Current Issues in Qualitative Research

An Occasional Publication for Field Researchers from a Variety of Disciplines

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Volume 1, Number 8 August 2010
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Philosophy of Science and Mental Health Research:

Where are Studies on Effects of MI on Families?
Jane F. Gilgun
University of Minnesota, Twin Cities, USA

T he National Institutes of Mental Health (NIMH) have just put out a news release
announcing that researchers have discovered that people with major depression may also
have undiagnosed bipolar disorders, an important discovery (Symptoms, 2010). The
release goes into some detail about the evidence supporting the discovery.
As I read the news release and then looked at recent articles published in The American
Journal of Psychiatry, I became concerned about the narrow focus of this research (e.g., in Angst
et al, 2010). The research is on the identification of symptoms of mania that may appear in
persons diagnosed with major depression. Knowledge of symptoms is important, but insufficient.
What might the researchers have learned if they had asked family members if loved ones with
major depression sometimes show symptoms of mania?
Needed: Focus on Families
Where are studies that identify the effects of major depression/bipolar disorders on
families? On children? Where are the studies of what it is like to have major depression? People
with mental illnesses (MI) usually live with other people. Persons with MI may be may be
parents and spouses. We need information about family experiences with persons with MI.
Family may cope better with persons with MI if they had accurate information on what it
is like to have an MI. If we had information about the effects of MI on families, maybe our
policies and programs would be of great help and head off long-term suffering.
When symptoms of MI flare up in parents, children can be frightened, confused, and
traumatized. Episodes of MI shatter the foundations of parent-child relationships, which is
parental psychological availability and emotional attunement. By definition, episodes of MI lead
to detachment from others and often erratic behaviors and obliviousness to the effects of these
behaviors.
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Jane F. Gilgun, Ph.D., LICSW, is a professor, School of Social Work, University of Minnesota,
Twin Cities, USA. Her articles, books, & children’s stories are available on Amazon Kindle, the
Apple store, & scribd.com/professorjane for a variety of mobile devices.

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 This is how a mother described a few of her husband’s behaviors. He had a diagnosis of
bipolar disorder. I interviewed her as part of my research on interpersonal violence (Gilgun, in
press, 2008).
He’d complain about having to drive the kids to different functions or things that they
were in, or complain about the time and money that went into their extra-curricular
activities, even though I’d ask permission first. I always asked him. Is it ok if they sign up
for this? Is this ok? It costs this much money. It’s this time. Oh yeah, no problem, no
problem. But then when he had to go pick them up or drop them off, or it messed with his
comfort, then he would either just not show up, or call at the last minute and say he
couldn’t be there. A lot of times I’d be at work or I’d be somewhere else. So then I’d
have to scramble or leave where I was to go get the kids. So, he messed with your life a
lot, and just made it really chaotic.
We need to know a lot more about the effects on children and spouses of behaviors associated
with diagnoses of MI.
The Ecology of Mental Illness
Spouses of persons with a flare-up of MI can experience fear and trauma. We do know
now their experiences, nor what is helpful and what is not, what spouses require to keep them-
selves together and to help their children cope. We know little about how courts deal with
spouses with diagnosed MI that is out of control. We need much more information about the
ecology of MI.
This is the experience of a woman quoted above when she sought a divorce from her
husband, who denies his diagnosis of bipolar disorder and refuses treatment. They are an upper
middle-class family.
Here’s this guy that has been told, time and time again, by judges, by police officers, by
all different things, to either do or not do something. He doesn’t listen, and he hasn’t had
any kind of real consequences, because he doesn’t really care. Yeah, he might be in
trouble, and he might be on probation, but you know what? He was never uncomfortable.
He had to spend more of his mom’s money, which isn’t even his, so he still has his whole
lifestyle that he wanted. He can go out. He can go out with friends. He can go to the
movies. He can go out to eat. He can play golf. He can go bowling. Whatever he wants to
do. He can go on trips. He’s been on at least three trips in the last year and a half, to
warm destinations. We’ve been on none. We didn’t even have food, and he’s going on
these trips. We had neighbors giving us food, and we lived on peanut butter and macaroni
and cheese for a pretty good chunk of time. So, yeah, and it makes me really mad, at the
court system—because that should be their job. From my point of view, it’s like I’m a
parent. I have to be consistent. I have to raise well-adjusted, responsible children.
This is the kind of information we also need about untreated MI—what it does to spouses and
families. Maybe then we can craft more helpful interventions; maybe public policy will fit the
situations that families and children are living. We also need information about the ecology of
MI, such as how courts handle spouses with MI and the effects of their rulings and what happens
when individuals ignore rulings to the further detriment of their families. This quote also hints at
family of origin issues. This ex-wife had views about these.
The woman just quoted believes that family of origin issues contribute to her ex-
husband’s behaviors.

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 He’s very entitled, spoiled person. So a lot of it goes together. And, again, his mom
supports him in everything he does… He’s never had to support himself, ever. His mom
paid for his college. He lived in a condo during college so he didn’t have to live in the
dorms. Paid for his food. He’s only had to do, kind of like what a high school kid would
do. Pay for maybe your gas and your insurance, if even. That’s all he’s really ever had to
do. You know, his mom has bought all of his vehicles. Houses. You know, dwellings that
he’s lived in. Right now she owns the condo he’s in. She used to own the house that the
kid and I are in, but I just bought it back.
This woman’s story suggests that ecological factors, including family practices, may contribute
to the out-of-control behaviors of persons with MI. We need to know much more about these
factors if we are to be responsive to troubling issues that untreated and out-of-control MI raise.
Public policy, professionals, and family members need information like this.
Needed: A New Philosophy of Science
A focus on symptoms of MI to the neglect of their effects and ecologies originate in a
philosophy of science that values objectivity, precision, distance from lived experience, and
mathematical proofs. There is nothing innately harmful in these perspectives, and they do
advance knowledge, but they also exclude other ways of knowing that are also valuable. To
understand the ecology and effects of MI, we require another philosophy of science that values
interactive, ecological analyses and subjective accounts of human situations.
This is the human sciences tradition of research (Gilgun, 1999, in press) that is concerned
with understanding human situations in context. The basic assumption is that situational
variables influence actions and the interpretations what persons make of life events. The
meanings that persons attribute to situations influence their actions and interpretations.
Understandings of MI would be greatly enhanced if research focused the meanings that arise
within situations where MI is at issue.
Human sciences traditions are also emancipatory, meaning the purpose of the research is
to understand problematic human situations so as to make things better. Researchers who follow
rational-technical philosophies of science shy from emancipatory perspectives because they
somehow taint the research, or because researchers believe research and making things better are
separate.
Conclusion
Focus on symptoms is important, but leaves out human dimensions of MI, such as how
MI affects children and families and how courts, police, and other agents of social control
respond to MI. Family of origin issues, such as factors that contribute to behaviors associated
with MI, are significant and under-researched. NIMH and other funding bodies would do well to
question whether their philosophies of science are responsive to the human dimensions of MI.
Researchers might question their underlying assumptions about what is important in mental
health research.
References & Further Reading
Angst J, Cui L, Swendsen J, Rothen S, Cravchik A, Kessler R, & Merikangas K. (2010).
Major depressive disorder with sub-threshold bipolarity in the National Comorbidity Survey
Replication. American Journal of Psychiatry. Online ahead of print August 15.
Blumer, Herbert (1986), Symbolic interactionism. Berkeley: University of California
Press.
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 Gilgun, Jane F. (in press). Qualitative research: Enduring themes and contemporary
variations. In Gary F. Peterson & Kevin Bush (Eds.). Handbook of Marriage and the Family (3rd
ed.). New York: Plenum.
Gilgun, Jane F. (in press). Reflections on 25 years of research on violence. Reflections:
Narratives of Professional Helping.
Gilgun, Jane F. (2008). Lived experience, reflexivity, and research on perpetrators of
interpersonal violence. Qualitative Social Work, 7(2), 181-197.
Gilgun, Jane F. (1999). Methodological pluralism and qualitative family research. In
Suzanne K. Steinmetz, Marvin B. Sussman, and Gary W. Peterson (Eds.), Handbook of Marriage
and the Family (2nd ed.) (pp. 219-261). New York: Plenum.
Symptoms of bipolar disorder may go undiagnosed in some adults with major depression
(2010). National Institutes of Mental Health website:
http://www.nimh.nih.gov/science-news/2010/symptoms-of-bipolar-disorder-may-go-
undiagnosed-in-some-adults-with-major-depression.shtmlScience Update • August 16, 2010
About This Publication
Current Issues in Qualitative Research is an occasional publication for field researchers in a
variety of disciplines. Jane F. Gilgun, Ph.D., LICSW, is the editor and publisher. To submit
articles to this publication, Professor Gilgun cordially invites researchers to email brief articles of
three to five pages to her at jgilgun@umn.edu. Field researchers are individuals who do in-depth
work with informants in the settings in which informants live their lives. If they do interviews,
the interviews are in-depth and seek to understand individuals within their particular situations.

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