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This study from the Institute for Juvenile Research in Chicago emphasizes the unconscious gratification which the parent derives from his child's neurotic
symptoms. A number of brief examples illustrate this thesis. One mother induces her son to attack her so that she may enjoy the pain of a twisted arm; another mother unconsciously fosters and enjoys a seductive relationship between her daughter and her husband; while a third mother provokes her daughter into burning the apartment, thus vicariously acting out her own repressed wishes to kill her family by fire. In most of the examples cited, the identification of the provocative parent with the child is obvious. The authors believe that their observations cast some light on the vexing question of symptom choice and also on the origin of behavior problems in twins. In several instances they show that a parent's veiled hint, dire prediction, expressed aversion, or overanxious reaction was utilized by the child as a cue to canalize his conflicts into some typical mode of problem behavior. The parent's secret gratification accounts, in part, for the long delay between the onset of neurotic symptoms in a child and his appearance at a clinic. So long as the parent does not feel too much social pressure or too much guilt because of his child's misbehavior, the symptoms are ignored. When the guilt or social pressure increases to an uncomfortable degree, or when the child's secondary gain outweighs that of the parent, then the latter takes action. In the sets of twins who were seen, it was noted that one of the parents encouraged the expression of his own ego-syntonic impulses by one twin, and of his ego-dystonic impulses by the other. The latter twin was considered ill by the parent.
Their experiences have led Szurek and his colleagues to evolve a technique of 'collaborative therapy' in which the child is treated by one psychiatrist and the significant parent by another. This approach is not without its difficu