What Is A Family Symptom Bearer?
In psychology, the term ‘family symptom bearer’ essentially refers to a scapegoat in the family who displays psychiatric problems brought on by the extreme dysfunction, especially with regard to communication, of the family as a whole.
In other words, the family symptom bearer is a kind of conduit through which the psychological problems of the whole family unit are expressed.
It is also suggested that the dysfunctional family of the family symptom bearer is unconsciously motivated to ensure his/her status as the mentally ill member of the family is maintained and that his/her mental illness does not improve…
But why should this be?
One theory is that identifying one family member as ‘the mentally ill one’ detracts attention from the psychological problems of the other family members, of which they may feel ashamed or wish to conceal for other reasons (perhaps wanting to put out the coded message: ‘we’re not the problem, s/he is!’).
“Too much sanity may be madness — and maddest of all: to see life as it is, and not as it should be!”
Often, however, the family symptom bearer is the least psychologically disturbed of the family on many levels and may have the greatest insight into the disturbed family’s extreme dysfunction – making him/her a kind of ‘family truth revealer’, in effect.
The psychiatrist RD Laign suggested that certain family members may have an unconscious need to take on and maintain a caretaker role, due to their own inadequacies, which motivates them (again, on an unconscious level) to prevent the family symptom bearer from recovering. Furthermore, the focus on the family symptom bearer helps to avoid a focus on, and analysis of, the toxic interactions of the family as a whole.
It is also suggested that the family symptom bearer is, in effect, acting out and representing in a tangible manner the whole family’s psychological problems.
The family may frequently deny that the family symptom bearer’s psychiatric problems are a representation and expression of the whole family’s pathological interactions, scapegoat him/her, deem him/her a destructive influence, troublesome and difficult and even exclude him/her from the family, thus evading their own culpability.
The family symptom bearer’s response to the dysfunctional family is, however, unwilled, non-deliberate and unconsciously driven – often, too, s/he is the most sensitive and vulnerable of all the family members.
Frequently, the family symptom bearer has suffered abuse from his/her family and will have unprocessed trauma issues; s/he is also at increased risk of developing problems relating to excessive alcohol and/or drug consumption.
It is important to note that the family symptom bearer’s problems are the RESULT OF WIDER FAMILY PROBLEMS, NOT THE CAUSE OF THEM.
It is therefore vital that the family symptom bearer’s psychiatric difficulties are analyzed in the context of the dysfunctional family dynamics responsible for their genesis ideally by the means, in most cases (if the family is amenable), of intensive family therapy.
FAMILY SYSTEMS THEORY AND THE FAMILY SCAPEGOAT
FAMILY SYSTEMS THEORY :
FAMILY SYSTEMS THEORY was developed by the American psychiatrist, Murray Bowen (1913-1990). The theory proposes that :
a) The family acts as a highly complex system
b) This system is made up of family members who are emotionally intertwined
c) The ‘units’ of the system (i.e. the emotionally intertwined family members) interact in highly complex ways
d) Family members, through emotional interaction, affect each other’s thoughts, behaviors, and emotional states (though are often unaware of the degree to which this process is taking place)
e) Some family members are more emotionally interconnected than others, but all are emotionally interconnected to some extent.
THE EFFECTS OF ANXIETY PERMEATING THE FAMILY SYSTEM :
When one or more of the family members become anxious, the anxiety becomes ‘contagious’ and ‘infects’ other members of the family. As the level of anxiety increases, so, too, do the emotional interactions between family members become correspondingly, increasingly stressful.
Eventually, a particular family member (the most sensitive and vulnerable, as stated above)) starts to absorb the majority of the anxiety produced by the family system which puts this person at risk of developing various forms of mental illness including depression and anxiety disorders. In this way, this individual acts as a kind of ‘container’ or ‘vessel’ into which the lion’s share of the stress and anxiety generated by the entire family system is poured; this process, in turn, can result in him/her becoming the ‘family symptom bearer’ / ‘family scapegoat’ / ‘family black sheep’ (see related article recommendations below).
I provide an example of how this can play out below :
Let’s take a hypothetical family consisting of four members: mother, father, oldest son (age 16), and youngest son (age 14). Now, let’s imagine the following scenario :
The family functions relatively well until the parental marriage comes under strain. The stress and anxiety generated by this marital friction permeate the whole family.
In response to the increased anxiety in the family home, the father spends much more time at the office, becoming a workaholic; the mother, to distract herself and bolster her self-esteem and self-image, throws herself into charity work and religious activities; the oldest brother cuts off from the family, spending his time in his bedroom listening to music or doing homework (when he is not bullying his younger brother); the youngest son responds by getting drunk, taking drugs, getting into fights and becoming involved in petty crime.
The family then identifies the youngest son as being at the root of the family problems and decides they should all attend family therapy sessions.
However, the family therapist points out that the youngest son is NOT, in fact, the source of the family’s problems, and that therapy can only work if all family members face up to their own specific problems.
However, the father, mother, and older brother do not wish to entertain the idea that they might have anything to do with the way in which the family has become dysfunctional, insisting, instead, that it is the youngest son who needs to be ‘fixed’, certainly not any of them!
Having made their feelings on the matter abundantly clear, the family then terminates the family therapy. Permanently.
Because the family is still convinced that the youngest son is, as it were, ‘the root of all evil’, the family packs him off to a psychiatric hospital for a couple of months.
Due to the fact that the youngest son is now away from the malign influence of the family atmosphere (rather than due to any treatment the hospital attempts to provide proactively) the youngest son’s psychological condition improves considerably. Eventually, therefore, his family (magnanimously, in their own grossly distorted and self-serving view) grant him permission to return home.
However, when the son does return home because the other family members have failed to acknowledge, let alone address, their own issues, the youngest son’s psychological condition deteriorates again and things go from bad to worse…
In other words, it is the system as a whole that needs to be ‘repaired’, not just one part of it (i.e. the family member displaying the most inconvenient, and least socially acceptable, symptoms / psychological defenses).
Bateson, G., Jackson, D., Haley, J., & Weakland, J. (1956). Toward a theory of schizophrenia. Behavioral Science, 1,
Bowen, Murray (1966), “The Use of Family Theory in Clinical Practice”, Family Therapy in Clinical Practice (reprint ed.), Lanham, MD: Rowman & Littlefield (published 2004), pp. 147–181, ISBN 0-87668-761-3
Bowen, Murray (1974), “Toward the Differentiation of Self in One’s Family of origin”, Family Therapy in Clinical Practice (reprint ed.), Lanham, MD: Rowman & Littlefield (published 2004), pp. 529–547, ISBN 0-87668-761-3
R. D. Laing, The Politics of Experience (Penguin 1984)
David Hosier BSc Hons; MSc; PGDE(FAHE).