Meissner, W. W. (1964): Thinking About the Family – Psychiatric Aspects. In: Family Process, 3 (1), S. 1–40.
Abstract: THE LAST DECADE has seen a remarkable progression in psychiatric thinking. Since the turn of the century the dominant concern has been with the management of the transference phenomenon. The basic frame of reference for this orientation was provided by psychoanalytic theory; the basic assumption within this framework was that the intrusion of any other persons into the patient-therapist relationship would contaminate the transference. Gradually the focus of concern was broadened to include significant figures related to the patient, particularly the mother. Once the focus of therapeutic interest had been extended to the realm of interpersonal relationships, it was only a matter of time for the entire family to be drawn into the picture. The last decade, however, has seen a significant development within this progression, namely the shift from a basically individual orientation to a specifically family-centered orientation (107).
The important shift from seeing family relationships in terms of the patient to seeing the patient in terms of the family structure really marked the beginning of family therapy as such and launched the study of family processes into a new era of exploration (28). This was possible because the understanding of developmental processes, the conceptualization of interpersonal relationships, the understanding of individual functioning and intrapsychic dynamics, were now cast in a new framework and could be approached from a relatively new perspective. The question which this development posed for psychiatric thinking was whether the shift in perspective required a correlative shift in theoretical orientation or not. The question remains unanswered, but we shall try to explore in this study the evidential bases and theoretical formulations which bear upon it. Our ultimate objective will be the clarification of issues and problems which must be thought through in working toward an understanding of the family.
Haley, Jay (1964): Research on Family Patterns An Instrument Measurement. In: Family Process, 3 (1), S. 41–65.
Abstract: aResearch Associate, Mental Research Institute of the Palo Alto Medical Research Foundation. This research was partially supported by the U.S. Army Medical Research and Development Command (grant no. DA-49-193-MD-2396). Recording equipment was provided by the Ampex Foundation. Computer programming was conducted by Janet Beavin, Research Assistant. Gratitude is expressed to the National Science Foundation under Grant Number NSF-Gp948 for support of the computers at Stanford University.
This is a report of an investigation to determine whether, and on what dimensions, the patterns of interaction between members in one family can be differentiated from those in another family. Can it be shown, for example, that the interchange in a family where one or more members suffers from some form of psychopathology is different from that in a family without evident psychopathology? In this presentation there will first be a clarification of this particular area of family research and a discussion of the kinds of problems which arise. Then there will be a report of a study of 80 families with a measurement which appears to differentiate families from one another, which differentiates most “disturbed” from “normal” families, and which indicates the possibility of measuring change before and after Family Therapy in the most simple way possible with the use of an instrument rather than human judgment.
Miller, Daniel R. & Jack C. Westman (1964): Reading Disability as a Condition of Family Stability. In: Family Process, 3 (1), S. 66–76.
Abstract: To explain a psychogenic symptom like retarded reading, clinicians typically adopt one of two positions. Traditionally, they have regarded it as a substitute for conflicting impulses, but in recent years a number of authors (1, 3, 4, 7, 8, 11, 12, 13) have concentrated on the vicarious satisfaction the symptom provides one or both parents and have shown how it is supported by collusive arrangements among members of the family. Just where internal dynamics fit into the interpersonal picture is a point on which these authors tend to differ.
Our initial observations of children with functional retardation in reading convinced us that an etiological study would require information about both internal dynamics and family relationships and would confront us with the knotty problem of defining associations between the two kinds of analysis. But even before we could think about these associations it became necessary for us to define the concepts required for the phrasing of questions, there being no commonly accepted terminology for describing the properties of social relationships.
In describing the provisional results of our study we begin with an account of our methods, following which we summarize some representative findings about the internal dynamics of children and parents. After defining terms such as stability, compatibility, bond, and subidentity, which we found most helpful in thinking about the data, we conclude the paper with observations about relationships and their connections with retarded reading. We separate data about the individual from data about his relationships to contrast the kinds of insight each contributes to the origin and maintenance of symptoms.
Zuk, Gerald H. (1964): A Further Study of Laughter in Family Therapy. In: Family Process, 3 (1), S. 77–89.
Abstract: Consideration will be given in this paper to a special function of laughter in human communication. By far the greater emphasis in the numerous theories of laughter has been on its individual or intrapersonal function; its interpersonal or communicational function has not received as much attention. It is the purpose of this paper to show that laughter does serve an important communicational function. The hypothesis of the study is this: that in human situations laughter is frequently employed, consciously or unconsciously, as an important nonverbal message which qualifies meaning for the purpose of disguise. A brilliant example of this function of laughter is contained in the powerful modern drama by Albee (1), “Who’s afraid of Virginia Woolf?” The dialogue is filled with instructions to the characters to laugh or smile as they speak their lines. Albe states explicitly that the laugh, chuckle or smile is often made to qualifyfor example, emphasize or negatein order to disguise intent. Sometimes a character appears to have conscious awareness that by his laughter he wishes his comment to be disregarded or ignored, or that he wishes special conditions to be attached to it. At other times, the character seems quite unconscious of his laughter and its intended meaning.
As Albee’s profound psychological drama unfolds, the incidence of laughter seems to decline. A recent study in which the writer was involved (10) showed a similar trend in laughter as family members became more involved in family psychotherapy sessions. The parents of a schizophrenic girl were observed to laugh less frequently as the psychotherapeutic “drama” progressed. The greatest incidence of their laughter occurred in the first fifteen minutes of psychotherapy sessions. The lowest incidence occurred in the period from the thirtieth to the forty-fifth minute of the sessions. Conversely, the greatest incidence of bizarre laughter in the schizophrenic daughter occurred in the interval from the thirtieth to the forty-fifth minute, and the least in the first fifteen minute interval. The daughter simply reversed the pattern established by the parents. It was conjectured that the pattern of laughter in the family members was evidence of a form of complementarity among them; that laughter served to maintain a secret line of communication among the family members.
Some comments made in a recent study (7) bear on the meaning of laughter. As the members of a family were being interviewed together, the laughter of the mother took on special meaning. The writers interpreted as follows: “These laughs, which became characteristic, are an extremely important means of communication for her. They are placed throughout the record, usually in reply to her husband, indicating cynicism and doubt, in response to his communication of affect.” The mother’s laughter, say the authors, had a special communication function. When not laughing, she was “… wooden, routine and nearly apathetic.” The mother used laughter to communicate a wide range of feeling “… including bitterness, sarcasm and doubts of sincerity.”
The hypothesis has been formulated that laughter is frequently employed as an important nonverbal mechanism to qualify meaning for the purpose of disguise. Support to document the hypothesis will be sought in excerpts from family psychotherapy sessions with three families seen in intensive, long term family psychotherapy in the Family Therapy Project at Eastern Pennsylvania Psychiatric Institute. The purpose of presenting the excerpts is specifically to illustrate laughter as a qualifier of meaning. But there is a special clinical significance to the study of the excerpts. In each case the family undergoing psychotherapy contains one member who is schizophrenic. A striking symptom of the schizophrenic person is bizarre laughter. The study also attempts to relate the bizarre laughter of the schizophrenic patients to subclinical patterns of laughter occurring in their families.
Green, Richard (1964): Collaborative and Conjoint Therapy Combined. In: Family Process, 3 (1), S. 90–98.
Abstract: During recent years, as a result of contributions made by groups in New York, Bethesda and Palo Alto, (1, 2, 3, 4, 5, 8, 10, 11) inroads have been made toward understanding and treating a psychotic patient as a living, interacting component of the family constellation. A typical treatment approach has been to include with the “identified patient,” or the one initially accepted for treatment, parents and perhaps siblings in therapeutic sessions. This approach, referred to as “conjoint family therapy,” may offer advantages over collaborative and individual therapy in some settings. The advantages of direct observation of family interaction and the need to reset the family homeostatic mechanism which is upset by alteration in one family member’s behavior has been well documented (7). “Collaborative Therapy” where a separate family member is concurrently seen by a therapist who is in collaboration with the alternate member’s therapist, may also offer advantages. A significantly better understanding of an interacting family member may be obtained during a given period of time as therapists communicate and set straight distortions resulting from exclusive contact with one patient. A clearer view is obtained of each patient as a functioning, interacting dynamic individual, and one therapist may influence the second therapist towards a therapeutic maneuver that the first predicts will have a significant effect on his own patient. However, there may be disadvantages to this technique, too. Conditions might not permit comprehensive, continued communication between therapists. Co-therapists may obtain a more distorted view of their own or the other patient than they would obtain if they observed the interacting constellation which is vividly seen in conjoint therapy. Intentional, simultaneous intervention between each therapist and his patient is not possible unless planned like “chess moves” with the hope that inter-therapist communication of behavioral dynamics has been accurately predictive. The collaborative approach does offer, however, in selected cases, advantages over conjoint therapy. In the latter, decisive inroads into an individual’s dynamics are clearly limited by the group setting. Transference and countertransference phenomena are significantly diluted. Should more attention be dispelled toward one family member in a more depth probing effort, other group members may feel rejected and become rebellious and possibly even sabotage the effort. While interactional patterns are more clearly seen in conjoint family therapy than in either the individual or collaborative approach, less opportunity may be available for intensive intrapsychic intervention.
Geismar, Ludwig L. (1964): Family Functioning as an Index of Need for Welfare Services. In: Family Process, 3 (1), S. 99–113.
Abstract: We are beginning to see, as a basic element in community welfare planning, endeavors to devise objective means of assessing need for services. Even though a theoretical formulation of need is crucial to social work education and practice, the need concept remains unsystematized and unrelated to theory building efforts (1). The most widely accepted objective process which seeks to provide an orderly approach to the subject, the community survey, is simply a descriptive method listing problems or looking toward the other side of the welfare equation, the structure of communal enterprises. A more recent movement, devoted to determining priority of need for services with the aid of polling techniques, has limited its effort to ascertaining the views of the community leadership on the problem of need (2, 3, 4, 5). Both approaches essentially institute a course of action aimed at need assessment without conceptual clarification.
The present approach offers an approximation to the measurement of need by social functioning analysis, a technique which examines role performance in relation to familial and community role expectations. Although this method also avoids a definition of the concept of need, it operates on the basis of the seemingly defensible assumption that major needs are reflected in the degree of malfunctioning experienced by individuals and families in the home and community. A degree of standardization in the study is achieved by two means: The family is made the focus of research; the physical, social and emotional welfare of family members and community expectations are set up as criteria for social functioning.
A further advantage of social functioning analysis resides in the fact that it provides a common conceptual base for examining client groups, thereby making the study of problems and the inferential assessment of need relatively independent of the particular frame of reference employed by any one agency. In this way it will be possible to relate patterns of social functioning of clients as well as non-client populations to social service patterns found throughout the community.
Fisch, Richard (1964): Home Visits in a Private Psychiatric Practice. In: Family Process, 3 (1), S. 114–126.
Abstract: Family therapy, as I use the term, depends on the idea that the behavior of individuals can best be understood as a result of social interaction in the family setting. In contrast to the conventional model of internal dynamics, the family point of view places the emphasis on individual behavior as a part of group process. Therapists working with families have found themselves increasingly involved with such social concerns as communication, group organization, group definition of situations, and role theory. One consequence of this is that their therapy draws away from a medical context towards a more social one. In turn this leads to changes in their operations. In this paper I am concerned with one such change, the treatment of people in the home.
My own interest in home visits stems from increasing work with families in private practice and a desire to broaden my understanding by seeing them in a more natural setting. This seems to be somewhat at variance with reports by other therapists. For instance, Perry (1) reports that as a result of home visiting he began to conceptualize the family as the patient, as opposed to seeing the identified patient as the “sick one.” Other workers have initiated home visits as an extension of a community agency, the prime purpose being to avoid some hospitalizations (1, 2, 3, 4). Those psychiatrists who usually make home visits as a regular part of private practice do so in a medically oriented framework, seeing it as a kind of office visit but one more convenient for the patient (4). Brown in his study finds, interestingly enough, that those therapists who thought most highly of the value of home visits rarely did so themselves, while those who made regular and frequent visits did so essentially as a convenience to their patients and did not see any clinical advantage to it (4). Davidson also reports similar results in his study (5), finding that home visits were generally shunned by the psychoanalytically oriented and practiced rather regularly by eclectic and organically oriented psychiatrists.
Narain, D. (1964): Growing up in India. In: Family Process, 3 (1), S. 127–154.
Abstract: In this review of recent research on the socialization of the child in India, I have chosen to tell the story of growing up in India as far as possible in the words of the writers themselves, limiting my own remarks to the minimum. Whatever disadvantage this method has, it has the advantage of conveying to the reader not only the writers’ exact phrasing of the situation but also it gives the reader the feel for various nuances, of different emphases and of areas of agreement and disagreement.
Cheek, Frances E. (1964): The ‘Schizophrenogenic Mother’ in Word and Deed. In: Family Process, 3 (1), S. 155–177.
Abstract: Since 1948, when Frieda Fromm-Reichmann first pinioned her with a phrase (9), the “schizophrenogenic mother” has taken her place in the folklore of invidious womanhood. In Fromm-Reichmann’s formulation, certain malevolent characteristics of the mother were, in many cases, associated with the etiology of the schizophrenic disorder. Thus, her coldness and rejection of the schizophrenic set in motion a fatal emotional and behavioral withdrawal culminating in the psychotic break. Schizophrenia as a defect of “mothering” made sense to many clinicians in terms of their formulations of family dynamics, while a variety of related findings such as the etiology of the disorder of “morasmas” supported the hypothesis.
In the years that followed much clinical and research attention was focussed upon the mothers of schizophrenics. The early studies consisted mainly of reports of clinical findings or examinations of case record material often without any attempt at controlled comparison. Later investigators, particularly psychologists and sociologists, introduced more rigorous techniques of investigation, while the entry of sociologists into the field in the 50’s was associated with an enrichment of the conceptual tools for the handling of the problem with the introduction of concepts of social class (13) and the social system concepts of the Parsonian school (8).
However, despite a proliferation of studies in the area it proved to be quite difficult to arrive at a clear and unequivocal delineation of the characteristics of the mother of the schizophrenic. Quite contradictory findings emerged. In many studies the classical picture of the cold, rejecting, aloof mother appeared (1, 11, 24), but in others she was found to be overly protective, intrusive or symbiotic in her relations with the patient (2, 15, 20) while in some studies she showed none of these invidious characteristics (14, 17).
The variability in findings has been attributed to various causes, particularly to problems of the methodology used in the investigations. For instance, it has been suggested that the case record studies invariably reflect overprotection because the overprotective mother is most likely to contribute information in an anamnesis (21). Certainly a significant problem in all these investigations has been the fact that information about the characteristics of the mothers has been subject to coloration through the eyes of the clinician or through his informant, whether the schizophrenic, the father or the mother herself who may have quite biased ideas about her own characteristics.
Carroll, Edward J. (1964): Family Therapy-Some Observations and Comparisons. In: Family Process, 3 (1), S. 178–185.
Abstract: Family therapy, after inconspicuous germination in a few widely separated places for several years, has suddenly come into flower and new shoots are appearing on all sides. There are an increasing number of articles, most of which define family therapy by the particular practice that the author follows. Thus it might be defined as collaboration between different therapists seeing different members of the family, or as two or more family members being seen at the same time and place by one therapist, or again, by the focus of treatment. Perhaps the focus of treatment is the most meaningful way of differentiating family therapy from other types of therapy, and thus it may be defined as treatment centered upon the dynamic functioning of the family as a system, regardless of the number of family members present at any particular session. The term system is here used in the sense of a self sustaining, complex, hierarchal organization as described in the General Systems Theory of von Bertalanffy (3).
The development and evolution of family therapy has been surveyed by Grotjahn (2), giving many psychoanalytic references, and by Jackson (4), giving predominantly psychiatric references. Other reviews of interest are those by Ackerman (1), by Sanua (5) from a sociologic orientation, and by Frankiel (6) of the Family Service Association of America.
Now that family therapy is being used, many wonder that it has not been a part of therapeutic methodology all along. It seems incongruous that the traditional psychiatrist should devote such a great amount of time listening to the patient’s patientþs account of his family and at the same time avoid any opportunity for first hand observations of them.
Hill, Reuben (1964): Methodological Issues in Family Development Research. In: Family Process, 3 (1), S. 186–206.
Abstract: Many of the problems of method and technique encountered by researchers attempting to study families developmentally stem from the primitive state of the conceptual frame of reference in use and still others from the special requirements of the longitudinal method of data collection which has been linked to the developmental approach to family study. I have accordingly organized my presentation around these two axes beginning with a description of the family development frame of reference and the problems involved in operationalizing its chief concepts, followed by a delineation of the research situation of researcher and cooperating families in longitudinal studies, and I will conclude with a listing of some of the solutions which have been devised in recent years.
Yarrow, Marian Radke, John D. Campbell & Roger V. Burton (1964): Reliability of Maternal Retrospection: Preliminary Report. In: Family Process, 3 (1), S. 207–218.
Abstract: The inherent interest in family relationships and the obvious significance of this area for the psychological and social sciences undoubtedly account for the great amounts of research energies expended in studies of the family. This research investment continues despite the very considerable obstacles to research in this area. As behavioral scientists we very much want to know the dimensions of family structure and functioning, and especially do we want to know the influence of the family upon its members. Only such intensely high demand for this information would lead and hold investigators to an area of study posing so many methodological difficulties. The same explanation might conceivably account for our frequent willingness to rely on data that, as measures of family variables, are flimsy bits gleaned by approaches at least one or two steps removed from the actual functioning and interactions of family members.
In this paper we shall be very critical of the data in family researchmore directly of the methods of family researchnot to discourage or belittle all our research attempts in this field but to draw our attention to the research means employed in attempting to reach very difficult research ends. By methodological stock-taking, i.e., by doing research on research techniques, we may find our way toward more effective methods. We will be concerned primarily with research on parental practices, values, and other familial influences upon child behavior and personality.
Abstracts of Literature. (1964): In: Family Process, 3 (1), S. 219–226.
Rose, Jerome V. (1964): Review – Delinquents, Their Families, and the Community, by C. Downing Tait, Jr., M.D. and Emory F. Hodges Jr., M.D., Charles C Thomas, Springfield, Ill. In: Family Process, 3 (1), S. 227–228.
Abstract: The authors report their experiences with the Maximum Benefits Project, Commissioners’ Youth Council, District of Columbia, 1954-1958. The original goal was to research approaches to the needs of all children in the public schoolsto ascertain the special mental health services necessary on all levels. At some point they found it necessary to desert their original goal and apply the attention of the project to delinquency in the deprived areas. Using the Glueck Social Prediction methods they identified potential delinquents and then attempted prevention of overt delinquency with an approach that was very broad, including casework and, in some cases, psychotherapy. Follow-up failed to reveal an appreciable reduction in incidence of delinquency, due in part to failure of the group to obtain proper cooperation of parents. In the second section of the book the authors offer their ideas about more effective ways of preventing delinquency, all of these revolving around a system of diagnosing and treating families and, in extreme cases, housing these families in a “family therapeutic community.”
Schlamp, Frederic T., John Weakland & Jay Haley (1964): Family Experiments: Some Alternative Hypotheses by Frederic T. Schlamp, Ph.D., with replies by John Weakland and Jay Haley. In: Family Process, 3 (1), S. 229–245.
Abstract: In the field of family communication and family relationships, perhaps the only real emphasis upon controlled experimentation has come from the “double bind” theory. Particularly the analysis of Weakland and Fry (“Letters of Mothers of Schizophrenics,” Am. J. Orthopsychiat. 32, 604-623, 1962) and the experimentation of Jay Haley (“Family Experiments: A New Type of Experimentation,” Fam. Proc. 1, 265-293, 1962) have presented meaningful, systematic and testable hypotheses within an experimental frame of reference. As forward looking as this research is, however, no classically crucial experiment has been run. The experiment of Haley and the careful investigation and analysis of Weakland and Fry however, give a verisimilitude of crucial hypotheses-testing and it is for this reason that a certain critical evaluation, alternate hypotheses presentation, and suggestions for more critical research designs are in order.
Let me first describe what I will call a “normal” family. Let me further hypothesize that one son from this “normal” family has been hospitalized with a diagnosis of schizophrenia. The parents and the siblings, but particularly the mother, is quite concerned for her son. The concept of mental illness is not out of the range of experience for this family. The dread, fear, awareness of social stigmata, and the feelings of personal inadequacy are felt by them in the same way that it is felt by many families of hospitalized psychotic individuals. Over the period of years the parents have built up a deep love for their son and are very concerned about the likelihood of his recovery. Both of the parents, and to a lesser extent the siblings, of the psychotic patient wish to do all they can to help him recover and to help him share in an active outgoing life. They are unaware, however, of the nature of psychosis. They have many quasi superstitious attitudes and unspoken feelings concerning psychotics, and are quite honestly ambivalent in many areas about what they “should” do. The son, on the other hand, although in remission, shares the customary aftermath of a psychotic episode in that he is somewhat apathetic, has problems with communications, probably centering around his own ambivalent feelings, and yet once having committed himself to a method of action, he can maintain this adequately for some time before his own self doubts and recriminations (partially unconscious) block further single purpose behavior.
In such a situation we introduce the family experiments of Haley. Essentially this consists of father, mother, and the schizophrenic child forming various “coalitions” with each other. This means that a button is pressed signalling a desire for a coalition with another partner and leaving the way open for a mutual scoring between these two partners. Implied in the instructions to the “players” are that each person is supposed to try to “win”, probably with some reference to seeing how they work as a family, or at least there will be implied to most parents “how good are you?”In this situation the parents I have described would be most solicitous towards their “sick” son, and yet also anxious to do well. The son, on the other hand, would be slow to respond both in pressing coalition buttons and in releasing coalition buttons. That is, once having responded, he would tend to perseverate for a period of time, as is characteristic of many schizophrenics in partial remission.
Brown, Saul L. (1964): Letter to the Editor. In: Family Process, 3 (1), S. 246–246.
Rosenbaum, Max (1964): Letter to the Editor. In: Family Process, 3 (1), S. 246–246.
Coodley, Alfred (1964): Letter to the Editor. In: Family Process, 3 (1), S. 246–247.
Fisch, Richard (1964): Reply to Letters. In: Family Process, 3 (1), S. 248–249.
Boverman, Maxwell (1964): Collaboration of Psychiatrist and Clergyman: A Case Report. In: Family Process, 3 (2), S. 251–262.
Abstract: Recently pastor and psychiatrist, on being confronted by a deteriorating family crisis involving an acutely psychotic member, contrived an experiment in combined care. Distinctive in this effort were the closeness with which the pastor and psychiatrist engaged themselves, the ways in which the pastor participated in intimate involvement with the family and attempts to use the peripheral relationships of the family in the parish. Since this cooperative experience seems to be unique in the literature it is considered worthy of report.
To the trained observer the psychotic person shows ample evidence of understandable mechanisms of self-defeat and illogical living patterns. However, the application of this knowledge today by individual psychotherapy of the psychotic patient is successful only with the occasional patient who is able to undertake this task responsibly. More frequently there are technical difficulties in establishing successful individual treatment such as: getting the patient to come to the psychiatrist’s office for even an initial consultation; termination of treatment by the patient or family, especially when it appears that therapy is being helpful; the establishment of unproductive or destructive stalemates, often with psychotic acting out.
Some of the limitations of individual therapy may be inherent not only in the illness itself but also in the context in which it occurs, that is, in terms of poor motivation of the patient because of infantile gratifications and secondary gains. Studies of the interpersonal dynamics within the families in which these patients live throw some light on the particular intricacy and intensity of that pathological interpersonal behavior of the family which may deter meaningful motivation for constructive change.
There is a certain similarity between the characteristic dynamics within the family and the ways in which the family operates socially and engages those outside the family. There is the same kind of smooth, apparently agreeable relationships with mutual denial of hostility and without assertion of identity or differences. Some of these families are adept at the superficial social amenities and thereby are able to establish mutually exploitative situations, especially in regard to the “sick” member. It has become routine to expect that the family makes demands in an infantile or contradictory way for “understanding help” from persons who could not possibly fulfill them. Those approached may be friends, pastor, family physician, relatives, personnel advisors, teachers and others peripheral to the family.
Adams, James R. (1964): The Pastor’s Viewpoint. In: Family Process, 3 (2), S. 262–272.
Abstract: Every church has its share of screwballs, alcoholics and neurotics. Few congregations escape the fate of having a respected member go through a violent mental or emotional crackup. A clergyman, if he cares at all about the people whom he serves, knows he has some responsibility for all these unfortunate individuals and for their families. This responsibility seems awesome because every case contains a maze of complex and sordid factors. Often the pastor feels forced to choose between staying out of the situation completely and being so caught up in it that his time and emotional reserves are nearly exhausted by his efforts.
Until last year this seemed to be the limit of my choice as a pastor when it came to dealing with members of my congregation who had serious emotional problems. I always found this a terrible choice to make. On the one hand, I wanted everyone in the parish to look to me as a trusted counselor and friend in time of trouble. My reason for going off to seminary was that somehow as a clerygman I could help people; I could be of use to them. On the other hand, whenever someone sitting in my office began talking about murderers lurking in the basement or spiritual marriages with people they had never seen, I wanted to get rid of him as soon as possible. On the few occasions when I had tried to be a sympathetic listener, I found that the listening could go on for hours and days. I was subjected to a barrage of visits and phone calls consisting mostly of garbled and repetitive conversation. Sometimes, when the troubled person’s talk and behavior were less bizarre, the trap was more subtle, especially when dealing with women who were unhappy with their husbands.
Baxter, James C. & Sonya Cornell Arthur (1964): Conflict in Families of Schizophrenics as a Function of Premorbid Adjustment and Social Class. In: Family Process, 3 (2), S. 273–279.
Abstract: That scores of “premorbid adjustment,” as measured by the Phillips (1953) Scale of Premorbid Adjustment, may, in some cases, be confounded with effects of social class has been shown in recent reports by Chapman, Day and Burstein (1961) and Chapman and Baxter (1963). Phillips Scale items rely heavily on premorbid sexual and affiliative behaviors, which have been shown to relate closely to social class variables (Kinsey, Pomeroy and Martin, 1948; Myers and Roberts, 1959). Therefore, it is possible that social class differences have been confounded with differences in level of premorbid adjustment in some studies using this scale. This would mean that behavioral differences thought to be related to schizophrenia could in fact be a function of social class, or perhaps a joint function of both social class and premorbid adjustment. In reviewing the evidence available on the matter, Chapman and Baxter find that the results of several studies conducted in the Duke laboratory can be reinterpreted in terms of expected effects of social class differences. Data provided by Farina (1960), showing differences in patterns of parental dominance and conflict, and by Garmezy, Clarke, and Stockher (1961), showing differences in patterns of parental domination perceived by the patient, seem to be the only findings inconsistent with such an alternative explanation. In both of these studies, however, social class was evaluated in a less detailed way than that used by Chapman and Baxter.
Another characteristic of samples obtained by rating patients’ adjustment according to the Phillips Scale also warrants consideration. In rating patients according to this procedure, one may also obtain groups differing in the structure of their primary family. Since good premorbid patients are most often married, they could be expected to have been hospitalized from their conjugal home rather than from the parental home, while poor premorbid patients, who are usually unmarried, would more often be hospitalized from the parental home. If one then studies interpersonal variables in the parental family, it is possible that the immediacy of the stress of dealing with and hospitalizing the patient could influence the results. This seems especially likely in the case of studying role conflict by direct observation of the parental families, as Farina did.
The present investigation was aimed at studying patterns of interpersonal conflict in the parents of good and poor premorbid patients with the variables of social class and the family from which the patient was hospitalized controlled.
Tyler, Edward A. (1964): The Process of Humanizing Physiological Man. In: Family Process, 3 (2), S. 280–301.
Abstract: How man, the physiological animal, becomes man, the social human is presented here as a social theory of human behavior. New born man is basically an animal who first relates to other men because of his physiological helplessness. Through his physiological dependency on sophisticated members of his species, he learns to also become psychologically dependent, but further growth introduces a struggle for autonomy. The establishment of an autonomous existence sets the stage for development of reciprocal relationships between autonomous individuals of roughly equal status. This humanizing process follows an orderly pattern from birth to death and any “normal” or “abnormal” human behavior can be explained or predicted by this parsimonious theory. Also presented is a superficial consideration of some physiological concepts which make the development of human psychological behavior not only possible, but extremely probable.
It is obvious that if no human infants were able to survive, the human species would soon disappear. In this theory psychosociological behavior is considered to be a special case of adaptive behavior designed specifically for human survival in an environment of other humans. The physiological dependency of the infant man on an adult human for his individual, as well as species, survival is the crucial factor in development of those behaviors which we term social and psychological i.e., the humanizing process. Reared by monkeys, wolves, or porpoises, he would become psychosociologically a monkey, a wolf, or a porpoise with marked physical limitations if he survived at all (15).
Grönseth, Erik (1964): Research on Socialization in Norway. In: Family Process, 3 (2), S. 302–322.
Abstract: The general findings of the few studies done on socialization standards and practices in Norway, with exception of a few studies including data on sex-role learning (1, 2, 3, 4, 5) are summarized in this paper. These studies are all done in South Norway, the most populus and urbanized part of the country. The data are based in part on comprehensive, anthropologically derived observations (6), in part on a few intensive studies of from 20 to 100 families (7, 8, 9, 10, 11). The more specific results of the latter and of a couple of related studies concerning family structure and socialization will be presented in the subsequent sections.
Jones, Dorothy M. (1964): Binds and Unbinds. In: Family Process, 3 (2), S. 323–331.
Abstract: Revolving, spiralling, mushrooming processes cannot be described in linear fashion, and there lies one of the major problems in explicating the pivotal variables which comprise the field of interaction in a family. In an attempt to develop a testable hypothesis about interaction systems in families with a schizophrenic child, I conducted a series of pilot interviews to determine the nature and content of the rules in the family. It became apparent, however, that it was not the existence of the rule which caused the disorder, but rather the way in which the rule was implemented and incorporated into a system of interaction. There was a patterned process in gyrating motion of which the components fed, reinforced and derived from a particular system of interaction. This paper will present an excerpt from a family interview which dramatizes the family’s characteristic habits of behavior and interaction. The theoretical frame of reference derives from social systems concepts (4, 10, 15) and from recent studies in the interaction field in families (3, 8, 9, 11, 12, 13, 14).
The specific system of interaction in this type of family will be described here as a process of binds and unbinds. This is not a reference to simple binds but to the double bind described by Bateson et al. (1, 2, 5, 6, 7). This is a communication mode in which contradictory injunctions are expressed on different levels of abstraction, and where something is shifted from one level of abstraction to another in order to conceal or disguise its meaning. When one member of a family places a reciprocal in such a bind, the reciprocal attempts to remove himself from the bindto unbind himself. There are various ways in which this can be accomplished, but in the process being described, the reciprocal unbinds himself by placing the binding member in another bind, and in this process of binding and unbinding, the family members place themselves in a convoluting series of more and more confused binds, increasingly distant from their sources of origin, and increasingly disguised. The result is a process in which meaninglessness is effected in a context of contending to be meaningful; ambiguity and equivocation in a context of professing to be clear cut and explicit; concealment in a context of ostensible openness; and disguise in a context of revelation. It is both implicit and explicit, subtle and crude. The multiple sources of this process include the life history of each family member, the life history of the family group, the family’s network of connections and cultural setting, and the family’s particular manner of interaction and relationship. Despite the manifold dimensions of this process, its nature is persistent, consistent and ubiquitous.
Sweetser, Dorrian Apple (1964): Mother-Daughter Ties between Generations in Industrial Societies. In: Family Process, 3 (2), S. 332–343.
Abstract: Very few studies of cross-generational family relationships have raised the question of whether there are differences in the relations of married sons and married daughters with the parental generation, and yet those who have investigated this question have consistently reported evidence of stronger ties between married daughters and parents than between married sons and parents. However, evidence to date has been limited to the United States of America and England.
This paper reports a study of cross-generational family relations in two other industrial societies, Finland and Sweden.1 The study was limited to nonfarm families, since a special set of kinship norms applies to farm families in these two countries. The specific form of cross-generational tie which was studied was the sharing of a household by married couples and older parents. The hypothesis tested was that wives’ parents would more often share households with married couples than would husbands’ parents. Age differences between husbands and wives, which make it more likely that a wife’s parents will be alive than will her husband’s parents, were controlled in the analysis of the data. Differences between social classes and between households with different kinds of heads were also investigated. The concluding section of the paper proposes that stronger ties between married daughters and parents than between married sons and parents is a fundamental characteristic of family relationships in industrial societies. An explanation of why this should be so, based on kinship
Levy, Joshua & Nathan B. Epstein (1964): An Application of the Rorschach Test in Family Investigation. In: Family Process, 3 (2), S. 344–376.
Abstract: ONE ASPECT of our ongoing comprehensive research program in Family Psychiatry is the project involving the development of new techniques of family investigation.1 We have found that the well-established Rorschach Test, if
administered first to individual members of the family and then to the whole family, is a highly useful technique for generating, exploring and testing our hypotheses about the psychological functioning of individual family members and the family as a unit.2 The detailed analysis of the Family Rorschach data furthers our understanding of some of the most significant concepts of family functioning. For example: modes of reaching family equilibrium, the effects of distorted communication (e.g. “double bind”) on the family unit, etc. The general purpose of this investigation is to gain an understanding of:
1) The psychological functioning of the personalities of individual family members.
2) The transactions of the individual members within the family unit.
3) The relationship between 1 and 2.
Paul, Norman L. & George H. Grosser (1964): Family Resistance to Change in Schizophrenic Patients. In: Family Process, 3 (2), S. 377–401.
Abstract: The recognition that family interaction is an essential ingredient, if not a major determinant, in the etiology and persistence of schizophrenia, is gaining considerable ground. This family interaction has been viewed from various vantage points, e.g. double-bind (1), skewed (2), schismatic (2), symbiotic (3) and pseudomutual (4) relationships. These approaches have in common a recognition of, first, the interactional nature of what we might call the schizophrenic process, and second, a certain persistence of the relationships between the family members and the patient which have all the earmarks of a fixation in their role relationships to one another. Our findings are in accord with these investigations and reveal, in addition, the existence of a static equilibrium.
The conjoint patient-family therapy setting (5), as developed over the past few years, is perhaps one of the most useful tools yet evolved in studying these patterns of interaction in families with a schizophrenic patient. Although the setting of such family sessions, at the hospital or in the psychiatrist’s office, may be challenged as being artificial when compared to what occurs at home or in the community, we feel that the fixity of role relationships is likely to manifest itself just as well in this contrived situation. The presence of the therapist introduces a new element which does not negate the above. His participation helps to crystallize more sharply both the nature of existing relationships and the quality of object relations to strangers.
Utilizing this setting, the authors have studied a series of family units, each with a schizophrenic patient, to delineate the fixity in role transactions. The pattern emerging from such role transactions is here considered a fixed family equilibrium which includes, as its integral part, the role responses of the patient including his pathology and the characteristic responses of the family members to him. The term “equilibrium” as used by the authors here does not imply normalcy; it is merely a term signifying a relatively unchanging dynamic state to which there is a tendency to return when disturbed by such changes as aging, births, deaths, etc., which normally require sequential adaptations. While all families, like other human groupings, tend to maintain their structure and equilibrium while evolving gradually in relation to internal and external changes (6), our sample of families are characterized by an absence of such evolution with stereotyped response patterns.
This paper shall illustrate, by means of a variety of case excerpts, the patterns of family response to schizophrenic patients that develop during the early phase of conjoint patient-family therapy. We shall endeavor to demonstrate that patient movement in the direction of more differentiated self-image and social maturity of response is associated with a dislocation of the original family equilibrium and gradual changes in the response patterns of other family members.
Kantor, Robert E. (1964): Schizophrenia and Symbolic Interactionism. In: Family Process, 3 (2), S. 402–414.
Abstract: THE GOAL of establishing a thoroughly interactional theory of schizophrenia is of late beginnings. Two series of empirical events, both hardly more than a decade old, forced these beginnings. The first event was the rise of perceptual testing as an operational measuring stick for psychosis. The second event was the rise of family therapy, which completed the growing realization that schizophrenia emerges from a specific family context and is a product of familial interactions.
Both of these events made it clear that older vocabularies, older concepts, and most particularly, older assumptions, were inadequate for a current description of schizophrenia-as-interaction. If an interactional theory were ever to do more than add footnotes to the texts of earlier theories, it must lay out its differences in premise. To this end, the present attempt is to examine and illumine the fundamental assumptions both unique and imperative to the interactional point of view.
A statement is in order here about the notion of interaction. It is clearly not an idea of common sense alone and is recent in the chronicles of thought. As the concepts of forces, vectors, and elements became accepted as ways of describing human conduct, the notion of interaction was a logical, even inevitable, development. Interaction as an idea is a complex one, involving not only the concepts of human engagement and recoil, but also something deeper, namely the intrinsic plasticity of the colliding humans.
This human modifiability stems from the fact that people act with reference to each other. Each man fits his conduct to the conduct of others by checking what they are doing or what they mean to dothat is, by reading the meaning of their acts. He builds up his own behavior on the basis of such interpretations of the behavior of others. Essentially, group action occurs through the mutual tailoring of individual lines of action. Such tailoring among men assumes that there are predictable forms of social interaction which make social relationships possible. Thus, psychological events called social, are, in a profound sense, relational. Given this general framework, the basic assumptions of interactionism can more easily be drawn.
Jackson, Don D. (1964): Family Affairs. In: Family Process, 3 (2), S. 415–416.
Abstracts of Literature. (1964): In: Family Process, 3 (2), S. 417–424.
Sonne, John C. (1964): Metaphors and Relationships. With a Comment of Don D. Jackson. In: Family Process, 3 (2), S. 425–426.
Abstract: Particularly through the discoveries of psychoanalysis, dreams, delusions and symptoms are now seen as symbols, having in addition to their manifest content, a latent unconscious content. Generally, analysis of the symbol aims to find the latent object, or impulse, which is represented in the manifest symbol. For example, telephone pole equals penis, or kleptomania equals penis envy. The discovery of the unconscious marked the assumption by mankind of a new creative burden. It is posed most acutely and poignantly and painfully for us by the schizophrenic, whom we now understand, but cannot help. The schizophrenic stands, in his isolation, as a monument to the aloneness we all feel, a failure at creative human interaction. No one poses to us a greater challenge to our creativity. Yet we, with all our increased material, are unable to be creative with the medium we use.
I am reminded of advice that I once received to not see a particular male patient, because therapy would mobilize his homosexuality. I am also reminded of having been told by more than one preceptor to beware when material seemed to be appearing with unusual clarity, lest the patient be an undiagnosed schizophrenic. I had the feeling of not wanting to engage in an analytic process which would lead to no synthesis; yet, if I analyzed only people who had a good capacity for creative synthesis, I still had learned nothing about creative synthesis, or how to treat people who had a problem with it. Obviously, making the unconsious conscious often resulted in an unintegrated therapy. Do we not know how to help our patients to comprehend qualities? Do we not know how to help them take the jump to metaphorical thinking.
Keats said “The sun, the moon, the earth and its contents, are material to form greater things, that is, ethereal thingsgreater things than the Creator himself made.” Has the effect of our scientific study of schizophrenia been to diversify our materials and forms, rather than to create an organic synthesis? Shelley said that moral science only arranges the elements that poetry has created. Do we not need poetry in the psychotherapy of schizophrenia, in addition to our new found knowledge about the unconscious and communication?
Kantor, R. E. (1964): Review – The First Five Minutes, by Robert E. Pittenger, Charles F. Hockett, John J. Danehy, Paul Martineau, Ithaca, N. Y., 1960. In: Family Process, 3 (2), S. 429–429.
Abstract: As its central contribution, this book offers a psycholinguistic portrait of the first five minutes of an initial interview between a young woman and her psychiatrist. Basically, the authors assume that they can observe and describe the events of a psychiatric interaction in such a way as to put the techniques of therapy before the scientific community.
This particular five minute episode proffers some empirical advantages: since it is in the first of three interviews studied by Gill, Newman, and Redlich in their book, The Initial Interview In Psychiatric Practice, an opportunity exists to compare the deductive processes of several expert investigators; and also, the recorded data are accessible to other qualified persons for validation.
Glick, Ira D. (1964): Review – Family Ill Health, An Investigation in General Practice, by ROBERT KELLNER, C. C Thomas, Springfield, Ill., 1963. In: Family Process, 3 (2), S. 429–430.
Abstract: This book is the fourth of a series of Mind and Medicine Monographs edited by Michael Balint.
It represents a succinct report of a family physician’s attempt to document the incidence of illness in family members (illness defined as the patient’s decision to seek medical help) and an attempt to understand within the framework of family interaction what produced these contacts.
The research method used was to include all patients in Dr. Kellner’s practice in England, excluding those not registered for two consecutive years, those not living in a three-mile radius, and those in which there were no family members in the practice. This left 356 families out of 1735 patients. Of these, the clinic and office visits of all family members were tabulated and recorded chronologically over a two-year period. For example, “mother and son seen in the same month for upper respiratory infections, father in following month for hernia.”
Berlin, Irving N. (1964): Review – Personality in the Making, by Helen L. Witmer and Ruth Kotinsky, Science and Behavior Books, Inc., Palo Alto, California, 1964. In: Family Process, 3 (2), S. 430–430.
Abstract: The reissuing of Personality in the Making by Science and Behavior Books as a paperback meets a long-left need.
Those of us who teach personality development in psychiatry, child psychiatry, social work, psychology, education, nursing, etc. have missed its presence in school bookstores as teaching material for our courses on personality development.
This book, which synthesizes the 1950 White House Conference on Children and Youth, presents in a clear and precise way the research findings on child development and personality theory which have formed the basis and background for all subsequent research in the following decade. It will never be out of date. The material presented is so basic and beautifully delineated in each of its sections that it is at once a source book for courses in personality and child development in a wide variety of professional schools and for inservice training in all child-serving agencies as well as an authoritative and clear reader for the intelligent layman.