Notes

Outline

Family Systems

Basic Assumptions Individual may carry symptoms for family Symptoms may be transgenerational Contextual--relational Patterns Reciprocal causality

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Terminology Family rules Organized repetitive patterns of interactions Homeostasis Families maintain dynamic equilibrium

"Double-bind" Double-bind Two contradictory messages delivered together

Approaches Explore family system for unwritten rules Invite all family members to therapy Transgenerational Meanings, rules, perspectives Change context rather than help cope

Murray Bowen’s Multigenerational Family Therapy [Psychodynamic]

"Differentiation of self vs." Differentiation of self vs. Undifferentiated family ego mass Emotional reactivity vs.. Thinking

Training of Bowenian Family Therapists Visit own family of origin in times of high tension Controlled, detached style De-emphasize collaboration or connection with client

Triangulation

Genograms Intergenerational family study Visual mapping to see patterns May include: Cultural and ethnic origins Religious affiliation Physical location of family Dates of marriages, deaths, births Physical or mental illness

Virginia Satir’s Human Validation Process [Person-centered therapy]

Biography Satir trained as educator, social worker First director at esalen Wholistic approach Body work Gestalt Dance therapy Pioneered family sculpting

Assumptions Movement toward positive growth All individuals possess resources needed for change and growth Interaction between clients and therapist Mutual influence Shared responsibility

Levels of Messages What one felt, but since it did not fit the rules, was denied (suppression) What one felt but ignored as unimportant (denial) What one felt but could not say (inhibition) What one felt but was unaware of (repression)

Four Defensive Stances  Placater: Passive, self effacing Agrees with others  Blamer: Disagrees, Finds fault Self righteous finger pointer  Super-reasonable:  Rigid posture Extremely logical and intellectual  Irrelevant: Unrelated and distracting actions Considers neither self nor others

Congruent Communications Send level messages Words and feelings match Neither self or other or context is denied

Carl Whitaker’s  Family Therapy [Experiential]

Atheoretical Stance “My theory is that all theories are bad except for the beginner’s game playing, until he gets the courage to give up theories and just live …any indoctrination tends to be constrictive and constipating”

Assumptions Troubled people Alienated from emotions, frozen Stereotyped, safe routines Stress necessary for change Therapist creates tension Teasing and confronting

Techniques Focusing on fantasies and symbols Intensify here-and-now Uses co-therapists to counterbalance “craziness”

Salvador Minuchin’s Structural Family Therapy [Behavioral]

Background Trained in native argentina Treated delinquents in urban slums Utilized local black community leaders as paraprofessionals Directive, even blunt

Family Subsystems Spousal Husband and wife Parent-child Siblings Extended family

Boundaries CLEAR: firm yet flexible DIFFUSE: enmeshed relationships RIGID: disengagement within/between systems

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Role of Therapist Challenge rigid transactional patterns Push for clearer boundaries Increase degree of flexibility Block stereotyped interactional patterns

Jay Haley’s Strategic Family Therapy [Behavioral]

General Framework  Focus on symptoms  Set a clear goal for therapy  Assign tasks  Method oriented Problem focused No attempt to instill insight  Short range goals

Stages Of Family Life Courtship period Early years of marriage Childbirth and rearing of children Middle years of marriage Weaning parents from children Retirement and old age

Therapist’s Role Consultant, expert Little focus on client/therapist relationship Therapist directive and authoritarian Therapist may operate covertly Paradoxical intention, manipulation

Social Constructionism [Integrative]

General Framework Reality is multi-perspectival and subjective Reality based on language and narrative Collaboration and empowerment

Reflecting Team Participant-observer therapy “I wonder if the team at this point has any ideas that might be helpful.”  “May I ask them?” Style of response mirrors client’s: rhythm, speed, style Team remains positive, discreet, respectful, sensitive, imaginative

Narrative Aproach Dominant culture narratives are reframed Medical model stories not accepted as “truth” Reauthor, in oral tradition Retelling of life stories “cannot step into same stream twice”

Characteristics Of A Healthy Family Legitimate source of authority Stable rule system Stable and consistent nurturing Effective and stable child rearing and marriage maintenance Family values and goals Flexibility in boundaries, roles