In this domain we are aiming to measure the degree and quality of attentiveness or mutuality that marital partners show for each other in a relationship where constraints or limitations have been applied to the interacting system through the emergence of depressive symptoms in one or both partners. Raush, Barry, Hertel & Swain (1974) have formulated the interactive dynamics of a disturbed marital system and see contextual variables such as depressive behaviour as enhancing or diminishing the meaningful quality of communication between individuals.Human communication can only continue so long as one individual responds to the other in some way either verbally or non-verbally. The communication also has to be punctuated so that both can participate and contribute to the ongoing communicative patterns. To be properly responsive to one's communicative partner means listening carefully to the content and intention of what it is he or she is trying to communicate and to respond to this, but to respond to it idiosyncratically and thus add to the richness and flow of the pattern. The depressed patient has long been held to be unable to do this since he is seen as someone who is so preoccupied with his own internal feeling state that he is unable to respond to the outside world as he would ordinarily be able to do. If this were true we would expect to find that with patients and their spouses there was a very distorted pattern of communication and one which was quite different from that of our surgical patients and their spouses.We have already shown in earlier papers how there are certainly enhanced levels of tensions between psychiatric patients and their spouses. This could arise from the fact that the non-communicative quality of the interaction is so great that it generates a good deal of tension between the members of the couple as they struggle to get across to each other. This domain of responsiveness should illuminate this fact, therefore, more clearly than we have been able to so far. Mishler & Waxier's (1968) analysis of patterns of responsiveness with young schizophrenics and their families demonstrated that the parents at least had a strongly idiosyncratic response pattern which persisted regardless of which of their children they were actually being tested with. Thus with both the 'sick' child and the 'well ' child their style of responsiveness tended to be rather similar, but they did find marked differences between the normal families and the families with a schizophrenic member. In general they produced a rather fragmentary style of responsiveness by comparison with the sick families, which had either a ritualized pattern of response with low levels of interruption and fragmentation or something approaching it.Raush et al. (1974) studied patterns of conflict and avoidance in marital partners and found more coercion and punitiveness in the discordant couples and high levels of mutual support and empathy in the harmonious group. We have not found any other parallels in the literature to the detailed way in...

This paper reports the initial analysis of a series of observations of a number of depressed patients communicating with their spouses and with a third party. This is part of a larger study which arose out of our dissatisfaction with the traditional ways of thinking about depressed patients. By and large there is general agreement about the people who are called ‘depressed’; there are constellations of symptoms and signs which can be evaluated by using one of the many rating scales for depression which have a degree of reliability and consistency. However, we feel that most of the thinking which underlies these efforts is based on presuppositions which would place ‘the depression’ within the patient, that is to say that there is something wrong within the patient which causes the symptoms and gives rise to the signs. These views are reductionist in character and we have by contrast attempted to reexamine certain aspects of depression using non-reductionist ideas.

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