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This is a rich and humane study of the effectiveness of psychotherapy in the treatment of schizophrenia. It is enriching because the authors amply consider the controversies which continue to rage about the nature and origins of schizophrenia and present an array of useful and possible interventions.
Bertram Karon is Professor of Psychology at Michigan State University and is the Project Director at the Michigan State Psychotherapy Project. Gary VandenBos is the Director of National Policy Studies for the American Psychological Association. He lives and practices in Washington, D.C. Their point of view is that schizophrenia is a state of mental and emotional disorganization that arises from a disturbance in interpersonal relations. It is something that could happen to anyone given a period of appropriately severe stress. Karon and VanderBos are very familiar with the literature about schizophrenia, current and historical, psychodynamic and organic, and provide an excellent summary of it. They point out that the allegedly unintelligible response of the schizophrenic to his environment is quite intelligible given some basic appreciation that this person lives in a state of terror and torment. Interestingly, Karon and VandenBos take trouble not to blame parents for what happens to their psychotic offspring. However they do discuss the parental contribution and give some excellent examples of the damage that some parents can unwittingly do within the context of an extended family drama over several generations.
The authors reserve their sharpest criticisms for the genetic studies of schizophrenia, especially the twin research of Kety, Rosenthal and Wender. Karon and VandenBos show that identical twins only account for a 10% increase in the incidence of schizophrenia in adopted offspring and that this 10% can easily be accounted for by the selection procedures of the adopting parents. They ask why children whose biologic parents were schizophrenic should be more likely to