Epilogue

This brings an already overlong work to an end. Most of the problems with which I set out have been explored and to aid their solution a new conceptual framework has been proposed.

Throughout the work I have concentrated on problems of aetiology and psychopathology, believing that it will only be when we have a good grasp of what the causes are of psychiatric disorder and how they operate that we shall be in a position to develop effective measures either for their treatment or for their prevention. My strategy has been to select one set of putative causal factors—the disruption or threatened disruption of an affectional bond—and to trace the consequences; and in doing so to identify so far as possible those other conditions that, occurring before, during or after the disruption, influence the consequences for better or worse. From an examination of the evidence, drawn from many disciplines and many lands, it has been possible to indicate how certain combinations of circumstance lead to certain forms of personality disturbance and how these affect not only the individual but almost invariably members of his family as well. Among such disturbances are to be counted many common clinical disorders, including states of anxiety and phobia, of depression and suicide, and also disturbances of parenting and marriage. Together, these are the kinds of disorder from which suffer a majority of all those who claim the attention of clinical workers in the Western world today.

Nevertheless, although disruptions of bonds, and experiences related to or consequent upon disruption, undoubtedly play a causal role in these and other conditions, we remain ignorant of how large a causal role they play and in precisely what circumstances they play it. In order to find out, continuing research, using a broad range of methods, will be necessary. Only when that is done, and the conceptual framework itself refined, elaborated and tested, shall we know how productive the enquiry described will tu