Family and social factors

The work of R. D. Laing (The Divided Self) and many others, as in Bateson's 'double bind', has focused attention on family dynamics and on the attitude of society as primary causes of schizophrenia. In retrospect, the work of Laing and others seems to be more cultural than scientific, coinciding as it did with the 'anti-psychiatry' movement and wider criticism of the Western nuclear family.

The main survivor from these ideas has been the concept of 'expressed emotion' (EE), whereby patients with schizophrenia who come from families who react strongly to their behaviours are known to be at increased risk of relapse. Family therapy (Pilling et al., 2002) can reduce the risk of relapse, but this result may not necessarily support the concept of EE, as the therapy could be operating in other ways.

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