Early research by Julian Leff at the Institute of Psychiatry and
David Goldberg at UCLA on schizophrenia focused on the role of
“expressed emotion” in families. They coined this term to
essentially describe a negative and critical communication style
that appeared to characterize many of the families who had
members suffering from schizophrenia. The results from their
early studies were indeed impressive. Patients who lived with
family members who were overly critical of them and had a
negative communication style relapsed more often and quicker.
These results have been replicated across almost all major
mental disorders (except one)*, and of course bipolar disorder.
Patients with bipolar disorder actually have the highest
sensitivity levels to expressed emotion/criticism. Interestingly
enough, other research by Elizabeth Kuipers at the Institute of
Psychiatry has indicated that the levels of expressed emotion
are best predicted by the degree of “perceived responsibility”
of the person who is most critical. I