Survival dilemmas: Case study of an adult child of a schizophrenic parent

This article describes aspects of the treatment of an adult child of a schizophrenic parent. Many theories on irrationality in the family setting illuminate the range of impingement on the child's reality when a parent is disturbed in this way. Current research has absorbed itself in interpretations of data on risk, vulnerability, disorder, and early trauma, which have implications for prevention as well as therapeutic treatment of the adult survivor. Profound effects on Ms. P's early development are elaborated in the therapy, in which the treatment stance is influenced by Kohut's theories of the self, particularly as applied to the establishment within the holding environment of specific transferences that facilitate reconstructive work.