- Email: [email protected]
Family education in mental illness
Schizophrenia Elsevier
SCHIZO
Research,
87
5 (1990) 87-88
Book
00153
Lidz, T., The Origin and Treatment of Schizophrenic Disorders, 2nd edn., 145 pp. International Universities Press, Madison, CN, 1990. USD 19.95 In 1967, Dr. Lidz delivered the Salmon lectures. 17 years after the publication of these lectures in hardcover (1973), a paperback version is now available. Keenly written and only 130 pages in length, one will be provoked, taught, and ultimately gratified in a single evening. In the current heyday of biological psychiatry, the rendering of Dr. Lidz’s work linking the origin of schizophrenia to pathological communications within the family of the patient will provoke strong reactions. Moreover, Dr. Lidz takes many positions bound to make even the most ‘eclectic’ biologists wriggle. For instance, even though Dr. Lidz agrees that neuroleptics are helpful in treating schizophrenia, he implies they are simply ‘tranquilizers’, denying potential implications about the neurochemical specificity of these agents. Earlier, he suggests that the evidence supporting a biological underpinning of schizophrenia is a morass of contradictory studies and failed replications. This dated notion neglects the recent clarification that many patients with schizophrenia demonstrate subtle changes in brain structure at frequency greater than that of control subjects. Unfortunately, Dr. Lidz’s caveat still applies to a vast majority of biological findings (witness the recent scuffling over the schizophrenia ‘gene’).
SCHIZO
reviews
Antibiology aside, the notion of the family as a cause of schizophrenia, particularly the stereotype of the emasculating mother of the ‘skewed’ family, may lead to a mean spiritedness which can alienate caregivers from the already suffering families of the schizophrenic patient. Despite several cautions about this outcome rendered in the therapy section, the very power of Dr. Lidz’s descriptions of impaired families could engender antifamily attitudes that are countertherapeutic. Moreover, while discounting biological data in its entirety, he is compelled by small bits of data gathered from family therapists who are hardly unbiased. A large body of evidence linking disturbed families to characterological pathology rather than schizophrenia goes ignored raising an important criticism of Dr. Lidz’s hypothesis: why do most individuals from skewed or schismatic families not become schizophrenic (could it be genetic vulnerability?). Despite these issues, this volume triumphs with the final chapter, ‘Therapy’. In 35 pages Dr. Lidz provides an absolutely dynamic and impeccably correct account of how to communicate and deal with the schizophrenic patient and family and the hows and whys of psychiatric hospitalization in this disease. I heartily commend this chapter to medical students, psychiatry residents, and suspect that it might be a useful update for many who regularly care for patients with schizophrenia. CRAIG N. KARSON LITTLE ROCK, AR
00154
Hatfield, A.B., Family Education in Mental Illness, 211 pp. Guilford Press, New York, 1990. USD 35.00 (hard cover) Agnes B. Hatfield’s ‘Family Education in Mental Illness’ provides clinically useful information for mental health professionals about the impact of psychiatric illness on the family and the benefits of
0920-9964/90/$03.50
0
1990 Elsevier Science Publishers
B.V.
family mental illness education. It contains relevant information for mental health professionals, but seems to lack a clear target audience. The book is organized in three sections. The first section, ‘The Family and Mental Illness’, offers valuable information about the tragic impact of mental illness on the family. Chapters include: ‘Social Context’, ‘Mental Illness: A Catastrophic
88 Event’, ‘Meeting Environmental Challenges’, and ‘New Directions in Providing Help to Families’. This section makes frequent reference to the valuable ‘National Alliance for the Mentally Ill’. I found the section to be a very credible, concise description on family process as it relates to treating an identified family member with a psychiatric illness. The second section, ‘Curriculum Content for Educational Programs’, provides some mental illness clinical information that is quite basic. This section will probably have little to offer psychiatrists or residents in psychiatric training programs. It could be somewhat valuable for other mental health professionals, such as social workers, psychologists and nurses. Even for non-physician mental health practitioners other more detailed references on psychiatric diagnosis and treatment will offer better, more useful information. This is the book’s weakest section. The final, brief, third section is titled ‘Educational Approaches’. It consists of concise, practical
chapters on ‘Learning and Instruction’, ‘Teaching Problem-Solving Skills’, ‘Providing Emotional Support to Families’, and ‘Issues in Program Development’. It is difficult to write a book for all mental health professionals, given the divergence in training and interests within the field. Agnes B. Hatfield’s ‘Family Education in Mental Illness’ contains sections and information that is likely to be useful to many professionals. The book’s strength lies in the first section, ‘The Family and Mental Illness’, which serves to remind us how mental illness affects both our patients and their families. By reading ‘Family Education in Mental Illness’ one develops clinically useful insight and reinforces empathy for the family of the mentally ill patient. This book also offers strategies for educating our patient’s families and in so doing, maximizing the patient and their family’s clinical care. STEPHENF. PARISER COLUMBUS, OH
SCHIZO
Research,
87
5 (1990) 87-88
Book
00153
Lidz, T., The Origin and Treatment of Schizophrenic Disorders, 2nd edn., 145 pp. International Universities Press, Madison, CN, 1990. USD 19.95 In 1967, Dr. Lidz delivered the Salmon lectures. 17 years after the publication of these lectures in hardcover (1973), a paperback version is now available. Keenly written and only 130 pages in length, one will be provoked, taught, and ultimately gratified in a single evening. In the current heyday of biological psychiatry, the rendering of Dr. Lidz’s work linking the origin of schizophrenia to pathological communications within the family of the patient will provoke strong reactions. Moreover, Dr. Lidz takes many positions bound to make even the most ‘eclectic’ biologists wriggle. For instance, even though Dr. Lidz agrees that neuroleptics are helpful in treating schizophrenia, he implies they are simply ‘tranquilizers’, denying potential implications about the neurochemical specificity of these agents. Earlier, he suggests that the evidence supporting a biological underpinning of schizophrenia is a morass of contradictory studies and failed replications. This dated notion neglects the recent clarification that many patients with schizophrenia demonstrate subtle changes in brain structure at frequency greater than that of control subjects. Unfortunately, Dr. Lidz’s caveat still applies to a vast majority of biological findings (witness the recent scuffling over the schizophrenia ‘gene’).
SCHIZO
reviews
Antibiology aside, the notion of the family as a cause of schizophrenia, particularly the stereotype of the emasculating mother of the ‘skewed’ family, may lead to a mean spiritedness which can alienate caregivers from the already suffering families of the schizophrenic patient. Despite several cautions about this outcome rendered in the therapy section, the very power of Dr. Lidz’s descriptions of impaired families could engender antifamily attitudes that are countertherapeutic. Moreover, while discounting biological data in its entirety, he is compelled by small bits of data gathered from family therapists who are hardly unbiased. A large body of evidence linking disturbed families to characterological pathology rather than schizophrenia goes ignored raising an important criticism of Dr. Lidz’s hypothesis: why do most individuals from skewed or schismatic families not become schizophrenic (could it be genetic vulnerability?). Despite these issues, this volume triumphs with the final chapter, ‘Therapy’. In 35 pages Dr. Lidz provides an absolutely dynamic and impeccably correct account of how to communicate and deal with the schizophrenic patient and family and the hows and whys of psychiatric hospitalization in this disease. I heartily commend this chapter to medical students, psychiatry residents, and suspect that it might be a useful update for many who regularly care for patients with schizophrenia. CRAIG N. KARSON LITTLE ROCK, AR
00154
Hatfield, A.B., Family Education in Mental Illness, 211 pp. Guilford Press, New York, 1990. USD 35.00 (hard cover) Agnes B. Hatfield’s ‘Family Education in Mental Illness’ provides clinically useful information for mental health professionals about the impact of psychiatric illness on the family and the benefits of
0920-9964/90/$03.50
0
1990 Elsevier Science Publishers
B.V.
family mental illness education. It contains relevant information for mental health professionals, but seems to lack a clear target audience. The book is organized in three sections. The first section, ‘The Family and Mental Illness’, offers valuable information about the tragic impact of mental illness on the family. Chapters include: ‘Social Context’, ‘Mental Illness: A Catastrophic
88 Event’, ‘Meeting Environmental Challenges’, and ‘New Directions in Providing Help to Families’. This section makes frequent reference to the valuable ‘National Alliance for the Mentally Ill’. I found the section to be a very credible, concise description on family process as it relates to treating an identified family member with a psychiatric illness. The second section, ‘Curriculum Content for Educational Programs’, provides some mental illness clinical information that is quite basic. This section will probably have little to offer psychiatrists or residents in psychiatric training programs. It could be somewhat valuable for other mental health professionals, such as social workers, psychologists and nurses. Even for non-physician mental health practitioners other more detailed references on psychiatric diagnosis and treatment will offer better, more useful information. This is the book’s weakest section. The final, brief, third section is titled ‘Educational Approaches’. It consists of concise, practical
chapters on ‘Learning and Instruction’, ‘Teaching Problem-Solving Skills’, ‘Providing Emotional Support to Families’, and ‘Issues in Program Development’. It is difficult to write a book for all mental health professionals, given the divergence in training and interests within the field. Agnes B. Hatfield’s ‘Family Education in Mental Illness’ contains sections and information that is likely to be useful to many professionals. The book’s strength lies in the first section, ‘The Family and Mental Illness’, which serves to remind us how mental illness affects both our patients and their families. By reading ‘Family Education in Mental Illness’ one develops clinically useful insight and reinforces empathy for the family of the mentally ill patient. This book also offers strategies for educating our patient’s families and in so doing, maximizing the patient and their family’s clinical care. STEPHENF. PARISER COLUMBUS, OH