Implications for expressed emotion therapy within a family therapeutic context

Expressed emotion instruments measure variant levels of criticism, blaming, and anger within families of mentally ill people. Some theorists believe that high levels of expressed emotion predispose schizophrenic patients for relapse. However, recent trends in family therapy indicate that high expressed emotion may naturally result from caring for an ill family member. Families may therefore often feel unfairly blamed by practitioners for causing mental illness. The author examines the usefulness of integrating expressed emotion measures into family therapy from three theoretical perspectives: the transactional perspective, the coping and adaptation perspective, and the systems perspective. Each of these perspectives provides a framework for incorporating expressed emotion measures into the broader context of research on and treatment of schizophrenia. The author postulates that appropriate controls designed to reduce pent-up emotion in families must accompany expressed emotion interventions in family therapy. Appropriate controls might include exercise, meditation, spiritual focus, or membership in a support group.