Understandably, parents of schizophrenics find the classification of schizophrenogenic parent offensive. No one wants to believe that they could have caused, even inadvertently, such terrible suffering in someone they love. But therapists who treat schizophrenics generally report a parenting interaction different from that usual to neurotic patients (although there are cases where relevant noxious life events have nothing to do with parents; in other cases, both parents and child are tragic victims of bad or absent professional advice). Communication deviance, measured from parental interaction, the Rorschach Inkblot Test (Rorschach, 1932), and the Thematic Apperception Test (TAT; Murray, 1943) has been found to characterize parents and adoptive parents of schizophrenics. Expressed emotion (intrusive hostility) of parents increases rehospitalization. Genetic factors, at most, represent increased vulnerability.
Pathogenesis, based on clinical observations, is measured from the TAT and is defined as the degree to which the parent, when there is a potential conflict between the needs of the child and the needs of the parent, unconsciously acts in terms of the parent's needs without regard to the potentially conflicting needs of the child. Pathogenic parents, as well as their children, are victims in the same way that any patient who suffers psychological symptoms based on unconscious factors is a victim and not a culprit. In a series of studies, mothers of normals averaged 35% pathogenic. Mothers of schizophrenics averaged 65% pathogenic. Fathers of schizophrenics are nearly as high. Most convincing are clinical observations. Clinical examples of the meaning of pathogenesis are provided.