Theodore Lidz
Encyclopedia
Theodore Lidz was an American psychiatrist
best known for his articles and books on the causes of schizophrenia
and on psychotherapy
with schizophrenic patients. An advocate of research into environmental causes of mental illness
, Lidz was a notable critic of what he saw as a disproportionate focus on biological psychiatry
.
. After two years of medical internship at Yale-New Haven Hospital
, he became an assistant in neurology at National Hospital, Queen's Square in London. He took his residency in psychiatry at Johns Hopkins University
. It was while studying there with Adolf Meyer
that Lidz learned to examine personal history and experience as sources of psychotic as well as neurotic disorders.
During his residency, Lidz met Ruth Maria Wilmanns, a German-born psychiatrist who had fled the Nazi regime in 1934 and arrived at Johns Hopkins in 1937. They were married in 1939, and they shared their professional interests in psychiatry as well as a love of art until her death in 1995.
In January 1942, Lidz enlisted in the Army and served in New Zealand
, Fiji
and Burma. In Fiji, as the hospital's only psychiatrist, he had several hundred psychiatric casualties from Guadalcanal
in his personal care.
Returning to Johns Hopkins in 1946, he became chief of the psychiatric section of the Department of Medicine and initiated research on psychosomatic conditions. At the same time, he followed Ruth Lidz into psychoanalytic training in the Washington-Baltimore Institute, where they studied with Harry Stack Sullivan
and Frieda Fromm-Reichmann
. With Ruth Lidz, he conducted a study of psychiatric troubles among parents of patients hospitalized for schizophrenia. The resulting article documented a high rate of psychiatric disturbance, although not of schizophrenia
itself, among the parents (reference cited below). The paper provided the starting point for Lidz's later studies.
In 1951, Lidz moved to Yale
as professor and chief of clinical services in psychiatry and to build the Department of Psychiatry. With Stephen Fleck
and other collaborators, he launched a long-term study comparing 17 schizophrenic patients and their families with 17 non-schizophrenic hospitalized patients and their families. By the late 1950s, the research group published the first of many articles on parental relationships associated with the emergence of schizophrenia in young adults (reference cited below).
Lidz did not consider schizophrenia to be a disease or an illness. He considered it to be a personality disorder which was a reaction to a sick organization.As psychiatric research on the causes of schizophrenia turned to patterns of genetic inheritance and functions of neurotransmitters, Lidz argued that family approaches
remained more helpful to treatment and fought the classification of schizophrenia as an incurable, lifelong condition. He studied the creativity of many artists, religious leaders and even scientists who were schizophrenic for periods in their lives. While acknowledging that contemporary medications often alleviate some symptoms of schizophrenia, he emphasized the successes that he and others had achieved with psychotherapy
. He viewed the common failure to offer long-term psychotherapy as a betrayal of schizophrenic patients.
In their book, Schizophrenia and the Family (1965), Lidz, Fleck and Alice Cornelison compiled findings of what remains perhaps the most detailed clinical study of a series of schizophrenic patients and their families.
On a 1970 trip to Fiji, the battlefields of Guadalcanal and New Guinea
, Lidz studied patients from radically different cultural backgrounds and collected indigenous artifacts. Publications followed on the significance of paranoia
when supported by beliefs in black magic
and on personality development in the context of New Guinean culture. Some years later, the Lidzes donated their collection of New Guinean artifacts to the Peabody Museum of Natural History at Yale.
Although formally retired in 1978, Lidz continued to treat patients, lecture and publish into the mid-1990s. In his latter years, he expressed regret that he could not write one more book to argue that biology-based lines of research and training in current psychiatry are, as he said, "barking up the wrong tree."
His textbook The Person has been widely used in courses on personality development at schools of medicine, nursing and social work, and in graduate programs in psychology.
Theodore Lidz died in 2001 at the age of 90.
Lidz illustrates his point with the “skewed” N. family. When he interviewed Mr. and Mrs. N., Mrs. N. dominated the interviews even when the questions were directed expressly to her husband. Though very efficient in his profession, Mr. N. felt he did not know anything about how to raise the children and relegated all judgment on family affairs to his wife. But his behavior transcended mere passivity. Dr. Lidz observed that Mr. N. behaved as a spokesman
of his wife; he paraphrased her demands and questions. His wife “tended to treat him as a child”. Lidz concludes:
Lidz noted that schizophrenogenic mothers manage to be impervious to the needs and wishes of other family members. “As her psychotic or very strange concepts remain unchallenged by the husband, they create reality within the family”. Dr. Lidz calls this phenomenon folie à deux, a shared delusion between two parents. And if the delusional ideas of the dominant parent are shared by all family members, the result is a folie en famille.
Lidz criticised a culture of blame against schizophrenogenic mothers, however, writing:
As the mainstream psychiatric field embraced biological psychiatric techniques, the concept of the “schizophrenogenic mother” lost credibility in the profession. There are still some professionals
, however, who believe that traumatogenic modes of parenting cause psychosis.
"...I think surgery has no place except maybe in some extraordinary condition, I don't think we know enough about lobotomy to say with perfect certainty. In the department as a whole, I don't think there have been any in the 20 years I have been here. Shock treatment may have some value in acute disturbances where the patient is apt to injure himself and nobody can make contact, but this is a rare occurence." (Lidz, 1971)
Psychiatrist
A psychiatrist is a physician who specializes in the diagnosis and treatment of mental disorders. All psychiatrists are trained in diagnostic evaluation and in psychotherapy...
best known for his articles and books on the causes of schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
and on psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
with schizophrenic patients. An advocate of research into environmental causes of mental illness
Trauma model of mental disorders
Trauma models of mental disorders emphasize the effects of psychological trauma, particularly in early development, as the key causal factor in the development of some or many psychiatric disorders .Trauma models are typically founded on the view that traumatic experiences...
, Lidz was a notable critic of what he saw as a disproportionate focus on biological psychiatry
Biological psychiatry
Biological psychiatry, or biopsychiatry is an approach to psychiatry that aims to understand mental disorder in terms of the biological function of the nervous system. It is interdisciplinary in its approach and draws on sciences such as neuroscience, psychopharmacology, biochemistry, genetics and...
.
Biography
Born in New York City and raised on Long Island, Lidz attended Columbia College and the Columbia University College of Physicians and SurgeonsColumbia University College of Physicians and Surgeons
Columbia University College of Physicians and Surgeons, often known as P&S, is a graduate school of Columbia University that is located on the health sciences campus in the Washington Heights neighborhood of Manhattan...
. After two years of medical internship at Yale-New Haven Hospital
Yale-New Haven Hospital
Yale-New Haven Hospital , Connecticut's largest hospital with 966 beds, is located in New Haven, Connecticut.The hospital is owned and operated by the Yale New Haven Health System, Inc...
, he became an assistant in neurology at National Hospital, Queen's Square in London. He took his residency in psychiatry at Johns Hopkins University
Johns Hopkins University
The Johns Hopkins University, commonly referred to as Johns Hopkins, JHU, or simply Hopkins, is a private research university based in Baltimore, Maryland, United States...
. It was while studying there with Adolf Meyer
Adolf Meyer (psychiatrist)
Adolf Meyer, M.D., LL.D., , was a Swiss psychiatrist who rose to prominence as the president of the American Psychiatric Association and was one of the most influential figures in psychiatry in the first half of the twentieth century...
that Lidz learned to examine personal history and experience as sources of psychotic as well as neurotic disorders.
During his residency, Lidz met Ruth Maria Wilmanns, a German-born psychiatrist who had fled the Nazi regime in 1934 and arrived at Johns Hopkins in 1937. They were married in 1939, and they shared their professional interests in psychiatry as well as a love of art until her death in 1995.
In January 1942, Lidz enlisted in the Army and served in New Zealand
New Zealand
New Zealand is an island country in the south-western Pacific Ocean comprising two main landmasses and numerous smaller islands. The country is situated some east of Australia across the Tasman Sea, and roughly south of the Pacific island nations of New Caledonia, Fiji, and Tonga...
, Fiji
Fiji
Fiji , officially the Republic of Fiji , is an island nation in Melanesia in the South Pacific Ocean about northeast of New Zealand's North Island...
and Burma. In Fiji, as the hospital's only psychiatrist, he had several hundred psychiatric casualties from Guadalcanal
Guadalcanal
Guadalcanal is a tropical island in the South-Western Pacific. The largest island in the Solomons, it was discovered by the Spanish expedition of Alvaro de Mendaña in 1568...
in his personal care.
Returning to Johns Hopkins in 1946, he became chief of the psychiatric section of the Department of Medicine and initiated research on psychosomatic conditions. At the same time, he followed Ruth Lidz into psychoanalytic training in the Washington-Baltimore Institute, where they studied with Harry Stack Sullivan
Harry Stack Sullivan
Harry Stack Sullivan was a U.S. psychiatrist whose work in psychoanalysis was based on direct and verifiable observation .-Life and works:Sullivan was a child of Irish immigrants and allegedly grew up in an...
and Frieda Fromm-Reichmann
Frieda Fromm-Reichmann
Frieda Fromm-Reichmann was a German psychiatrist and contemporary of Sigmund Freud who emigrated to America during World War II.-Life and work:...
. With Ruth Lidz, he conducted a study of psychiatric troubles among parents of patients hospitalized for schizophrenia. The resulting article documented a high rate of psychiatric disturbance, although not of schizophrenia
Schizophrenia
Schizophrenia is a mental disorder characterized by a disintegration of thought processes and of emotional responsiveness. It most commonly manifests itself as auditory hallucinations, paranoid or bizarre delusions, or disorganized speech and thinking, and it is accompanied by significant social...
itself, among the parents (reference cited below). The paper provided the starting point for Lidz's later studies.
In 1951, Lidz moved to Yale
YALE
RapidMiner, formerly YALE , is an environment for machine learning, data mining, text mining, predictive analytics, and business analytics. It is used for research, education, training, rapid prototyping, application development, and industrial applications...
as professor and chief of clinical services in psychiatry and to build the Department of Psychiatry. With Stephen Fleck
Stephen Fleck
Stephen Fleck was a professor in the Psychiatry and Epidemiology and Public Health Departments at the Yale University School of Medicine from 1953 to 1983 and professor emeritus from 1983 until his death....
and other collaborators, he launched a long-term study comparing 17 schizophrenic patients and their families with 17 non-schizophrenic hospitalized patients and their families. By the late 1950s, the research group published the first of many articles on parental relationships associated with the emergence of schizophrenia in young adults (reference cited below).
Lidz did not consider schizophrenia to be a disease or an illness. He considered it to be a personality disorder which was a reaction to a sick organization.As psychiatric research on the causes of schizophrenia turned to patterns of genetic inheritance and functions of neurotransmitters, Lidz argued that family approaches
Child abuse
Child abuse is the physical, sexual, emotional mistreatment, or neglect of a child. In the United States, the Centers for Disease Control and Prevention and the Department of Children And Families define child maltreatment as any act or series of acts of commission or omission by a parent or...
remained more helpful to treatment and fought the classification of schizophrenia as an incurable, lifelong condition. He studied the creativity of many artists, religious leaders and even scientists who were schizophrenic for periods in their lives. While acknowledging that contemporary medications often alleviate some symptoms of schizophrenia, he emphasized the successes that he and others had achieved with psychotherapy
Psychotherapy
Psychotherapy is a general term referring to any form of therapeutic interaction or treatment contracted between a trained professional and a client or patient; family, couple or group...
. He viewed the common failure to offer long-term psychotherapy as a betrayal of schizophrenic patients.
In their book, Schizophrenia and the Family (1965), Lidz, Fleck and Alice Cornelison compiled findings of what remains perhaps the most detailed clinical study of a series of schizophrenic patients and their families.
On a 1970 trip to Fiji, the battlefields of Guadalcanal and New Guinea
New Guinea
New Guinea is the world's second largest island, after Greenland, covering a land area of 786,000 km2. Located in the southwest Pacific Ocean, it lies geographically to the east of the Malay Archipelago, with which it is sometimes included as part of a greater Indo-Australian Archipelago...
, Lidz studied patients from radically different cultural backgrounds and collected indigenous artifacts. Publications followed on the significance of paranoia
Paranoia
Paranoia [] is a thought process believed to be heavily influenced by anxiety or fear, often to the point of irrationality and delusion. Paranoid thinking typically includes persecutory beliefs, or beliefs of conspiracy concerning a perceived threat towards oneself...
when supported by beliefs in black magic
Black magic
Black magic is the type of magic that draws on assumed malevolent powers or is used with the intention to kill, steal, injure, cause misfortune or destruction, or for personal gain without regard to harmful consequences. As a term, "black magic" is normally used by those that do not approve of its...
and on personality development in the context of New Guinean culture. Some years later, the Lidzes donated their collection of New Guinean artifacts to the Peabody Museum of Natural History at Yale.
Although formally retired in 1978, Lidz continued to treat patients, lecture and publish into the mid-1990s. In his latter years, he expressed regret that he could not write one more book to argue that biology-based lines of research and training in current psychiatry are, as he said, "barking up the wrong tree."
His textbook The Person has been widely used in courses on personality development at schools of medicine, nursing and social work, and in graduate programs in psychology.
Theodore Lidz died in 2001 at the age of 90.
"Schizophrenogenic parents"
In the books Schizophrenia and the Family and The Origin and Treatment of Schizophrenic Disorders Lidz and his colleagues explain their belief that parental behaviour can result in mental illness in children:- In [such] families the parents were rarely in overt disagreement, and the family settings were reasonably calm. But, as we studied these seemingly harmonious families, it became apparent that they provided a profoundly distorted and distorting milieuMilieuMilieu is the word for environment in French, and, for hundreds of years, also in Dutch, Swedish, English, and other languages that were strongly influenced by French culture and French language, primarily during the 17th and 18th centuries....
because one spouse passively acceded to the strange and even bizarre concepts of the more dominant spouse concerning child rearing and how a family should live together. We termed the seemingly harmonious ones as “skewed”.
Lidz illustrates his point with the “skewed” N. family. When he interviewed Mr. and Mrs. N., Mrs. N. dominated the interviews even when the questions were directed expressly to her husband. Though very efficient in his profession, Mr. N. felt he did not know anything about how to raise the children and relegated all judgment on family affairs to his wife. But his behavior transcended mere passivity. Dr. Lidz observed that Mr. N. behaved as a spokesman
Spokesman
A spokesperson or spokesman or spokeswoman is someone engaged or elected to speak on behalf of others.In the present media-sensitive world, many organizations are increasingly likely to employ professionals who have received formal training in journalism, communications, public relations and...
of his wife; he paraphrased her demands and questions. His wife “tended to treat him as a child”. Lidz concludes:
- Mrs. N. was clearly a very difficult and disturbed woman who despite her fluid self-boundaries […] seemed to retain a tenuous balance by imposing her view of the world upon the few persons significant to her, and by keeping her life and her family life confined within the narrow limits she could navigate.
Lidz noted that schizophrenogenic mothers manage to be impervious to the needs and wishes of other family members. “As her psychotic or very strange concepts remain unchallenged by the husband, they create reality within the family”. Dr. Lidz calls this phenomenon folie à deux, a shared delusion between two parents. And if the delusional ideas of the dominant parent are shared by all family members, the result is a folie en famille.
Lidz criticised a culture of blame against schizophrenogenic mothers, however, writing:
- I also find it very distressing that because the parents’ attitudes and interactions are important determinants of schizophrenic disorders, some therapists and family caseworkers treat parents as villains who have ruined the lives of their patients.
As the mainstream psychiatric field embraced biological psychiatric techniques, the concept of the “schizophrenogenic mother” lost credibility in the profession. There are still some professionals
Anti-psychiatry
Anti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...
, however, who believe that traumatogenic modes of parenting cause psychosis.
Ethics
In his professional career, Theodore Lidz objected to the overuse and often misuse of shock treatment, chemotherapy and surgery in the treatment of schizophrenia, believing that such methods had no place except in an "extraordinary condition"."...I think surgery has no place except maybe in some extraordinary condition, I don't think we know enough about lobotomy to say with perfect certainty. In the department as a whole, I don't think there have been any in the 20 years I have been here. Shock treatment may have some value in acute disturbances where the patient is apt to injure himself and nobody can make contact, but this is a rare occurence." (Lidz, 1971)
See also
- Silvano ArietiSilvano ArietiSilvano Arieti was a psychiatrist regarded in his time as one of the world’s foremost authorities on schizophrenia. He received his M.D. from the University of Pisa but left Italy soon after because of Benito Mussolini's increasingly racial policies...
- R.D. Laing
- Lloyd deMauseLloyd deMauseLloyd deMause, pronounced de-Moss , is an American social thinker known for his work in the field of psychohistory. He did graduate work in political science at Columbia University and later trained as a lay psychoanalyst...
- Alice MillerAlice Miller (psychologist)Alice Miller née Rostovski was a psychologist and world renowned author, who is noted for her books on child abuse by their own parents, translated in several languages...
- Stephen FleckStephen FleckStephen Fleck was a professor in the Psychiatry and Epidemiology and Public Health Departments at the Yale University School of Medicine from 1953 to 1983 and professor emeritus from 1983 until his death....
- Anti-psychiatryAnti-psychiatryAnti-psychiatry is a configuration of groups and theoretical constructs that emerged in the 1960s, and questioned the fundamental assumptions and practices of psychiatry, such as its claim that it achieves universal, scientific objectivity. Its igniting influences were Michel Foucault, R.D. Laing,...
- Trauma model of mental disordersTrauma model of mental disordersTrauma models of mental disorders emphasize the effects of psychological trauma, particularly in early development, as the key causal factor in the development of some or many psychiatric disorders .Trauma models are typically founded on the view that traumatic experiences...
- Interpretation of Schizophrenia