In the last three months or so, I have been studying symbiosis; e.g. parent-child symbiosis. Why? When I reviewed the quantitative research on families of schizophrenics, it was striking how symbiosis as a factor in development of schizophrenia has been neglected by all the quantitative researchers. It seemed odd when you consider how strongly Murray Bowen and other schizophrenia researchers of the 1950s had emphasized it. (Hill, Lidz, Mahler, Searles, Wynne, et al.).
While beginning to look at symbiosis, I recalled a 1978 Froma Walsh study about grandparent death that nobody, including Froma, was ever quite able to explain. Not surprisingly, Bowen theory can explain it.
Grandparent death near grandchild birth
We all have four biological grandparents. In the general population, about 10% of individuals have had a grandparent die within two years of their own birth. Think about it and you’ll realize that’s a reasonable figure. I’m one of those 10%.
Walsh, working in a large schizophrenia study at Michael Reese Hospital in Chicago, had noticed in the course of meeting families there that she kept hearing from them more than she would have expected about a grandparent death around the time of the birth of the one who was now in their study as a result of a schizophrenia diagnosis.
She then did this project of carefully gathering information about deaths in the extended families of those in the larger schizophrenia project. Of the 70 families of schizophrenics for which she got information, 29 of those or 41.4% had a grandparent die within plus or minus 2 years of their birth. In one comparison group of 25 families from a general nonclinical population, 8% of the offspring individuals had this coincidence of grandparent death near their birth. In a second comparison group of 45 hospitalized individuals with nonschizophrenic diagnoses, 20% had a grandparent death near their birth.
Walsh talked to another schizophrenia project at Rutgers University and Yale University where Monica McGoldrick was working and asked her to check the records of families in that project. 40.8% had a grandparent death near birth. Another group(Yates et al. 1989) was studying whether life events of various kinds showed up in certain developmental stages for adolescents who ended up with severe diagnoses. Without specifically looking for grandparent deaths, it popped up in their data that schizophrenics had more grandparent deaths in the first trimester of the pregnancy that produced them. This group had no explanation. They even called the finding serendipitous.
Froma Walsh also never had a satisfactory explanation for her findings, though she had mentioned Bowen’s 1960 “A Family Concept of Schizophrenia” paper.
What’s going on here? Is it serendipitous to find the same result in 3 different projects? If not, what’s going on?
Speculation based on Bowen theory
I believe that Bowen theory provides tools for understanding these findings. For my own clarity, I have sketched in more detail how this might happen, letting multigenerational transmission process, differentiation, death shock wave reaction, and family projection process inform my thinking.
All families have some degree of symbiotic attachment among their members. The family symbiosis provides some patterned functioning that gives a kind of imperfect stability to the family. When a child from that system grows up and marries, that will destabilize that family symbiosis to a greater or less degree. Adjustments have to be made in every case, and the new marriage becomes intertwined with the previous generation’s family symbiosis for the two spouses. The imperfect stability is restored.
The same process has taken place in the spouse’s family of origin, where the new marriage destabilizes and then restores the temporary stability of the family of origin’s symbiosis.
Likewise, the same process takes place in low differentiation marriages, but can play out differently, due to the low differentiation. A low differentiation marriage involves two people from low differentiation families of origin.
Consider a hypothetical low differentiation marriage. Inevitably something happens that disturbs the stability. Whether a big or small event, low differentiation systems seem primed to have big reactions to events of whatever size. The intense reactions destabilize the extended family symbioses. Example events include death of a central figure, geographic move of a member important to the stability of the family symbiosis, a major illness or sharp change in functioning of a person important to the stability, a job loss, war, economic collapse, natural disaster. Any of these can destabilize one of the two big extended family symbioses of the spouses in our hypothetical marriage.
Any of these events can rupture the extended family symbiosis, resulting in intense waves of reaction throughout the two linked extended family systems. The two extended family systems frantically try to restabilize. One way is to develop symptoms of all kinds. Sometimes that’s enough to restabilize, sometimes not. Physical, social, and emotional symptoms may form. Geographic moves of some fragment of the system is another ploy that may work for a while to restabilize the system.
The hypothetical marriage we are focusing on is hit by the waves of anxiety from one or the other or both family of origin symbioses. They scramble. They distance, or fuse, or get more involved in work , or have affairs, or develop other symptoms.
Or, if they have a newborn, they may project intense helpless neediness on their realistically dependent infant or toddler. Usually it would be the mother who locks in on the infant with an intensity over and above the normal mother-child symbioses from marriages with average level of differentiation. The father-husband backs off, distances, and supports the intense mother-child symbiosis with a sigh of relief.
If that child has genetic-epigenetic vulnerabilities of any kind(schizophrenia, autism, ADHD, physical deficiency, affective disorder, etc.), then the conditions are set for possible eventual(sooner or later) development of severe symptoms in that child. Associated with that will be a decades long parent-child intense symbiosis that never achieves the usual average kind of resolution of the symbiosis.
This obviously is all very speculative. But it is one way of accounting for what appears to be a fact, that schizophrenics have had more grandparent deaths that occurred near the time of their birth. In a low differentiation family system, a grandparent death that occurs near in time to the birth of a grandchild can have a very different impact than what occurs in an extended family system of average level of differentiation.
References
Bowen, M. (1960). A Family Concept of Schizophrenia. In The Etiology of Schizophrenia, edited by Don D. Jackson., 346-370. New York: Basic Books, Inc. doi:10.1037/10605-012
Walsh, F. W. (1978). Concurrent Grandparent Death and Birth of Schizophrenic Offspring: An Intriguing Finding. Family Process, 17(4), 457-463.
Watt, Norman F., and Armand Nicholi. “Early Death of a Parent as an Etiological Factor in Schizophrenia.” American Journal of Orthopsychiatry 49.3 (1979): 465-73.
Yates, B. T., Fullerton, C. S., Goodrich, W., Heinssen, R. K., Friedman, R. S., Butler, V. L., & Hoover, S. W. (1989). Grandparent Deaths and Severe Maternal Reaction in the Etiology of Adolescent Psychopathology. The Journal of Nervous and Mental Disease, 177(11), 675-680.
Extremely interesting facts that have not been easy to explain. I like your effort. The parents in the situation of low level of DoS combined with a high level of stress and destabilizing event, the death of a parent, project helplessness onto the infant. As you say, the infant is realistically helpless, which gives the parents a justification for their intensity. Projection doesn’t always mean helplessness; parents can project coldness, or aggression, etc. Do you think the projection of helplessness is more likely to lead to symptoms of schizophrenia?
Not necessarily. It doesn’t help. It’ll depend on the level of differentiation of the marriage and families of origin. And this particular projection combined with low differentiation can result in severe diagnoses other than schizophrenia.
Jim Edd, It would be interesting to follow the process in a few families with this idea in mind. I am thinking about the birth as a destabilizing factor that leads to a focus on the grandparent and their death. I’m working with a family I’ve known for some time that just had two grandchildren. One of the young parents and his partner are not schizophrenic but they are borderline. Their baby was diagnosed with Turners, mild, in utero. The young man’s father has become a focus, on his health and functioning, for his wife and the higher functioning daughter who gave birth to her second son. I kind of kid him about now he can go now since he’s got two new ones to replace him. I know him well enough and he knows me to understand my meaning. I hope all survive and the babies thrive.
I like what you told the grandfather. It’s a good reminder for me. I always was dispensable, but even more so with two grandchildren, who seem to be on their way.
And I am thinking of following the related theme, families where both birth and grandparent death are simultaneously destabilizing events.
very thoughtful putting of facts together with explanations.
Did I get the facts right. There is a 10% chance of a grandparent death and a 1% chance of schizophrenia.
Can it be that people are not as focused on this as they still do not know what to look for in the interactional patterns?
Lately I am more focused on a description of what the interactional pattern is that leads to “schizophrenia.”
This what I submitted to the Bowen center for the fall symposium..
Whose brain is in my head, or who put their tea cup in my soup bowl
System thinking promotes both the ability to perceive the emotional nature of the family and the ability to take responsibility for self.
When families are anxious the past generation’s emotionality repeats. Statements like “we should, we must must or we have to..” are erosions of the other’s self. More demanding words like “you will or else” or at the extreme “Do it my way or die.” are clear threats.
The family unit pressures some to give way to others and in this way returns to earlier states of dependency. Perceived verbal or nonverbal threats disrupt the individual’s ability to become autonomous.
Family members unwittingly participate in the erosion of self and others by participating in the use of the four automatic mechanisms resulting in greater fusion and need for agreement.
Using systems thinking one person at a time begins to alter his/her participation in this emotional process. Slowly people begin to change their way of thinking and being in the group. Not everyone can change at the same time and some are unable to stop focusing on changing others. One can learn to see this and not react while still holding others responsible.
A short interview will demonstrate a long term effort to 1) observe and understand the way one is guided by the family emotional process 2) to focus on self by using NeurOptimal to lower reactivity, and increase the integration of thinking and feelings when relating to others.
As people begin to be more responsible for self and not as focused on others those in the extended family have also begun to also use the NeurOptimal system reflecting both more open contact and the increasing ability of people in the system to focus on self.
Yes, I agree. Probably people don’t see this phenomenon because they don’t have a way of thinking that allows them to see “the interactional patterns”. It only took me 38 years to see it, principally because it took me that long to get more of the revolutionary parts of Bowen theory into my bones.
Yes, your facts are right. In the general population, about 1% of people have a schizophrenia diagnosis sooner or later. And in the general population, about 10% of us had a grandparent death near the time of our birth.
I hope you post here some of what you are seeing in “interactional pattern” that “leads to schizophrenia”.
This is very interesting and very well done. I have a cousin who was born within six months of the death of our maternal grandmother. Her father was very emotionally attached to his mother, very handsome, and very special in the family. My cousin was named after our grandmother and physically resembled her father’s family. By the age of 2, it was clear there was some kind of a problem. She was diagnosed with cerebral palsy but there was much more to it. Emotionally she remained completely dependent on her parents for life. She was aphasic and in time required total care. Both of her parents invested a huge amount of life energy into her. They had two other children who were far less important. My cousin’s mother at age 97 will always talk of how blessed she is. My cousin was seen as a blessing, God’s gift, never a burden or problem. This is such a natural process. As you might expect, Kate served as a tremendous stabilizer for her parent’s marriage.
Your description speaks volumes.
For the past year or so, I have been more alert when I hear families which are extremely positive about their child who has profound deficiencies. I got on to this from seeing interviews with Jordan Spieth, one of the current young very successful golfers. He has a 15 year old sister who has Down’s Syndrome. He gushes about how important she is to him and the family. It reminded me of one person in my family who is so extremely and relentlessly positive, in the face of her brother’s suicide 45 years ago and her ex-husband’s suicide 15 years ago, about a year after their divorce.
Jim Edd,
Your drawing of the complex connections is an illustration of the difference between systems and cause-effect thinking. On first reading of the data on schizophrenia and grandparent death, one might think that the loss and family reaction to loss is the “cause” of schizophrenia. I am fascinated with your description of your own thought process in seeing the much larger picture.
You got my point. Grandparent death/birth is not a single isolated cause, which is how many try to interpret these results.
Jim Edd,
This is such important work at a time when caregivers almost automatically reach for drugs and rarely look at the larger family picture when behavioral health issues arise.