I wrote a comment about the perils of blame on the Op-Ed page at the Mad in America blog. I'm wondering if either I have got it all wrong by seeing blame in the piece where no blame was intended, or else I've rightly sensed that psychologists are publicly back to blaming family for a relative's mental illness because they are sensing a growing strength in numbers. At least one other blogger at the Mad in America site got jumped on recently for family bashing. He denied it of course, but like the Op-Ed author, he sprinkled his post with anecdotes about nasty family members of his patients. I call this kind third party relaying of a message "hear say." Perhaps it's hypocritical of me, but in my opinion, it's okay for a patient to blame a family member for his suffering (as he's 100% entitled to interpret the cause of his suffering the way he does because he knows his experience) but it's different thing for a psychotherapist to turn around and publicly make negative attributions on individuals he's probably never met outside of the therapy room. What purpose does this serve? There are ways of getting a healing message across that will not lead to charges of family bashing.
I think it's appropriate for parents and relatives to examine their role in a family member's mental illness (parents, especially), and I know how difficult it has been to get this message across in the era of no-blame antipsychotics, when parents would prefer to blame faulty biochemistry rather than venture out into more helpful ways of looking at mental illness. I do believe in personally looking in the mirror and then doing whatever it takes to changing aspects of the relationship that may have caused trauma for your relative. I do believe this and I encourage others to do the same thing because one really can help someone recover this way.
Selling the "look yourself in the mirror" message is a particular hard sell to parents because all parents feel guilty at some level about the way they have raised their children, whether there is a diagnosis of mental illness or not. Nobody likes criticism. Most people don't react well to it, unless it's done constructively. When psychiatrists or psychologists write or speak in a public forum, I believe they have a special duty to be non-inflammatory, and non-judgmental. This doesn't mean that, if they believe the family environment is an important factor in the development of mental illness, they shouldn't say so, but they should be super vigilant about how their words will be construed.
I'd like to know what you think about Albert Silver's Op-Ed piece. Is he really family bashing or have I got it wrong? I'd like to hear what you think because I believe this topic is going to become increasingly debated as psychotherapy gains ground at the expense of medications. I contributed a lengthy comment at the end of his Op-Ed in which I pointed out that there may very well be a backlash if the role of family in mental illness isn't handled constructively.