Expressed emotion in families : its significance for mental illness / Julian Leff, Christine Vaughn.

  • Leff, Julian P.
Date:
[1985], ©1985
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Licence: Attribution-NonCommercial 4.0 International (CC BY-NC 4.0)

Credit: Expressed emotion in families : its significance for mental illness / Julian Leff, Christine Vaughn. Source: Wellcome Collection.

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    The Discovery of Expressed Emotion: Induction or Deduction? 9 While I would not rule out the usefulness of such data dredging in some desperate situation, I suspect that a more prudent approach is required — one in which the investigator has at least had an intimate role in collecting the data (Glaser and Strauss suggest using someone else's material for their exercise), and in which this is allowed to guide the search to some degree, rather than the scanning of the innumerable class tabulations involved in data dredging. However, whatever degree of preparedness the investigator brings to the data, it is easy to see how the course of the research is bound to be closely caught up with the level of personal confidence the investigator has in the significance of the sense of puzzlement I have emphasized. This is not the confidence that comes from meeting formal methodological or statistical criteria, though these may contribute to it; it is a much more personal belief about whether or not the anomaly is worth pursuing. Moreover, confidence is likely to center on an essentially economic issue: Should scarce time and money be spent in pursuing the anomaly, or should resources be allocated elsewhere? The issue of truth may at this point play a quite subsidiary role. The fact that the initial research dealing with expressed emotion and schizophrenia spanned a 12-year period and involved three substantial proj¬ ects, employing a number of workers, underlines the importance of the straightforward issue of the cost. An issue highlighted by the tradition of the MRC Social Psychiatry Unit to which I belonged was that all research work¬ ers, whatever their seniority, should be intimately involved in collecting re¬ search material, whether in the laboratory or in the field. The first study was of discharged chronic male patients who happened, against all odds, to have left the hospital, was begun in 1956, and was carried out in collaboration with Morris Carstairs and Gillian Topping. The second, begun in 1959 with Morris Carstairs, Elizabeth Monck, and John Wing, looked at what happened to schizophrenic male patients who left the hospital after any length of stay; in terms of such an economic perspective, it was the most critical of the three projects. It was by no means a foregone conclusion that the resources for an expensive prospective study, in which patients and their families were seen both at discharge and a year later, would be available. The final study, begun in 1967 with Jim Birley, John Wing, Judy Clarke, Rita Lang, Margaret Ray- field, and Susan Reid, had been preceded by 2 years devoted to the develop¬ ment of new measures of family life. Although the final prospective study demanded considerable resources, by then the momentum of the program made it relatively easy to justify. The term expressed emotion was comparatively late in emerging. In the accounts of the first study, we simply concluded that it might not always be a good thing for a male schizophrenic patient to return to the close ties of parent or wife. In the second study, we used the term high emotional in¬ volvement; the more neutral term expressed emotion was not formulated