Reframing in the Aetiology of Schizophrenia

Reframing in the Aetiology of Schizophrenia
A Brief Summary

The following patterns were published by Bateson and the Palo Alto group and are commonly referred to in the writings by the anti-psychiatry writers.

The essay “The Double Bind: The Intimate Tie Between
Behavior and Communication
” by Patrice Guillaume available on the web is well worth a read as is the excellent book, “Pragmatics of Human Communication” by Paul Watzlawick et al.

The primary basis is that of the “double bind” a theory proposed by Bateson et al and can be found in “Steps Towards an Ecology of Mind.”

1. Change of Frame.

No match in the content of the reply. A number of years ago I was working on a children’s orthopaedic unit (nursing) and was amazed at how often the nurses would use what they called ‘Distraction Therapy’ on the kids when they were distressed. For example, a crying baby would be distracted by some jangling keys, a child crying for his absent mother would be advised to go and watch television, a teenager complaining of boredom would be told to go and do his homework etc. In short, the responses of the nurses frequently offered no match whatsoever to the child’s frame and the mismatching appeared (to me, at least) to increase the more unpopular the child was (especially those labelled with ‘Behavioural Problems) (see below: Status Disqualification)

From Patrice’s article:

Son: “Can we go to the park to play soccer?”
Father: “What a beautiful day for working in the garden.”

Reading Bradford Keeney’s work on “recursive frame analysis” is an excellent reader on this type of reframing. This kind of mismatch frequently occurs accidentally where the two communicators have their own mental preoccupations and are not really listening to each other.

Ever that that experience where you feel that you and the other person are having two completely different conversations? This reframing is only really schizophrenogenic if the conditions for the double bind are in place.

As in the following scene:

Son: “Can I have a sweet?
Mother: “You never consider what it is that I want!”

2. Sleight of Mouth.

The frame begins the same but switches to a different frame. (See Robert Dilts work on “Sleight of Mouth Patterns” for more on this)

Son: “I’m going to go to bed, I’m very tired.”
Mother: “Yes, I know, you have been grouchy all day.”

And from Patrice’s paper:

Daughter: “We have always gotten along well.”
Mother: “Yes, I’ve always loved you…”

I believe that variations on the next example are a very commonly occurring negative sleight of mouth reframe.

Son: “I’m sad”
Father: “Well, you would be. If only you would be more grateful for what you have! Not every child is as lucky as you are!”

In the above example, possibly on repeated exposure, the child can begin to associate his feeling of “sad” to what his parent defines as “ingratitude”.

A variation on this is the reframe of:

(Child is angry) Mother: “Those are not feelings that I brought up any child of mine
to have!”

3. Literalisation.

The words of the child are taken at a literal level so that the frame is switched. A favourite
technique of lawyers and politicians in order to make the opponent look silly. The technique basically involves reflecting back the other person’s language and switching the meaning of his intention by pivoting on a single word that possesses more than one meaning. Immensely frustrating, especially when caught in the ‘one down’ position.

Son: “You are always treating me like a child.”
Father: “But you are my child.”


Son: “I didn’t think that you would mind.”
Father: (interrupting) “That’s your problem, YOU NEVER THINK!”


Son: “Well, the funny thing is that….”
Father: “There is nothing funny about it!”

Frequently the syntax and grammar of words used in children’s subcultures have the opposite or starkly different meaning to that word when used in the adult world at large. The ability of the child to adapt to both peer environments of that of his friends and that of his adult peers will affect these reframes.

Daughter: “…but I have never slept with Billy.”
Mother: “No, but you have probably had sex with him!”

4. Status disqualification.

This method is the most common one I find used in the psychiatric settings by the healthcare ‘professionals’ The most common version on this is the classic:

Patient: “I’m really mad at the way you are all treating me.”

Classically, the patient will find himself being offered madication in order to calm down,
a reframe and sleight of mouth as well as a status disqualification. Often the reframe is not verbal or explicitly made and is done in the ‘patients best interests’. A classic by-product of ‘being professional’ where the patient’s behaviours and communications are framed into the textbook descriptions of how a schizophrenic should appear and should be – he is no longer a person, he is a diagnostic description, or in Laing’s terms he becomes a “non-person”.

Replies can go along the lines of:

Nurse: “You are not really mad, this is just the illness making you feel this

Or the syntax can be pivoted on the word “mad” from meaning “angry” into meaning “Insane” as in:

Nurse: “Of course you are mad, that is why you are here in the hospital.”

Or it can be framed as: “Then it is time for a review of your madication.”

Then, just to cap it all, later on in the shrink’s office during a team review meeting the shrink can say something like:

Nurse: “Now John, How are you feeling?? Is the madication helping at all, after
all, I hear you have been a little agitated?”

Another great example from Patrice’s article:

Mother: “I have observed that he doesn’t play very well with the other children.”
Son: “But I do, Mama!”
Mother: “He doesn’t realize because he is so little …”

In psychiatry and therapy, this is the classic game of “blame-the-patient-for-the-therapeutic-failures.’ The Status Disqualification reframe is again not necessarily explicit and can be embedded by the 7 features of the double bind (where the ‘victim’ no longer
needs to experience the full double bind process each time as they are already set into the
communication paradigms by repeated exposure and rehearsal.)

One of my favourites that I have observed in many formats is the classic:

Son: “I’m sad!”
Father: “Don’t be so silly, what on earth have YOU got to be sad about?”

In this example, the child is being both dismissed for expressing an emotion and told that he is silly for doing so. Now he is both sad and silly for being so. His emotions are also brought into question by the use of the word “you” in a way that marks him out as being different from the rest of the crowd and general hoi polloi. Another variation on the reframe is that of superior knowledge. Another from Patrice’s article:

Daughter: “I get along well with everybody.”
Mother: “With everybody, Cathy?”

I was representing a patient at a tribunal hearing against his compulsory treatment order. The guy was competently outlining to the psychiatric tribunal panel his future hopes and wishes and why he felt that he should be released from compulsory detention and forced madication.

His elderly mother told me afterwards:

“I just know how sick he is, my son would never have wanted to do those things he said.
He’s such a quiet boy usually when he is well.”

The patient was 49 years old.