Interpretation of Schizophrenia - Family Etiology

Family Etiology

Arieti then describes the psychogenic factors that lead to the disorder. The family environment and psychodynamics in the etiology of psychosis comes under scrutiny. Arieti describes the building of neurotic and psychotic defense mechanisms; the emerging schizoid personality, and fully developed schizophrenia understood as an injury to the inner self. Arieti believes that a state of extreme anxiety originating in early childhood produces vulnerability for the whole life of the individual.

A characteristic of Homo sapiens is a prolonged childhood with a consequently extended dependency on adults. This, according to Arieti, "is the basis of the psychodynamics of schizophrenia", a claim that also appears in later writers on child abuse such as Alice Miller and Colin Ross. Arieti reviews the paper by Frieda Fromm-Reichmann about the "schizophrenogenic" mother and reaches the tentative conclusion that only 25 percent of the mothers of schizophrenics in his clinical experience fit that image. However, he adds that only in a minority of schizophrenia cases "the child is able to retain the good maternal image". Arieti also mentions the work of Theodore Lidz, another trauma model author of schizophrenia. Like Lidz, Arieti emphasizes the weakness of the father of the schizophrenic patient in the paternal role. In Arieti's own words:

In the first edition of this book I have described one family constellation when a domineering, nagging and hostile mother, who gives the child no chance to assert himself, is married to a dependent, weak man, who is too weak to help the child . In these families the weak parent becomes antagonistic and hostile toward the children because he displaces his anger from the spouse to the children, as the spouse is too strong to be a suitable target.

The roles can be reversed when the domineering spouse is the father. Arieti is convinced that each schizophrenia case is representative of those human situations in which something went extremely wrong. "If we ignore it, we become deaf to a profound message that the patient may try to convey". For example, Arieti states about one of his patients that "his adolescence was a crescendo of frustration, anxiety and injury to self-esteem". Arieti also mentions a catatonic patient who, after introjecting the mother's engulfing behavior, believed that by moving he could produce havoc. The patient's feelings, according to Arieti, became reminiscent of cosmic powers that may cause the destruction of the universe, so the patient chose immobility. For Arieti, the selectivity of certain motor actions is proof that catatonia is not a biological disease or illness, but rather a disorder of the will.