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This is the third piece in an exchange of views between Robert Harris and George W. Brown, originally published in Medical Sociology News Volumes 5 and 6, between January 1978 and January 1979. All four parts are published here, together, for the first time.

Science and Common Sense: A rejoinder to Professor Brown

Robert Harris
Medical Sociology Research Centre
University College of Swansea, UK

Originally published in MSN Volume 5, Issue 3, September/October 1978



I thank Professor Brown for his lengthy reply to my article in the January edition of Medical Sociology News. However‚ for all its length‚ Professor Brown has not answered satisfactorily my main criticism which is that his research bolls down to the observation that discharged schizophrenic patients living with relatives who do not like then are more likely to be readmitted to mental hospital than are those patients discharged to families where they are liked. Brown simply states that in equating High EE with dislike I manage ‘to trivialise the matter’.

My criticism was, and remains, that in calling criticism‚ hostility and emotional over-involvement 'expressed emotion' and according this manufactured psychogenic variable a causal status in 'relapse' Professor Brown manages to reify the matter.

The crux of the contention is whether I am justified in regarding High EE as basically an indicator of dislike. Suppose during a conversation the person you are talking with makes several critical remarks about an absent third person and/or indicates strong hostility towards that person. It would seem to me that you would have strong grounds for concluding that the person you were talking to did not like the other person very much.

Professor Brown reminds us that ‘high emotional over-involvement was associated with relapse irrespective of criticism or hostility’. Indeed it was, but this indicator of High EE added only 7 out of 45 families to the High EE subgroup. Moreover‚ the predictive power of this indicator was much less than 7 or more 'critical comments'. The association between High EE and relapse was therefore created predominantly by the families who were critical about the patient. To make the matter clearer suppose‚ for example‚ than an England football team were to win the World Cup by fielding a side containing nine Manchester United players*. Would we not conclude that this indicated the overall strength and depth of Manchester United rather than English football as a whole? And would we not suspect special pleading if a commentator played down the contribution of the Manchester United players compared with the two from elsewhere? The analogy must not be pushed however‚ for while 11 football players constitute what is recognisably a team‚ Professor Brown's High EE is a reified device which serves to mystify the relations between people.

Since ‘marked emotional over-involvement' did not materially affect Professor Brown's results we might justifiably ask why he retained it in his 'overall index of EE’. Could it be that had he left it out he would have been clearly seen to be wearing no clothes?

This particular research conducted by Professor Brown would probably best be left burled in the pages of the British Journal of Psychiatry were it not for the fact that a recent collection of ‘Basic readings in medical sociology' (Tuckett and Kaufert 1978) gives pride of place to an article by Brown and Rutter which describes the methods used in the study I have criticised and another by Vaughn and Leff which replicates Professor Brown’s research on EE, warts and all. Both articles are to be found in the opening section of the book under the heading 'Sociology as a Science'‚ where presumably they are intended to stand as examples of the best scientific work available within medical sociology. Thus‚ the pretentions of those who count‚ while losing sight of what it is they are counting‚ are enshrined, legitimated and objectified for consumption by the next generation of students.

* I am grateful to Bill Bytheway for suggesting this analogy.

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Reference
David Tuckett and Joseph H. Kaufert (ed.) Basic Readings in Medical Sociology‚ Tavistock 1978.


Next: 'Science and Common Sense: A Final Reply' by George W. Brown