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Parents might unconsciously communicate their own unresolved trauma to their children.

Those children might communicate their parent's distress in psychiatric symptoms.

Trauma and adversity may travel through generations unless deliberately interrupted.

One of the challenges that analytic writers have with sharing their ideas about serious mental health diagnoses with a lay audience is that many parents of those with diagnoses of mental illness may be part of that audience. Those family members are trying to learn more about their child’s illness, and are often desperate for new perspectives.

However, from a psychoanalytic perspective, there is no way to talk about more serious psychiatric presentations without taking into account a patient’s childhood difficulties with their parents. How can we write about these important topics, these formative years, without sounding like the analysts of old discussing “schizophrenogenic mothers”, “refrigerator mothers”, and the “double bind”?

This is where biological psychiatry has a significant edge on analytic formulations of serious mental illness. Biological psychiatry places the blame squarely on a “bad brain” – bad genetics, bad neurotransmitters, bad wiring. This alleviates parents and patients alike of any personal contribution to suffering, and allows parents to unambivalently commit themselves to helping their child without worry of being blamed by the providers. In contrast, analysts like myself can’t help but notice common patterns among families who have children with psychotic organizations. And we feel that at least some of the etiology for psychosis lies in these disturbed relationships. But to say this to an audience made up of family members feels dangerous or even cruel.

And yet, when I am working with these families, I don’t feel blame. I feel empathy and........

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