating in keeping the sensitive one in the one down position in order to hold up the others. Bowen added a lot to the field when he included the emotional process in past and present generations. I have come to appreciate the automatic nature of this process in my own family which has been most enlightening.
The work you are doing is so in depth that it will offer much to the advancement of our thinking. Thanks.
Ann,
Yes, you can certainly see families in which the parents communicate differently with different siblings and in which different siblings deal with the communication in different ways.
But there are some families in which one or both parents communicate in this way with all siblings and mostly with anybody they run into, like a research tester. They seem oblivious to other individuals.
There exist families who have several children who later become schizophrenic. One example is described in the book Hidden Valley Road; 6 of the 12 children had schizophrenia diagnoses by adulthood.
Your sentence “…or the other siblings respond differently to those communication patterns and are not undermined by them as the more sensitive child would be” is very close to what I have come to believe. The sensitivity of the one can come from several of the variables in the long list. e.g. genetics, sensory gating deficits, adverse childhood experiences, low SES.
You certainly see families in which the sensitive one in the one-down position appears to support better functioning of everybody else, as you suggest. But also there are families where nobody appears to benefit.
Thanks Ann.
Jim Edd, Would the families that don’t benefit from the sensitive child in the one down position be in the phase of the process where the complications of the projection process outweigh its benefits? Maybe the sooner this happens the better and would sooner reflect higher levels of functioning in the parents/ family?
Or would they be families at the chaotic end of the spectrum where patterns are obliterated by the unrelenting emotional reactivity?
That is what I think happens. Anxiety gets too intense and subtleties get wiped out.
Jim Edd,
This is the first time I have seen such a comprehensive overview of research on schizophrenia and other extreme conditions. The detailed identification of family communication patterns, especially parental CD, is a most useful guide for observation of our own and clinical families. It goes a long way toward understanding the challenges that family members, especially children, face in an environment of de-selfing pressures. I wonder if one more factor would be status sensitivity. Would the individual who is in the ‘one down” position, more dependent on the other, be more vulnerable to giving up self? I have been watching a series about Turkish families called “Ethos” which portrays relationships within and between some interconnected families. The actors capture the communication deviance and distortions in a way that you can see the impasses and loss of self in vivo. Quite painful to watch.
Stephanie,
“De-selfing pressures”, what a great phrase. Status sensitivity, another great idea. I’m assuming that you mean that we would vary in our status sensitivity.
I think that de-selfing pressures, status sensitivity, plus several from my list of factors can leave one “more vulnerable to giving up self”.
May I use your two phrases?
Jim Edd
Deeply appreciate this very basic and fundamental look as to the emotional process so many great footnotes! just love your paper!
For a long time I’ve tracked the words that people use in order to have some way of gauging emotional intensity in the relationship you must you should you will you you you are to blame etc.
Also been wondering how the genetic fits into it and what would you change about your jeans in order to miss perceive your child and the child of course missed receiving a parent I found an article in nature about the size of pupils small pupil people take less risks and are less biased by what is gone before and the larger people individuals have more difficulty. I think there’s a tremendous amount to learn about families but we live in the era of emotional blindness plus plus plus where the left brain belief system in our general population is almost operating at the level of schizophrenia. Thanks again a great read!!
Andrea,
Thank you.
I’d like to hear more about the words you’ve found that reflect emotional intensity.
I haven’t the foggiest idea about how genetics fits into parental communication deviance. Probably in there somewhere.
Much more research about genetics in the child who later becomes schizophrenic. e.g. sensory gating deficits is one clear physiological phenomenon that can be found more often in schizophrenics. And it appears to be genetic. I assume it could be one of those genes that gets expressed in the right environment.
As I said to Ann, I think genes can contribute to the sensitivity in one individual. Which is a problem for a child growing up in a family with EE and CD.
Interesting about the pupils. Large vs. small pupils might be one thing contributing to variation in sensitivity. I think that’s what you meant.
Jim Edd
Regarding use of language, Jim Edd, certainly use those phrases.
Regarding status sensitivity, I recall Dan Papero saying that he thought it was part of most interactions. People reading one another to see if self if perceived as an equal or above or below the other. Human caste systems demonstrate how deep that runs. There is a huge literature on SES and perceived SES. A big factor in differentiation of self is the ability to define self as independent of SES or at least be less influenced by it in setting life goals.
Thank you.