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A Critique and Reformation of Double-Bind Theory

John S. Kafka, MD

Arch Gen Psychiatry. 1971;25(3):232-239.

Abstract
Clinical observations suggest a link between dissociative experiences in adult patients and underexposure to ambiguous communications during certain developmental phases. Formal characteristics of ambiguous and paradoxical communications are examined in detail. A theory is proposed which connects parental fear and intolerance of ambiguity with the offspring's inability to integrate paradoxical aspects of reality. This theory is contrasted with the double-bind theory which states that an abundance of certain paradoxical communications is schizophrenogenic. The "therapeutic doublebind" is seen as a "replacement" of essential paradoxical communications which were scarce and inadequate rather than overabundant during crucial developmental phases.

Author Affiliations
Washington, DC

From the Family Development Section, Child Research Branch, National Institute of Mental Health, the Department of Psychiatry, George Washington University School of Medicine, and the Washington Psychoanalytic Institute, Washington, DC.

Footnotes
Accepted for publication Sept 28, 1970.

Presented in part at Chestnut Lodge in 1963 and 1965, at the National Institute of Mental Health in 1966 and 1969, and at the Double-Bind Symposium of the 77th annual meeting of the American Psychological Association, Washington, DC, September 1969.

Reprint requests to Family Development Section, Child Research Branch, National Institute of Mental Health, Bethesda, Md 20014.

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