WE HAVE USED the empirical research data and the assessment methods described in chapter 4 to identify three distinct family types that have different characteristics in terms of two key dimensions: (1) the quality of parent-child attachment and (2) the way that affect is expressed among family members.
By combining these two dimensions of family environment, we have been able to deepen our understanding of the relational patterns in the families of patients with major psychiatric disturbance. These three family types have distinctly different treatment needs.
The first group, which we called the high-intensity family, is characterized by attachments that are strong and positive, if intense, and by interactions among family members that are overinvolved and sometimes highly critical, or intrusive. A second group of families, called low-intensity, is characterized by parents who are positively attached to the patient but who are also fairly low-key in terms of family affective climate—that is, they show little evidence of the entrenched criticism or intrusiveness toward the patient, expressed either in terms of attitude or behavior.
The third group of families, called disconnected, is characterized by family interactions in which one or both parents are noticeably disengaged from the patient or his problems. This fundamental emotional disconnection manifests itself through a wide range of family interactions. Some parents appear to be highly critical or overinvolved with the patient, whereas others appear to be totally uninvolved or mildly detached. Research measures, however, suggest that regardless of the surface