Unit on Family Therapies
Slide 1: Family therapies
Jay Haley, Milton Erickson, Peggy Papp, Monica McGoldrick, Salvadore Minuchin,
Chloe Madanes, Carl Whitaker, and many, many more...
Slide 2: An overview of family therapy ideas
-
Systems
-
Ways to identify patterns
-
Rules
-
Roles
-
Boundaries
-
Hierarchies and structures
-
Communication patterns
Slide 3: Cliff's Story
Why did Cliff come to therapy?
Slide 4: Systems
-
Individual can't be understood in isolation: affected by people and context.
-
Has rules, structure, organization
-
What was Cliff's context?
-
System is dynamic and effects are bidirectional.
-
System can stress or support a person.
-
Who is part of my system?
Slide 5:Interactions are bidirectional
Slide 6: What might you expect here?
Slide 7:
Given that a person is an integral part of his or her system, affecting
and being affected by it, should we ever intervene without considering
the system?
Slide 8: Identified patient
-
Identified patient is the reason that family enters therapy, but is not
the only problem.
-
The structure of the family should be addressed, often with the whole family
present.
Slide 9: Ways to assess patterns
-
Ecogram
-
Genogram
-
Timelines
Slide 10: A section of Cliff's timeline
1975 Cliff meets Mildred and they begin dating.
1976 Cliff and Mildred marry. Because
money is tight, they live with his parents and decide not to have
children for several years. This living arrangement is conflictual.
1979 Cliff and Mildred move into their own
home and begin trying to have children. Their relationship with
his parents improve. Conceiving turns out to be less easy than they
had expected.
1980 Cliff's mother is diagnosed with leukemia.
Mildred miscarries.
1982 Mildred miscarries again.
11/83 Mildred finds out that she is pregnant again.
2/84 Cliff's mother dies unexpectedly
from complications related to leukemia. His father says, "You're
not
going to embarrass me by crying are you?" He never cries.
Slide 11: Rules
-
System is governed by rules (both spoken and unspoken) about communication,
expression of feelings, privacy, gender roles, etc.
-
Rules are often most visible when contrasted with another system.
-
What are the rules for this system (this class)?
-
What rules might govern Cliff and Mildred's system? How could these
be useful or cause problems?
Slide 12: Roles
-
Every system is governed by typical roles governing functioning.
-
Typical roles include:
-
Identified patient
-
Parentified child
-
Caretaker
-
The baby
-
Black sheep
-
The angel
-
The distractor
-
The victim
-
The competent one
-
The incompetent
-
Roles are ok when they help the person and system and do not prevent person
from growing.
-
How might Cliff and Mildred's roles be problematic?
-
Roles tend to become more rigid when we're under stress, as a result of
positive feedback loops.
Slide 13: Positive feedback loops
Cliff
Mildred
"Strong" is good
"Weak" is good
Being strong means suppressing
Desires caretaker
emotions
Then she becomes ill.
Becomes stronger, overloaded,
Becomes weaker, less able to help
stressed
Recognizing this:
Becomes more stressed, depressed,
Becomes depressed, less capable
more withdrawing
Slide 14: Structural family therapy
(Salvador Minuchin)
-
What causes pathology?
-
What maintains pathology?
-
Pathological family structures and boundaries
Slide 15: Boundaries
-
Protects privacy
-
Limit flow of information
Slide 16: Healthy boundaries
Slide 17:Two kinds of disengaged
families
Slide 18: Healthy and disengaged families
Healthy
Disengaged
Allows needed information to pass from one
Prevents flow of most info or exchange of emotions
person
or subsystem to another.
Little effect of one person on another
Limits flow of inappropiate info
Often difficulties with communication and connection
Slide 19: Two
kinds of enmeshed families
Slide 20: Healthy
and enmeshed families
Healthy
Enmeshed
Allows needed information to pass from one
Difficult to distinguish between one person's emotions
person or subsystem to another.
& needs and another's.
Limits flow of inappropiate info
Problems with privacy, autonomy, individuation
Slide 21: Structure
All families have structure, with some people having more responsibility
and power than others.
Slide 22: Healthy
structure
Slide 23: Unhealthy
structures
Slide 24: How
can you identify problems in structure?
-
Children have more power or responsibility than one or both parents.
-
Children go to parentified child rather than parent.
-
What are the disadvantages of parentifying a child?
Slide 25: Communication
school (Haley, Satir, etc.)
-
All behavior (verbal and nonverbal) is communication.
-
Cannot not communicate, but communication can
-
Give conflicting messages
-
Come closer… but attacks when you do.
-
I want sex… but messages that indicate ambivalence about it.
-
Be ambiguous
-
What does silence mean?
-
Behavior may have different meanings because of your own history.
-
Goal of communication school is to clarify the communication process.
Slide 26: Clear,
nonconflicting messages?
Slide 27: What
is process of family therapy like?
-
Often direct and active process, with therapist an active member of the
system rather than only an observer.
-
Generally present rather than past oriented.
Slide 28: What
is process of family therapy like?
1. Joining (Rapport building)
2. Assessment
-Genograms, community genograms, timelines, family sculptures
-Enactments -- rather than talking about the problem, show it.
3. Reframe problem (as appropriate)
4. Reinforce new boundaries and structures
5. Try new ways of interacting
Slide 29: Family
sculpture
Page by jms
URL= http://psy1.clarion.edu/jms/cptfamilypp.html
Last modified November 1, 2001.
