Schizophrenic symptoms are virtually whatever makes the family unbearably anxious about the tentatively independent behavior of one of its offspring. These behavioral signs usually involved issues such as aggression, sexuality, and generally any form of autonomous self-assertion. These signs may well be the customary expression of the needs of an adolescent person, but, in certain families, even these are quite unacceptable and must, if necessary by some desperate means, be invalidated. A most respectable and readily available form of invalidation is to call such behavior 'ill'. The ill patient is then removed from the family, with the co-operation of various social and medical agents, and the family is left to mobilize all of its resources into pitying itself for the tragedy that has befallen it. Befallen it, of course, due to the hand of God which moves inexplicably and without relation to the actual needs of other people in the family.

The process of getting rid of someone is, of course, denied, usually by some form of assertion of the inherent peculiar badness and madness of certain individuals. This denial, which operates both in the family and in the wider society, is that most sterile, tortuous and yet all-pervasive piece of social illogic, the negation of the negation. The steps of the process are as follows: First, there is a negative act, an act of invalidation of a person by others; this may involved diagnostic labelling, passing sentence, physically removing the person from his social context: second (concurrently, rather than chronologically after), this negative act is denied in various ways; it is held that the person has invalidated himself or has been invalidated by his inherent weaknesses or disease process, other persons have nothing much to do with the matter. By means of this double negation the social group conceals its praxis from itself. The 'good', 'sane' people, who define themselves as such by defining certain of their number as 'mad' and 'bad' and then extruding them from the group, maintain a safe and comfortable homeostasis by this lie about a lie. The elected scapegoats often collide with this process, often finding that the only way they can feel needed by others or confirmed in a definite enough identity is by taking a mad or bad social role.

— David G. Cooper, psychiatrist, 1967