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Fam Proc 10:365-372, 1971

ABSTRACTS
Anthony, E., The Impact of Mental and Physical Illness on Family Life, Am. J. Psychiat., 127, 138-146, 1970.
In a sample of schizophrenics, manic-depressive and patients with tuberculosis, the author attempted to assess the impact of
their illness on the family. Method was to live with the family for a week; number of families is unspecified. Following
emotional illness, there is a disruption in family members and the family as a whole, followed by re-integration or
disintegration, depending on the family's pre-morbid adjustment, the previous so-cioeconomic and cultural level, as well as
the severity of the illness. Medical illness creates a fear of "contamination" and this causes subsequent disturbances in the
interpersonal relationships.
Bell, J. and Bell, E., Family Participation in Hospital Care for Children, Children, 17, 154-157, 1970.
This is a report of the authors' experiences visiting hospitals in Africa and in Asia in order to determine the role of the
family when a member is hospitalized. The more modern the facility, the less involved the family was with the patient. The
more involved the family was, the more psychologically secure were both patient and family.
Birdwhistell, R., The Idealized Model of the American Family, Soc. Casework, 51, 195-198, 1970.
This clinical essay focuses on the notion that the American family is organized around idealized goals (e.g., romanticized
love) that are unobtainable, thus leading to a sense of hopelessness and failure in the parents. It is hypothesized that these
feelings contribute to psychopathology in all members of the family. The author suggests that to improve health in the
family, the impossible goals must be unmasked.
Cohen, M., Freedman, N., Engelhardt, D. and Margolis, R., Family Interaction Patterns, Drug Treatment, and
Change in Social Aggression, Arch. Gen. Psychiat., 19, 50-56, 1968.
This study hypothesizes that family interaction patterns can be changed by the use of phenothiazine medication. The sample
was 126 schizophrenic patients, 18 to 48 years of age, who were attending an outpatient clinic for at least three months. A
randomized, double blind assignment to chlorpromazine, promazine, or a placebo was made and a social behavior
interview was given at the end of three months, focusing on the measure of conflict and tension in the home. Results
indicated that the most significant decrease in aggression occurred among the chlorpromazine-treated patients from low
conflict and low tension homes. Regardless of treatment, there was no change in social aggression in patients from high
conflict and tension homes. These results were interpreted as meaning that phenothiazines will significantly reduce patients'
aggressive behavior when the behavior is dissonant with family interactional patterns.
Framo, J., Symptoms from a Family Transactional Viewpoint, in Nathan W. Ackerman, (Ed.) Family Therapy in
Transition, Little Brown and Comapny, 125-171, 1970.
This is a clinical essay using numerous case examples to make the point that psychiatric symptoms are a manifestation of a
change in family homeostasis, as well as of conflict, intrapsychically and interactionally. Symptom choice, maintenance and
reduction of symptoms, as well as sharing and exchange of symptoms, are discussed.
Goodwin, H. M. and Mudd, E. H., Marriage Counseling: Methods and Goals, Comp. Psychiat., 7, 450-461, 1966.
This clinical essay on marriage counseling covers values in the contemporary marriage and basic concepts, indications,
goals, structure and process, and the future of counseling practice. Marital counseling is most effective in an unpressured,
unaccusing atmosphere in which can take place give and take, catharsis, new perspectives, and the supportive efforts of
new and mutually acceptable interaction patterns.
Harper, R., Marriage Counseling as Rational Process-Oriented Therapy, J. Ind. Psychol., 16, 197-207, 1970.
This is an essay based on the point of view that marriage counseling is "synonymous with" psychotherapy. Both lead to
"revision of interpersonal dynamics." Major processes and techniques in marriage counseling are discussed and compared

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to similar processes in psychotherapy.


Hoek, A. and Wollstein, S., Conjoint Psychotherapy of Married Couples: A Clinical Report, Int. J. Soc. Psychiat., 12,
209-216, 1966.
This is a clinical report of 30 cases in which the identified patient and spouse were treated conjointly by co-therapists.
Indications, objectives, treatment focus, type of cases, clinical findings, and a case illustration are presented in support of
this method of treatment. No results are reported.
Kempler, W., Family Therapy of the Future, Int. Psychiat. Clinics, 6, 135-158, 1969.
This is an essay on what family therapy will be like "in the future." Psychotherapy will be experiential. The orientation will
shift from "objective-individual" to "subjective-interpersonal," and the focus will be on the present, on what is happening at
this particular moment. There will be no such thing as diagnosis.
Kossoris, P., Family Therapy; An Adjunct to Hemodialysis and Transplantation, Am. J. Nursing, 70, 1730-1733,
1970.
This is a clinical paper pointing out that the stresses associated with renal dialysis and transplantation create symptoms in
not only the patient, but his family. Family therapy has been useful in the treatment of such symptoms.
Kritzer, H. and Pittman, F. S., Overnight Psychiatric Care in a General Emergency Room, Hosp. Community Psych.,
19, 303-306, 1968.
This is a clinical article reviewing the experience with 36 psychiatric patients who came to the emergency room because of
a crisis. As alternatives to inpatient hospitalization, overnight hospitalization and the emergency room were used. Rationale
was that the presenting problem was often a manifestation of underlying family problems and by temporarily relieving the
crisis and working out the future management inpatient hospitalization could be avoided. Results indicated that of 36
patients, 11 were essentially sent to a psychiatric hospital, 22 were discharged directly from the emergency room, and 3
signed out against medical advice.
Liss, J. and Sharma, C., Multi-Generational Dynamics in a Case of Ulcerative Colitis, The Psychiat. Quart., 44,
461-475, 1970.
One case is presented in support of the notion that ulcerative colitis is an illness due to family pathology. In this case, the
symptoms reflected "threatened loss of the symbiotic relationship with the mother." There is a review of the literature of
ulcerative colitis.
McKinley, C., Ritchie, A., Griffin, D. and Bondrant, W., The Upward Mobile Negro Family in Therapy, Dis. Nerv.
Syst., 31, 710-718, 1970.
This is a report of treatment using multiple impact therapy on three "middle class" black families. The identified patients
were acting out male children, who were considered to be "severely disturbed." Although the families were intact, they
were found to be grossly disorganized and chaotic with the primary dynamic being a power struggle between the mother
and father. Results of treatment indicated that the presenting symptoms of the identified patient could be alleviated and
relationships among siblings improved. It was not possible, however, to change the "destructive relationship" between the
parents. The "role reversal" technique of psycho-drama was one of the more effective techniques utilized.
Messer, A., The "Phaedra Complex," Arch. Gert. Psychiat., 21, 213-218, 1969.
This is a case report centering around the dynamics of a stepparent-stepchild attraction. There is dilution of the "incest
barrier." The mother-son incest tabu is far stronger than that involving father and daughter. Inability to cope with this
potential conflict, particularly when the parents are in a disturbed or mutually frustrating relationship, can lead to problems
with the children who are often the identified patients.
Muntz, H., Thought Disorder in the Parents of Thought Disordered Schizophrenics, Br. J. Psychiat., 117, 707-708,
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1970.
In order to test the hypothesis that there is a thought disorder in the parents of schizophrenic patients, the Banister
Repertory Grid Test and the Mill Hill Vocabulary Test were given to parents of 18 schizophrenic patients with a thought
disorder and 22 without such a thought disorder (who had other psychiatric illnesses). Results in contrast to other studies
indicated that there was a significant relationship between thought disorder in the parents and thought disorder in the
children.
Palombo, S., Merrifield, J., Weigert, W., Morris, G. and Wynne, L., Recognition of Parents of Schizophrenics from
Excerpts of Family Therapy Interviews, Psychiat., 30, 405-412, 1967.
This study attempts to explore the hypothesis that a judge, other than one trained by the authors, could distinguish parents
of schizophrenics from nonschizophrenics, working only with excerpts of parental behavior taken from family therapy.
Results indicated that other judges could, but only after being trained by the authors. When the procedure for sampling
parental behavior was changed, the ability to make significant predictions was diminished.
Patterson, B., McNeal, S., Hawkins, N. and Phelps, R., "Reprogramming the Social Environment," J. Child Psychol.
Psychiat., 8, 181-185, 1967.
This is a case report of conditioning techniques used to reprogram parent and child so that they become mutually
reinforcing in contrast to conditioning the child alone. The patient was a five-year-old autistic child. Observation of the new
conditioning was done in the home. There were twelve conditioning sessions lasting from ten to twenty minutes over a
four-week period. Changes in behavior were noted.
Raybin, J., The Curse: A Study in Family Communication, Amer. J. Psychiat., 127, 617-625, 1970.
The curse is a particular type of family communication usually expressing a wish that some harm befall another family
member and often connoting that the one who curses has the magical power to cause the harm to occur. It usually spans
several generations. Four case examples are presented in support of this conceptone patient thought she was a "bad
seed," a second case involved homosexual incest, and the last two, suicidal behavior which ran through the family. Family
therapy, as well as other therapies, are recommended to treat this disorder.
Reiss, D., Individual Thinking and Family Interaction. V. Proposals for the Contrasting Character Experimental
Sensitivity and Expressive Form in Families, J. Nerv. and Ment. Dis., 151, 187-202, 1970.
Based on three previous experiments, 12 variables on family interactions and individual thinking were factor analyzed, and
results were obtained for 14 of the families in the original sample (previously reported). Variables of shared experiential
sensitivity in families were more closely and generally related, either as cause or effect to the thinking of its members rather
than to variables in expressive form.
Reiss, D. and Elstein, A., Perceptual and Cognitive Resources of Family Members, Arch. Gen. Psychiat., 24, 121-134,
1971.
Three groups of families, each consisting of a father, mother, and a hospitalized child, were tested with a battery of
perceptive and cognitive tests. Children were the identified patient. Eight had paranoid schizophrenia, eight non-paranoid,
and eight were controls with other psychiatric diagnoses. Results indicated families of schizophrenics had lower scores for
the Shipley-Hartford Abstraction Test and showed more frequent overexclusions on Epstein's Inclusion Test and substantial
reduced reversal rates on reversal figures. Schizophrenic families had an inability to discern the underlying patterns, were
rigid, and used personal rather than conventional reality in interpreting the results.
Richman, J. and White, H., A Family View of Hysterical Psychosis, Am. J. Psychiat., 127, 280-285, 1970.
Four case reports are presented of hysterical psychosis with the emphasis on familial rather than individual psychodynamics
as being etiologic. Psychotic symptoms could be understood in terms of dominant family problems, themes, myths, and
fantasies.

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Rykoff, V., Sigal, J. and Sanders, S., Patterns of Report on the Hearing of Parental Voices by Emotionally Disturbed
Children, J. Psychiat. Res., 8, 43-50, 1970.
This is a first report of a series of experiments designed to examine factors that influence the ease or difficulty with which
family members appear to hear one another. Thirty-two children with nonpsychotic mental illness were compared with a
group of their siblings, plus two other control groups. The parents read statements carrying different affects that were then
played on separate tracts on the same recording tape simultaneously into both ears of the children. The children were asked
to report on what they heard. They also completed a Parent-Child Relationship Questionnaire and a Parental Dominance
Questionnaire. Results indicated disturbed children have particularly patterns of perceiving verbal communication within
the family, and these patterns are at least partially determined by a child's perception of the parent as rewarding or
punishing.
Ryckoff, I., Day, J. and Wynne, L., Family Role Structure and Schizophrenia, Proc. 20th Ann. Meet. St. Elizabeth's
Hospital, Washington, D.C., 22-26, 1957.
Two cases are presented in support of the concept that in families of schizophrenics, individuals attempt to fit themselves
into rigid roles without trying to rework them. It is postulated that the family system has hindered ego differentiation from
which critical faculties might develop.
Sherman, S. N., Practice Implications of Psychodynamic and Group Therapy in Family Interviewing, in The Family
is the Patient, Monograph VII, National Association of Social Workers, New York, 40-47, 1965.
This is an essay stressing the importance of relating an individual symptom to the structure and interactional processes
within the family. It is useful for both diagnostic and therapeutic purposes. The therapist must take into account both
individual psychodynamics, as well as interactional processes.
Sherman, S. N., Family Treatment: An Approach to Children's Problems, Social Casework, 47, 368-372, 1966.
This is a clinical essay about the use of family therapy in cases where the identified patient is at latency age. Previously
family agencies have not used family treatment for disorders in this age group, preferring individual therapy. Family
treatment is seen as helpful in ameliorating the children's problems and is the treatment of choice over individual therapy,
especially applicable as a "first phase of treatment and to many children's problems in a working-through phase."
Sherman, S. N., Aspects of Family Interviewing Critical for Staff Training and Education, Social Review, 40,
302-308, 1966.
This essay on training of social workers stresses that conjoint family therapy interviews, rather than individual interviews,
are helpful in understanding family dynamics, as well as in treating the case. The caseworker can be prepared by group
supervision, use of films or videotapes, direct observation, and participation as cotherapist.
Simmons, R., Hickey, K., Kjellstrand, C. and Simmons, R. L., Family Tension in the Search for a Kidney Donor,
JAMA, 215, 909-910, 1971.
This is a study of family relationships at the time that donation of a kidney is needed from a family member. A series of 78
consecutive cases from a renal transplant center were reviewed. In 21, children were recipients; in the remainder, adults
were the recipients. The focus, in contrast to previous studies, was on the family unit including the non-donor. Results
indicated that children did not seem to generate the same kind of crisis in decision-making as did adult recipients. In 13 of
the 57 adult cases, significant family tensions involving potential sibling donors revealed marked mixed feelings of the
donors in conflict with family members; e.g., the spouse of the potential donor refused to let the donor donate.
Smith, R., Discussion Tasks as a Measure of Influence Structure and Reversal of Role Structure in Normal
Families. Implications for the Study of Pathological Families, J. Psychiat. Res., 8, 51-61, 1970.
Influence of communication patterns in 12 American, white, middle-class families consisting of both parents and child were
studied by recording and analyzing their interaction on decision-making tasks. Each task was oriented toward a different
member of the family or the family as a whole. The response obtained depended on the type of task used to elicit structure.

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Wynne, L. C., The Family as a Strategic Focus in Cross Cultural Psychiatric Studies, in Caudill, W. and Lin, T. (Eds.)
Mental Health Research in Asia and the Pacific, Chapter 29, Honolulu: East-West Center Press, 463-477, 1969.
This is an essay on the family as a strategic focus for cross-cultural research. The family lends itself particularly well to the
four variables of primary conceptual systems: biology, personality, social structure, and culture. The changes in patterns
between the nuclear family and the extended family are discussed, as are family communication patterns. There is a review
of the literature in this area.
Wynne, L., Methodologic and Conceptual Issues in the Study of Schizophrenics and Their Families, J. Psychiat.
Res., 6, 185-199, 1968.
This paper explores some of the conceptual and methodological issues in research studies on schizophrenic families. It also
reviews the author's previous research and describes the samples used. Because of the early stages of work in this area,
research methods have usually been worked out only after the base line data had been obtained and the plea is made to do it
the opposite way.
Wynne, L. C., Consensus Rorschachs and Related Procedures for Studying Interpersonal Patterns, J. Proj. Tech.
and Pers. Assessment, 32, 352-356, 1968.
This is a review of family research using the consensus Rorschach (a relatively standardized situation in which behavior of
two or more persons interacting with one another can be observed, recorded, and studied using Rorschach cards). The
entire family works on each card. The Family Rorschach and Spouse Rorschach have also been used. Advantages include
simplicity and clinical freedom, but there is the hazard of a lack of standardization in administration and evaluation. In
addition, the problem of degree of participation by the tester is still unsolved.
Wynne, L., Communication Disorders and the Quest for Relatedness in Families of Schizophrenics, Am. J.
Psychoanal, 50, 100-114, 1970.
Based on previous research, this is a clinical essay on communication disorders and the quest for relatedness in
schizophrenic families. Schizophrenic families tend to relate at the expense of individuality and goal-directedness. A case
example as well as previous work of Singer and Reiss are presented in support of this concept.
Zuk, G., Family Therapy, Arch. Gen. Psychiat., 16, 71-79, 1967.
This is a theoretical paper on family therapy in which the author puts forth a model that contrasts with the
"in-sight-centered" psychoanalytic model. The therapist is a "go-between" for family members, and attempts to get them to
change. Techniques of doing this, as well as the family's defensive reactions, are described.
Zuk, G., On the Theory and Pathology of Laughter in Psychotherapy, Psychotherapy, 3, 97-101, 1966.
This is an essay based on the author's previous research, some clinical work, and other notions on the meaning of laughter.
Bizarre laughter in schizophrenics, which often seems unexplainable, became clear when it was systematically studied in
the family setting. It was found to be due to a "wish to communicate information differentially to members of the family
group."Clinical uses of laughter are discussed.

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