In the face of such troubling social forces, it’s hardly surprising that Freud-inspired analysts like Fromm-Reichmann rejected the idea of a biological basis of schizophrenia completely. Why should psychiatry sign on to a scientific discipline that treated humans like horses to be selected for breeding? Instead, Fromm-Reichmann believed that patients, deep down, wanted a cure—that they were waiting to be helped, like a wounded bird or a frail child in need of understanding. “Every schizophrenic has some dim notion of the unreality and loneliness of his substitute delusionary world,” she wrote. And the therapist’s mission—a high-minded undertaking that a new vanguard of American psychoanalysts soon embraced—was to break through the barriers the patient had erected and save them from themselves.
In 1948, Chestnut Lodge admitted a teenage girl named Joanne Greenberg, who would go on to bring Fromm-Reichmann a measure of immortality. Greenberg’s 1964 best-seller, I Never Promised You a Rose Garden—a fictionalized memoir, she later called it—was the story of a teenage girl named Deborah Blau who is trapped in the delusional kingdom of Yr. Deborah believes herself to be possessed by an outside force, much the way Daniel Paul Schreber felt that he had been, a half century earlier. (“There were other powers contending for her allegiance,” Greenberg writes.) Deborah seems walled off from the world forever until her therapist, Dr. Fried—a thinly disguised Fromm-Reichmann, with a surname unmistakably echoing Freud—breaks through and rescues her. Dr. Fried understands young Deborah’s demons—their source and their reason for being. “The sick are all so afraid of their own uncontrollable power!” Dr. Fried muses in the novel. “Somehow they cannot believe that they are people, holding only a human-sized anger!”
What Dr. Fried does for Deborah in this book influenced a generation of psychotherapists. Like Annie Sullivan in The Miracle Worker, Dr. Fried was a model of insight, compassion, and drive—patiently, ardently connecting with her patient, cracking her particular code. One of the keys, the doctor concludes, is recognizing that the girl’s own parents had unwittingly fanned the flames of mental illness in their daughter. “Many parents said—even thought—that they wanted help for their children, even to show, subtly or directly, that their children were part of a secret scheme for their own ruin,” the doctor reflects in the pages of Greenberg’s novel. “A child’s independence is too big a risk for the shaky balance of some parents.”
The mystery of schizophrenia is, apparently, solved: The eugenicists are wrong. People aren’t born with schizophrenia at all. Their mothers and fathers are to blame.
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AS EARLY AS 1940, Fromm-Reichmann had sounded the alarm over “the dangerous influence of the undesirable domineering mother on the development of her children,” calling such mothers “the main family problem.” It was eight years later, the same year that Joanne Greenberg became her patient, that Fromm-Reichmann came up with a term that would stick to women like Mimi Galvin for decades: the schizophrenogenic mother. It was “mainly” this sort of mother, she wrote, who was responsible for the “severe early warp and rejection” that rendered a schizophrenia patient “painfully distrustful and resentful of other people.”
She was far from the first psychoanalyst to blame the mother for something. Freud’s approach, after all, was to explain practically every mysterious impulse as the end result of childhood experiences coloring the unconscious mind. But now, in the postwar years, the dawn of a new era of American prosperity, many therapists had something new to worry about: mothers who refused to behave like the mothers of a previous generation. “A schizophrenic,” a Philadelphia psychiatrist named John Rosen wrote, within a year of Fromm-Reichmann’s invention of the term schizophrenogenic mother, “is always one who is reared by a woman who suffers from a perversion of the maternal instinct.”
In her own writings, Fromm-Reichmann remarked with unease at how “American women are very often the leaders, and men wait on them as wives wait on their husbands in European families,” and how “the wife and mother is often the bearer of authority in the family group.” She particularly disliked how fathers, like Don Galvin, become the confidants and pals of their kids, while mothers, like Mimi Galvin, become the disciplinarians. But once Fromm-Reichmann gave such mothers a name, the concept caught fire. John Clausen and Melvin Kohn from the National Institute of Mental Health described the schizophrenogenic mother as “cold,” “perfectionistic,” “anxious,” “overcontrolling,” and “restrictive.” The psychologist Suzanne Reichard and the Stanford psychiatrist Carl Tillman described the schizophrenogenic mother as the “prototype of the middle class Anglo-Saxon American Woman: prim, proper, but totally lacking in genuine affection.”
These descriptions seemed to lack a certain coherence. What, precisely, were these mothers doing to these children? Were they domineering or weak? Suffocating or withholding? Sadistic or apathetic? In 1956, Gregory Bateson, an anthropologist—and the husband of Margaret Mead—collected the various alleged sins of the schizophrenogenic mother into a theory he called the “double-bind.” The double-bind, he explained, was a trap that certain mothers set for their children. A mother says, “Pull up your socks,” but something about the way she says it projects the contradictory message, “Don’t be so obedient.” Now, even if the child obeys, the mother disapproves. The child feels helpless, frightened, frustrated, anxious—ensnared, with no way out. According to the double-bind theory, if children get caught in that trap often enough, they develop psychosis as a way of coping with it. Tormented by their mothers, they retreat into a world of their own.
Bateson invented this theory without so much as ten minutes of clinical psychiatric experience. But that made no difference. The double-bind, along with the schizophrenogenic mother, helped to turn mother-blaming into the industry standard for psychiatry—and not just for schizophrenia. In the 1950s and 1960s, it became hard to find any emotional or mental disorder that was not, in one way or another, attributed by therapists to the actions of the patient’s mother. Autism was blamed on “refrigerator mothers” who failed to show enough affection to their infants. Obsessive-compulsive disorder was blamed on problems in the second to third year of life, clashing with the mother around toilet training. The public conception of madness became hopelessly intertwined with the idea of the mother-as-monster. When, in 1960, Alfred Hitchcock’s Psycho placed the blame for the most famous delusional homicidal maniac of cinema, Norman Bates, squarely on the shoulders of his dead mother, it made all the sense in the world.
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THIS IS WHAT the Galvins would be up against when their boys started getting sick: an emboldened therapeutic profession seizing the moral high ground, doing battle with the devils of eugenics and surgery and chemical experimentation, and more than ready to search for a different way to explain the disease—a cause much closer to home. In 1965, Theodore Lidz, a prominent Yale psychiatrist best known for attributing schizophrenia to a patient’s family dynamics, said that schizophrenogenic mothers “became dangerous figures to males,” and had “castrating” relationships with their husbands. As a general rule, Lidz recommended that schizophrenia patients be removed from their families entirely.