A Reappraisal of Frieda Fromm-Reichmann and the Rise and Fall of Mother-Blaming in Schizophrenia

프리다 프롬-라이히만과 조현병에서의 어머니 비난 이태영 1 •김학철 2 •맹세리 3 •서화규 4 •송명선 5 •이현주 6 1 경북대학교 의과대학 정신건강의학교실, 2 벗숲정신의학연구원, 3 인하대학교 의과대학 정신건강의학교실, 4 부산대학교병원 정신건강의학과, 5 동탄 정신건강의학과의원, 6 서울대학교병원 정신건강의학과The so-called "schizophrenogenic mother"-a now-discredited notion that a particular maternal type causes schizophrenia-was named in a single sentence within Frieda Fromm-Reichmann's 1948 paper on psychoanalytic technique and dominated American psychoanalytic practice for roughly 25 years.This review reappraises the hypothesis with Fromm-Reichmann at its center.We first trace her life and clinical thought: her émigré Jewish background, the collaborative psychoanalytic treatment of psychosis she pioneered at Chestnut Lodge, and the ambivalence at the core of her thought, a humane clinical intuition that, once named, hardened into a diagnosable entity.We then follow the concept's theoretical expansion through Sullivan, Levy, Lidz, Wynne, Bateson, and Bowen, which recast the whole family as the pathogen of psychosis, and locate its persuasiveness in postwar American maternal anxiety and Frankfurt School critical theory rather than in controlled evidence, documenting the scale of the mother-blaming it licensed.The hypothesis was dismantled and, by the 1990s, effectively retired: by failed experimental tests, by adoption studies showing that liability follows biology rather than rearing, by the relocation of the family from cause to course in expressed-emotion research, by long-term outcome data, and by the family-advocacy movement.We argue that what was discarded is the single-cause etiology and the methodological practice that produced it, whereas Fromm-Reichmann's core clinical proposition survives as a living asset of contemporary psychoanalysis: that the psychotic patient's communication is meaningful, and that the clinician builds a working alliance by acknowledging that meaning.We close with implications for the family-centered Korean clinical setting.