The Double Bind Theory: Still Crazy-Making After All These Years PAUL GIBNEY With fifty years having passed since Gregory Bateson and his colleagues published their famous paper, ‘Towards a Theory of Schizophrenia’, it is an opportune time to review the theory and its clinical relevance today. Bateson’s team began with an interest in how the identity and functioning of self regulating systems was maintained through mechanisms of information, control and feedback. This work foreshadowed and gave momentum to the development of family therapy, with several members of the original research group later forming the initial schools of family therapy. Bateson, accompanied by Haley, Weakland and Jackson, formed a complex picture of the reciprocal complementariness and escalations that form family life. The ‘double bind hypothesis’ and ‘the schizophrenic dilemma’ were seen as part of a continuum of human experience of communication, that involved intense relationships and the necessity to discriminate between orders of message. Fifty years on, the double bind hypothesis of Gregory Bateson and his research group still offers ongoing insights, cause for reflection, an area and methodology of research, and proposes interventions that dismantle pathology and offer hope of new, more functional pathways. requirement of the third year of were our trusty supplies with which we with a schizophrenic member. The my social work course was an faced the multiple choice examination entry rounded out with the observation inter-disciplinaryA subject offered by at the end of the semester. that theories of this type supported a the Department of Psychiatry. Every It was in that quirky handbook that psychosocial model of the etiology of Wednesday afternoon hundreds of I first saw mention of ‘The Double Bind schizophrenia, and thus a psychosocial aspiring social workers, occupational Theory of Schizophrenia’. Essentially, model of its treatment, and then therapists, physiotherapists and the the entry said that in the mid-1950’s, duly noted that such understandings like would squeeze into one of the Bateson and his colleagues put aided and abetted the anti-psychiatry University of Queensland’s lecture forward a theory that schizophrenia movement of the 1960’s. (R.D. Laing, theatres to be given a basic overview was caused and/or promoted by David Cooper etc.) The handbook of the history of psychiatry, and irresolvable communicational then turned its attention to the anti- the constructs that organised the conundrums in families. It went on psychotic medication revolution and taxonomy of mental illness. These to say that other later studies were the promising field of dopamine lectures, plus the handy roneoed more specific in identifying ‘high e.e.’, research. double stapled handbook with a that is ‘expressed emotion’, as a key Occasionally, years later in ward summary of each lecture and topic, communicational element in families rounds, the somewhat philosophically 48 PSYCHOTHERAPY IN AUSTRALIA • VOL 12 NO 3 • MAY 2006 minded consultant psychiatrist with Some History and Context tribes of New Guinea and in Balinese whom I worked would be waxing Gregory Bateson’s original villages. Bateson sought to describe lyrical to the medical students training was as an anthropologist. social and communicational patterns about the theories of causation of Bateson’s grandfather, William, had within specific groupings, and was schizophrenia. He would add, studied classics and mathematics at fascinated by mother/child interactions “. there was interesting work done in Cambridge. Bateson’s father, William and the construct of messages that the 1950’s by a scholar called Bateson Bateson (known as W.B.) studied defined certain activities as play. In the 1940’s, Bateson and his first wife, Margaret Mead, became involved in the growing intellectual The essential hypothesis of the double bind movement of cybernetics. Cybernetics was a discipline largely co-ordinated theory is that the ‘victim’—the person as a multi-disciplinary endeavour who becomes psychotically unwell—finds by theorists such as Norbert Weiner and Warren McCullough. The field him or herself in a communicational concerned itself with self regulating systems and how their identity and matrix, in which messages contradict each functioning was maintained through mechanisms of information, control With fifty years having passed since Gregory Bateson and his colleagues published their famous other, the contradiction is not able to be and feedback. Bateson could see the paper, ‘Towards a Theory of Schizophrenia’, it is an opportune time to review the theory and its clinical discipline’s immediate applicability to communicated on and the unwell person is social interactions and the exploration relevance today. Bateson’s team began with an interest in how the identity and functioning of self and explanation of social systems. regulating systems was maintained through mechanisms of information, control and feedback. not able to leave the field of interaction. Whilst in a two year appointment at the University of California Medical This work foreshadowed and gave momentum to the development of family therapy, with several School in the late 1940’s, Bateson members of the original research group later forming the initial schools of family therapy. Bateson, began thinking and theorizing about accompanied by Haley, Weakland and Jackson, formed a complex picture of the reciprocal that suggested schizophrenia was zoology at Cambridge and notably the processes of psychiatry and its caused by double binds in the family’s became Britain’s first geneticist. subject matter. He worked with the complementariness and escalations that form family life. The ‘double bind hypothesis’ and ‘the communication patterns. Paul, our William Bateson named that discipline Swiss psychiatrist Jurgen Ruesch schizophrenic dilemma’ were seen as part of a continuum of human experience of communication, social worker, is a family therapist; he’ll ‘genetics’ and was responsible for to study human communication in explain more of that to you if you want to introducing Mendel’s laws of genetic psychotherapy. Bateson was a visiting that involved intense relationships and the necessity to discriminate between orders of message. ask him”. Mercifully, they were more inheritance into Western science. professor of anthropology at Stanford Fifty years on, the double bind hypothesis of Gregory Bateson and his research group still offers interested in dopamine and dosage. Gregory Bateson also studied and University and his central institutional However, at that time, in the early graduated from Cambridge. He connection was to the local Veteran’s ongoing insights, cause for reflection, an area and methodology of research, and proposes 1980’s, I was consuming the family undertook field work amongst the Hospital at Menlo Park. The hospital’s interventions that dismantle pathology and offer hope of new, more functional pathways. therapy literature vigorously and there, in its archives, was this compelling and productive theory. It has been fifty years since Gregory Bateson published ‘Towards a Theory of Schizophrenia’, forever emblazoned in bibliographies and reference lists as—Bateson, G., D. Jackson, J. Haley, and J. Weakland, ‘Toward a Theory of Schizophrenia’, Behavioural Science 1 (1956), 251-254. It would seem to be an opportune time and totally appropriate to review the theory and its possible clinical relevance today. This paper covers a few brief historical notes, an outline of that famous theory, some illustrations of ‘double binds’, some recent case histories that demonstrate its relevance today and some discussion of its limitations and its inestimable, and still unexplored, value. Illustration: Savina Hopkins PSYCHOTHERAPY IN AUSTRALIA • VOL 12 NO 3 • MAY 2006 49 director, Dr. John J. Prusmack gave other, the contradiction is not able to children who often need the parents Bateson a research freedom to pursue be communicated on and the unwell for survival, this prohibition can areas of interest and he chose to person is not able to leave the field of often be seen in suicide threats, study the processes of psychotherapy interaction. dramatic reversals and promises to and alcoholism. In 1952, Bateson The critical components of the be better, and promises of hitherto successfully gained a research grant double bind situation, according to unavailable resources. Often seen from the Rockefeller Foundation to Bateson and his colleagues, were as in interactions described in marital study Paradoxes of Abstraction in follows: therapy, for example: Communication. • Two or more persons, one of whom Primary Negative Injunction: He assembled a research team can be designated as the ‘victim’. ‘I’ll kill you if you stay.’ i.e. ‘Do not around him that included John • Repeated experience. The situation stay.’ Weakland, an engineer, Jay Haley, a is not a single trauma, rather a Secondary Negative Injunction: ‘I am used to people leaving me.’ i.e. ‘Do not abandon me.’ Tertiary Negative Injunction: Later attempts to locate ‘blame’ in the ‘That’s right. It is so typical of you to piss off and leave me. No guts to face family or to suggest the hypothesis was your problems. I’m prepared to stick with this.’ i.e. ‘Do not leave the field.’ aimed at ‘blaming families’ was the work • A partial arc—a snippet of that interaction—will induce the entire of less skilled theorists, given to dull and confused response in the ‘victim’. “Finally, the complete set of ingredients is reductive