Monday, September 28, 2009

The mother, as seen by the Br. J. Med. Psychol.

In the interests of scholarly research for my book, I paid a visit Friday evening to the local university psychology library to track down the 1961 edition of the British Journal of Medical Psychology (BJMP). It was well worth the trip. Almost the entire journal that year was devoted to the subject of schizophrenia, reminding me once again that schizophrenia used to be the exciting and perplexing main focus of psychiatric research. Coincidentally, 1961 was also the year that Carl Jung died, and there was a nice tribute to him in the Journal that singled out his interest in schizophrenia

In one study, mothers of schizophrenics were subjected to a battery of Rorschach tests, word association tests and were interviewed by a psychiatrist. He reports: "The speech of most of the group was so rapid and spontaneous as to be irrelevant and incomprehensible. In these cases the subjects moved from one topic to another with bewildering rapidity, their replies invariably being irrelevant to the questions asked."

Elsewhere in the article she is described as controlling, manipulative, sexually frigid, and unable to remember exactly when her child began and ended toilet training.

Flipping through the 1961 edition, the peculiarities of the mother are a running theme. The descriptions of her are stereotypical of women at that time and the British woman in particular. These days with reality television and Essex girls, one has the distinct impression that all British women are sexually available and flaunting it. Not so back then. Post-war Britain was a fairly grim, repressed place. The BJMP bequeaths such nuggets as the mothers confiding to the interviewer that they couldn't stand their husbands "pawing and slobbering" over them for sex. Several mothers tried to ingratiate themselves with the interviewer by asking him personal questions and bringing him restorative "tonics" over the course of several meetings. One mother confided that her husband was such a non-entity that she almost dusted him, too, when she hoovered and cleaned the house.

The BJMP is a telling snapshot of the prevailing attitudes to women at the time perpetuated by a male psychiatrist, a British psychiatrist at that. It is also possible that the findings tell us more about the psychiatrist than the mothers. What background did he come from? Was he a product of the British public school system, removed from his mother and sent to an all male boarding school at the age of six or eight, thereafter forever frightened of women? Were his own parents talkative or was the only sound heard at dinner the clanking of eating utensils on the plate?

The study findings can also be viewed as a commendable attempt to understand the problems of schizophrenia by interviewing someone (the mother) who is a major influence on the child's early development. Nowhere in the 1961 Journal did I read anything about medication. The efforts were to link the family situation to the deep personal problems of the patients. There was an interesting anecdote of a woman who had been confined for years to a mental institution. It was only when she had to change institutions and came under the influence of the lively, warm woman who ran the nursing home where she found herself, that three months later she just up and left, beginning a active new life of volunteer work and complete recovery.

The prevailing negative attitude towards the mother (and fathers, too) lasted until the first generation of antipsychotics allowed patients to leave the institutions in greater numbers in the 1960s and 1970s. As this occurred, it became no longer acceptable to link the parents to the problems of the child. There are several reasons for this. One reason is that psychiatrists no longer had easy access to a pool of research subjects. Two, as a parent, I might prefer to believe that my child's problems were biochemical in origin, as the drug companies maintained, rather than worry that I had ruined my child through improper toilet training or being sexually frigid or being myself a diluted schizophrenic. Third, the woman's movement challenged just about everything that had been written and said about women.

I am not so sure that psychiatrist's attitudes changed about the parents, and the mother in particular. Scratch beneath the surface of psychiatrists' beliefs, and I think this is where you will find that the attitude to the mother hasn't changed. After all, once they come into regular contact with the relatives of their patients, they are going to judge them. Like most mothers of mentally ill children, I no doubt come across to a doctor as protective, worried and manipulative. I am not there to win a popularity contest with them, and they will judge me accordingly. Institutional psychiatrists may be less judgmental as they are preoccupied with titrating the medications and barely have time for the patients, let alone studying their families. The research money is in studying the medications, so the spotlight has shifted away from the family environment as an indicator of schizophrenia.

For comparison with the 1961 BJMP, I will look into the more recent editions to see where its scholarly research is now focused. I am sure it will not make for such entertaining reading.
Andrew McGhie, A comparative study of the mother-child relationship in schizophrenia I. The interview, pp 201 Br. J. Med. Psychol. (1961), 34, 195

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