The belief that the patient's family has played an important role in the development of his mental disease appears to be held by a large proportion of professional workers concerned with psychiatric conditions. The idea is the central one in many attempts to explain the etiology of mental illness, and it appears to guide the professional activity of the majority of clinicians and researchers alike. While this hypothesis is held with conviction, data unambiguously supporting it, and especially data which elaborate the role of the family in mental illness more specifically, cannot readily be found, as Spiegel and Bell22 have pointed out.
Ambiguity as to just what role, if any, the family does play in the development of mental illness is not due to lack of attempts at clarification. Reports of such research efforts are plentiful. There are, however, some very substantial reasons for the con