The loyalty bind and sacrifice of the self: Family treatment of adolescent schizophrenia and schizophreniform disorder from a psychodynamic-systemic perspective

This article reviews treatment of families with a schizophrenically functioning adolescent from a psychodynamic systemic perspective. Systemic and psychoanalytic conceptions of family binding and the sacrificial nature of schizophrenic dysfunction, both on an intrapsychic and interpersonal level, provide the theoretical foundation for a multi-dimensional approach to treatment. This treatment approach is predicated on reframing of the adolescent's behavior, a co-therapy model of reparenting and multi-family group therapy to resolve the separation-individuation impasse characteristic of such families. The case of a 16 year old boy and his family is used to illustrate the concepts discussed.At the time this was written the author was a family therapist with Child and Adolescent Services, Coliseum Psychiatric Hospital, Macon, Georgia. He wishes to express appreciation to Dennis Jones, Ph.D., Program Director: A. Allison Grant, M.D., Clinical Director, and the staff of the adolescent unit.