The History of Family Systems Therapy Freud and Rogers believed that psychological problems were a result of neurotic conflicts and negative interactions to one’s family. 1920 – 1949 Social psychiatrist studied small group dynamics to improve their understanding of political problems and group structure boundaries. Kurt Lewin Conceptualized that a group is more than the sum of its parts. Child guidance movement John Bowlby determined that a child’s symptoms were usually a function of emotional distress in the family.
The History of Family Systems Therapy During the 1950’s, Dr. Gregory Batson, Jay Haley, John Weakland, and Don Jackson examined communication styles on mainly schizophrenic patients. Observations led to considering the family as an organism or a system with its own rules, patterns of functioning, and tendency to resist change. Families were treated as a whole. The Theory of Communication was developed in order to explain the development of schizophrenic behavior within family environments. In 1959 Don Jackson in conjunction with Virginia Satir started the Mental Research Institute in Palo Alto, California During the 1950’s, The Mental Research Center starts the first formal training program in family therapy.
The History of Family Systems Therapy In 1965, Theodore Lidz investigated the family dynamic of schizophrenia and introduced a new component to the finding conducted by the Palo Alto Group. Lidz noted that fathers had a profound influence on the development of schizophrenic symptoms in their children. Lidz noted that a large amount of the schizophrenic patients came from broken homes. Lidz studies contributed to symptomatic behavior and helped pave the way for family therapy. In 1970 Salvador Minuchin collaborated with Jay Haley to develop the structural family therapy model at the the Philadelphia Child Guidance Clinic. Addresses problems within a family by charting the relationships between family members or extended families. Minuchin subscribed to the systems notion of wholeness and equifinality. He believed that therapist should join the family system as a catalyst for positive change.
Origins of Psychopathology Structural Communication/Strategic Bowenian (Multigenerational)
Main Concepts Family is viewed as a system; the family system includes the individual members and their relationships and interactions. Interconnectedness- changes and problems that affect one member of the family also affect the rest of the family. Boundaries- rules that control the interactions of the members and their relationships. Homeostasis- maintenance of a stable state, or the typical way in which members within a family interact. Feedback loop- control mechanism in which a circular relationship exists. Open system- energy (information) can move into, within, and out of the system (family).
Structural Therapy Focuses more on how the family system helps to sustain psychopathology versus its cause. Views psychopathology as maintained by interpersonal dynamics of the family system and caused by the family’s inability to adapt effectively to changes. Structure of the family is based on the rules that direct interactions. Two types of pathological family structures Disengaged- boundaries are so rigid that there is little or no interaction between members. Enmeshed- individual boundaries are not respected, leading to a lack of autonomy and identity for individual members.
Communication/Strategic Therapy Views psychopathology as interpersonal problem within the family instead of an intrapersonal problem within one member (identified patient). Psychotic and pathological behaviors occur to maintain homeostasis when the system is threatened. Rules of relating provide organization for family functioning and are seen in the ways in which members of the family communicate. When rules are ambiguous, psychopathology is more likely to develop to restore order to the disorganized system.
Double bind communication Occurs in situations where the verbal and non-verbal messages are ambiguous, conflicting or unclear. This happens when the non-verbal message does not match the verbal message. An example would be when a child hug their parent and the parent stiffens at the child’s touch, while at the same time making the statement “I love you.” Verbally the parent says I love you but the non- verbal communication says they are not feeling what was expressed in their words.
The five axioms of communication 1. It is impossible not to communicate, even silence is communication. 2. Communication contains information, and a definition of the relationship A. Not only does communication carry information it also contains a command which defines how the interaction should take place. B. You have to consider that a communication always contains two aspects, a verbal and non-verbal message. 3. The punctuation in a communication defines the nature of a relationship and also can be used to define the person with the last word as having greater power.
Axioms 4. This axiom addresses what type of message is conveyed in verbal and non-verbal communications. A. Verbal communication is the clearest form of conveying a message in terms of content but there is a lot of room for ambiguity about the definition of the relationship between the communicators. B. The non-verbal communication defines the nature of the relationship. It can become a problem if the family relies too much on non- verbal communication because it can create more ambiguity in the relationship.
Axioms 5. There are two types of communication exchanges, symmetrical and complimentary, and these are identified by the type of relationship in which the communication is taking place. A. If equality is present then there is a symmetrical relationship and either party is free to take the lead in the interaction. In this type of relationship a pathology can occur if there is a schism or open warfare. 1. Schism is defined as a state of constant and chronic disequilibrium. This occurs when one or more parties in the relationship is constantly competing and an existence of mutual distrust. The lack of cooperation is also present in this state.
Axioms B. A relationship is complimentary when one party leads and the other party follows. This type of relationship can rigidify and prevent adequate growth. 1. When a parent insists that a child relate as an adult the child can experience depersonalization and aggressive acting out. 2. In a marriage when one partner displays overt control it can lead to domination of the family by that person and then there is a lack of reciprocity and give and take between partners. There is a rule of accommodation in these families and it is often at the expense of compromising oneself.
Bowenian (Multigenerational) Psychopathology almost always a multigenerational process Emotional illnesses caused when individuals unable to adequately differentiate themselves Fusion is the phenomenon that interferes with differentiation 2 aspects of immaturity because of fusion
Fusion between any 2 members relieves tension through triangulation The foci of triangulation shifts Triangulation tends to occur across generations Emotional cutoffs used to cope with unresolved attachments
Resulting undifferentiated family ego mass Importance of client and therapist differentiating from family of origin
Techniques of Treatment in the Family Systems Approach
Main Focus of Family Systems Approach Meet with all family members, not only with the individual who has the identified problem May include extended family members or other important figures in the individual’s life such as neighbors, teachers, friends, etc Believe that any change in the behavior or functioning of any one member of the family system is likely to influence the other members of the system
Overview of Treatment Techniques The Communication Approach The Structural Approach The Milan Approach The Strategic Approach The Narrative Approach The Experiential Approach
The Communication Approach Problems in effective communication contributes to family problems and dysfunction Called incongruent communication Congruent Communication the expressing of genuine feelings
The Narrative Approach Holds that family members conceptualize their problems and concerns through a series of stories about their lives and various members of the family system Externalization expressing a feeling or experience in words Relative influence questioning people are asked first to map the influence of the problem in their lives and relationships and then to map their influence on the life of the problem.
The Structural Approach Focuses on altering and restructuring the pattern of relationships between family members. To create more functional, balanced, and hierarchal family relationships Focuses on appropriate and adaptive levels of two problematic behaviors: Enmeshment and Disengagement Techniques are active and directive Joining- build and maintain therapeutic company with family Family Mapping: draw a map to identify boundaries or transactional styles Enactments: family engages in conflict situation that would happen at home Reframing: new perceptive or different interpretation on the problem situation in family
The Milan Approach Values neutrality as well as acceptance and respect for the family system Uses hypothesizing as well as positive, logical connotation to assist in better understanding family dynamics Encourages the use of a team approach Also uses “rituals” which is asking the family to behave in certain prescribed ways between sessions
The Strategic Approach Utilizes active and direct involvement by the clinician Believes that any attempt to change a member is met with either conscious or unconscious sabotage and resistance. Therefore paradoxical techniques are used, such as “reverse psychology” sometimes can be risky or controversial Reframing - altering the way one understands and interprets a given behavior.
The Experiential Approach Focuses mostly on the experiences of the client Humans are profoundly shaped by emotional experiences Important contributors to Experiential Approach Carl Whitaker Experiential-symbolic approach stressed choice, freedom, self-determination, growth, and actualization Stressed the importance of the relationship between the family and the therapist Did not purpose a set of methods; rather, it is the personal involvement that makes the difference Goal for authenticity, no right or wrong way to be
The Experiential Approach Important contributors to Experiential Approach August Napier wrote The Family Crucible with Whitaker Breakthroughs occur when family members begin to be “more separate, divergent, even angrier,” as well as “when they risk being closer and more intimate.” Outbursts of anger are often followed by greater intimacy and warmth unexpressed anger that keeps people apart also keeps them from loving one another.