Academic journal article Journal of Counseling and Development : JCD

Love, Loss, and Learning: The Experiences of Fathers Who Have Children Diagnosed with Schizophrenia

Academic journal article Journal of Counseling and Development : JCD

Love, Loss, and Learning: The Experiences of Fathers Who Have Children Diagnosed with Schizophrenia

Article excerpt

The onset of schizophrenia in the family has been described as "a disaster in which all are victims of the event and its sequelae" (Terkelsen, 1987, p. 128). Early signs of the illness often occur during late adolescence or early adulthood when the child is often still living with his or her parents, especially for males. Females tend to have a later onset, often in their mid-20s (Hambrecht, Maurer, Hafner, & Sartorius, 1992). Schizophrenia is one of the most common of the major mental illnesses, with an overall 1% lifetime risk across cultures (Birchwood & Jackson, 2001; Jablensky, 1995). The illness can present with a range of positive symptoms, such as hallucinations, delusions, bizarre behaviors, and marked disorders of thinking, as well as negative symptoms, such as social withdrawal, impairment of attention, lack of energy, poverty of speech, or a blunting of drive or emotions (Andreasen, Roy, & Flaum, 1995). ("Positive" symptoms refer to "new behaviors that are clearly abnormal," and "negative" symptoms refer to symptoms that reflect "the loss of normal functions"; Pennington, 2002, p. 209.) It is well recognized that prolonged negative symptoms, especially when they persist over a number of years, result in a great emotional burden on the family and are associated with an increased likelihood of a poor prognosis (Birchwood & Jackson, 2001).

Despite the recognition that the illness results in enormous stress in the family, relatively few studies have focused on the experience of parenting an adult child with schizophrenia, and in particular the experiences of fathers. Early research implicated mothers (Fromm-Reichmann, 1948; Hajdu-Gimes, 1940) and, later, fathers and mothers in the etiology of schizophrenia (Bateson, Jackson, Haley, & Weakland, 1956; Lidz, Cornelison, Fleck, & Terry, 1957). These early theories implying parental responsibility have significantly contributed to the blame and guilt that have all too often characterized the relationships between parents of children with schizophrenia and mental health professionals (J. M. Atkinson & Coia, 1995; Terkelsen, 1987). Although it has been suggested that "when professionals blame mental illness on poor parenting, mothers take the majority of the blame" (Milliken, 2001, p. 160), fathers also have been implicated in their child's difficulties, in their interactions with their child, and in their relationship with their spouse.

There is strong evidence to indicate that the development of schizophrenia has a genetic component (Pennington, 2002). Recent studies have drawn attention to the possible roles of neurochemical processes and structural brain abnormalities (Pennington, 2002). However, the etiology of schizophrenia is not well understood (Birchwood & Jackson, 2001). With an emphasis on the biopsychosocial nature of schizophrenia, the vulnerability-stress model (Zubin & Spring, 1977) has gained some support. This model proposes that psychosocial stresses influence underlying vulnerability factors resulting in the emergence or exacerbation of psychotic symptoms.

Both quantitative and qualitative studies have contributed to the field's current understanding of the impact of schizophrenia on family members. For example, Brown, Birley, and Wing (1972) found a positive correlation between expressed emotion (critical comments, hostility, and emotional over-involvement) among family members, and the frequency of relapse in the family member who has schizophrenia. These findings have led to the assumption by many mental health professionals that families with high levels of expressed emotion "reflect[s] a stressful family situation that precipitates acute psychotic relapse in the schizophrenic family member and interferes with rehabilitative efforts" (Kanter, Lamb, & Loeper, 1987, p. 376). However, contrary to this assumption, in a recent quantitative study using a cross-lagged, panel analysis focused on examining the direction of influence between symptom severity in 29 adults with schizophrenia and the expressed emotion of their mothers, King (2000) found that expressed emotion appeared to be the effect of symptom severity rather than its cause. …

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