“There have been many studies of social factors in relation to schizophrenia. These include attempts to discover whether schizophrenia occurs more or less frequently in one or other ethnic groups, social class, sex, ordinal position in the family, and so on. The conclusion from such studies has often been that social factors do not play a significant role in the ‘aetiology of schizophrenia’. This begs the question, and moreover such studies do not get close enough to the relevant situation. If the police wish to determine whether a man has died of natural causes or has committed suicide, or been murdered, they do not look up prevalence or incidence figures. They investigate the circumstances attendant upon each single case in turn. Each investigation is an original research project, and it comes to an end when enough evidence has been gathered to answer the relevant questions.” (Laing, 1967, Politics of Experience.)
Tag: mental health
Haverstock Hill
“Paul Zeal told me of how, one day, he and Laing had spotted me careering down Haverstock Hill on my bike: bobble-hat on the hawk-head, a Dr Who oversized overcoat flapping in the breeze, with my “Unfit to Plead” badge attached to the lapel, no doubt heading for another night at the Vortex, or the consoling disillusions of the White Heart Lane terraces. This sight(ing) had provoked Laing to casually share with Paul, “What a strange bunch we are!” And the strangeness, the incipient unreality, of the psychotic world is what Laing had a considerable capacity to acknowledge, whilst neither rejecting, nor reinforcing it.”
Chris Oakley (2012), Where did it all go wrong? In R.D. Laing 50 Years since The Divided Self, edited by Theodor Itten and Courtenay Young.
Factors thought to maintain children and young people’s mental health problems
From Alan Carr’s Handbook of Child and Adolescent Clinical Psychology (2nd ed) pp. 62-70:
Family system factors
- Inadvertent reinforcement, e.g., frequently inquiring about mood or commenting on negative conduct
- Insecure attachment, whereby children don’t experience carers as a secure base
- Coercive interaction, e.g., escalating negative interaction leading to withdrawal and relief, reinforcing behaviour just before relief
- Over-involvement, parental criticism and emotional over-involvement
- Disengagement, low frequency carer-child interaction
- Inconsistent parental discipline, leading to problems internalising rules
- Confused communication, e.g., indirect rather than direct communication
- Triangulation (not always negative), e.g., a “coalition” where one carer is peripheral
- Chaotic organisation
- Absent carer
- Carer relationship discord
Parental factors
- Parents with similar problems as child act as a role model maintaining the behaviour
- Resources for parenting compromised by mental health issues or criminality
- Misinterpreted crying (interpreted as intentionally punishing carer)
- Low self esteem
- External locus of control
- “Immature defences”
- Unemployment (failure to meet financial needs; impact on status)
- Boredom in work
- Excessive stress in work
- Role strain with parallel “homemaking” and working
Social network factors
- Lack of social support, e.g., lack of positive interactions with extended family/friends
- Chronic life stress
- Unsuitable education placement, e.g., understaffed schools
- “Deviant” peer-group e.g., peers using drugs
- Community problems, e.g., social disadvantage, racism, social exclusion, high crime rates
Problem maintaining treatment system factors
- Family members’ denial of problems
- Poor working alliance with clinicians
- Rejection of formulation and/or treatment plan
- Failure of communication between MDT members
- Failure of inter-agency network
- Conflicting formulations in multidisciplinary team and inter-agency work
- Culturally insensitive clinicians
Also flip side of these, protective factors, such as good physical health, high intellectual ability, high self-esteem, humour, positive engagement with treatment agencies, protective peer group, …