The leading psychoanalytic theory of schizophrenia is that of the schizophrenogenic mother. This theory states that the mothers of schizophrenic individuals tend to be cold, rejecting, and yet controlling. Throughout childhood, the mother engages in double-binding communication with the child, creating a relationship characterized by constant contradictions between verbal and non-verbal information. The child is left in a confused state and must choose to obey either the verbal or the non- verbal messages. This leads to a weakening of the child's understanding of reality wherein the child must develop his or her own creative explanation of events.

One criticism of this theory centers on new evidence indicating that a mother's relationship with a troubled child often differs from the way she acts with other children within the family. Disturbances in her relationship with a troubled child can therefore also be a result of situational influences, such as the behavior of that child. Expressed emotion (EE), which consists of the dimensions of criticism and emotional over-involvement, has also been shown to be a valid vulnerability risk for developing schizophrenia and indicative of the course outcome of the disorder; high levels of expressed emotion have been shown to predict greater chances of relapse.