In the psychology of the dysfunctional family, the identified patient is the family member in whom the dysfunction has most obviously manifested itself. As the chief symptom bearer in the family unit, an identified patient acts out the issues of the family on a subconscious level. This type of psychological projection is an unconscious attempt on behalf of the identified patient to shift focus from the problems of the family nexus to a tangible, visible external component.
The majority of identified patients are the first persons within a family to show signs of inner turmoil or conflict. The rest of the family does not automatically associate the problems of the identified patient as indicative of larger family issues. Instead, the identified patient, or IP, is viewed as a troubled individual or, in extreme cases, as someone with whom the family would be better off without. The IP is traditionally the first person in the dysfunctional unit to seek outside help in psychoanalysis, which, in cooperative families, can lead to family therapy.
An IP can develop as the result of any number of psychological problems within a family. It is usually an involuntary, subconscious response to damaging family situations. Examples of issues that may lead to the creation of an IP are narcissistic parents; physical, emotional, or sexual abuse; unresolved trauma; or scapegoating, the act of blaming or negatively treating an individual on an unwarranted basis for problems not of the individual's doing.
The type and extent of behavior exhibited by an IP varies from patient to patient. The IP may simply be viewed as disturbed or difficult. In many cases, the IP has developed a depressive disorder or some other form of psychosis as a way to transfer the family's focus from its core problems to an outlying issue that can be more easily dealt with. In more extreme circumstances, the IP may develop an addiction to drugs or alcohol or become involved in criminal activity.
Treating the IP will depend on the particular ways the issues of the family have manifested in him or her. Unfortunately, just because an IP has troubling issues does not mean the nature of the family's problems will be immediately evident. It will usually take intensive psychotherapy to get to the root of the IP's behavior, who, despite his or her actions and position in the family, may attempt to protect the family unit at any cost. Mental health professionals will often stress to IP's that certain behaviors and current circumstances are not the causes of family dysfunction but symptoms of larger underlying issues within the family nexus.