Ch. 1: History of MFT Flashcards
What were the 5 factors that led to the development of MFT?
- The extension of psychological treatment to include the full range of emotional problems (from Freud and psychoanalysis to Family Therapy)
- Intro of General Systems Theory (explore relationships among the parts that make the whole)
- Investigation of family’s role in a member’s development of schizophrenia
- Child Guidance and Marital Counseling movements
- Increased interest in group therapy as clinical technique
What was psychoanalysis?
Freud’s theory about psychosoexual development. May have considered context but believed in individual therapy so as not to “contaminate” therapy.
Why did analysts not like psychoanalysis?
- Problems in negotiating psychosexual stages of development led to variety of psychiatric diagnoses.
- Toxic influences of family was recognized and patients were removed from destructive family environment for treatment
- Many analysts realized the importance of the behavior’s interactional context and the relation between the parts of the family system
- moved away from thinking about individual’s disturbed behavior (focusing on person’s disturbed state of mind) to the effect of that same behavior on the family system.
Findings for schizophrenia research
- When the patient got better someone else in the family got worse
- The patient got better in the hospital but regressed when he/she returned to their dysfunctional home environment
- Dysfunction resides in the family system not in the individual members
General Systems Theory
A whole group has properties and characteristics separate from individual members
Alfred Adler
- Child Guidance Movement
- Early 1900s
- Student of Freud’s in Vienna
- Initiated Child Guidance Movement
- Broadened view of psychological problems from intraspychic view to include the social context
- First to believe that treating children could prevent development of mental problems
- Believed people were motivated to overcome feelings of inferiority
- A person’s behavior was consistent with their life style, whether functional or dysfunctional
- Social interest = helped people develop a life style in which they cared about the well-being of others instead of the need to feel superior.
Rudolph Dreikurs
- Child Guidance and Marital counseling movements
Associate of Adler’s in US 1920s - Extended Child Guidance movement to include marriage counseling
- Believed that the real problem was tensions that existed in the family and not the child’s symptoms
- Led to blaming the family
- Problem: Parents (usually moms) still treated separately from child
Abraham and Hannah Stone
Opened first Marriage Counseling Center in NYC 1929
Paul Popenoe
Founded American Institute of Family Relationships on the Wet Coast 1930
Emily Mudd
1932 began the Marriage Council of Philadelphia. She also helped found the American Association of Marriage Counselors in 1941 - was renamed American Association for Marriage and Family Therapy in 1979.
Kurt Lewin
Group Therapy and Group Dyanmics
- 40s and 50s researcher who developed field theory
- believed that whole is greater than the sum of it’s parts
- working in groups produced greater change in ideas and behaviors than individual tx
- there are stages of group development and predictable changes as family move through the life cycle
- used encounter groups and t-groups (training groups)
- used participant observation to study small group dynamics
- field theory
Wilfred Bion
Group Therapy and Group Dynamics
- Tavistock Institute in England
- studied groups and found that predictable properties emerge from group dynamics
How did group therapy and group dynamics help family therapy?
highlighted the distinction between what the groups discussed (content) vs. how they discussed it (process)
… process/content distinction
Why can we not use group therapy to treat families?
Family dynamics differ from group dynamics with strangers and thus group therapy techniques are not very successful in fam tx.
Peter Laqueur
1950 - started multiple family group therapy.
- saw several families together in a group using techniques from traditional therapy, psychodrama, and encounter groups
- families were used as co-therapists for each other.
Jacob Moreno
- 1940s
- created psychodrama: combination of group therapy and theatrical techniques
- similar to role playing: family members engage in enactments of troubling events, exploring family relations in the process
Family Process Journal
1960s - family therapy movement began to grow
- 1962 Journal was founded by Ackerman and Jackson
- Jay Haley as editor
The Pioneers: Ludwig von Bertalanffy
- 1940s developed General Systems Theory
- GST = parts of a system are interrelated and the whole is greater than the sum of its parts
… an individual’s behavior is connected to other family members’ behavior and reflects the family systems rules - allows for multiple valid analyses of the problem
The Pioneers: Nathan Ackerman
- “The Father of Family Therapy”
- among 1st to work with whole families
- 1938 said we should view family as a single entity
- 1958 wrote “The psychodynamics of Family Life” – working with whole family would help psychiatry have a deeper understanding of biological and interpersonal influences on personality development
- need to consider intra-psychic phenomena when working with families
- shifted therapeutic focus from individual to his/her interpersonal interactions
The Pioneers: John Bell
- 1951 was a psychologist at Clark University. Might have been first to treat families
- family group therapy.. if therapist could stimulate discussions, the family could solve its own problems
- structured his work to concentrate on stages
- often overlooked because he wasn’t published until the 60s nor did he establish a training center
The pioneers: Who were the members of the Mental Research Institute (MRI)? When was it founded? What did they do?
Members:
- Gregory Bateson
- John Weakland
- William Fry
- Don Jackson
- Jay Haley
- Virginia Satire
- Founded in 1959
- Studied communication patterns of families with a member diagnose with schizophrenia
- This group made significant contributions to the emerging theories about how families and systems work.
Cybernetics
- the study of how systems are controlled and how information feedback loops work
- found that symptoms function to keep families in equilibrium
The Pioneers: Bateson
- cultural anthropologist and scientist
- wife was Margaret Meade
- studied patterns, processes, and organization in communication
- aware of cybernetics
- studied theory of communication
Homeostasis
Tendency of families to resist change.
Behavioral Redundancy
Jackson and MRI found that people in continuing relationships develop rule-determined, repetitive patterns of interaction
Double Bind
- a 6 step concept described by Bateson
- individual receives contradictory commands within an important emotional relationship
- the recipient of the information can neither comment nor escape
- “damned if you do, damned if you don’t” situation
- originally hypothesized that the double bind was a disordered family communication style that led to the development of schizophrenic symptoms
Marital quid pro quo
- From Jackson
- roles that spouses develop don’t necessarily develop from gender differences, but emerge in the relationship as a result of a series “quid pro quo” or mutual exchanges
The pioneers: Jay Haley
- Heavily influenced by Erickson
- developed model of problem focused family therapy called “brief therapy”
- He used directives (tasks) to get the families to change their behaviors
- the directives were often therapeutic paradoxes
- Later worked with Minuchin and became interested in family coalitions
- bridged the strategic and structural models of family therapy
The Pioneers: MRI
Mental Research Institute
- center for the study of families in Palo Alto, CA
- Bateson, Satir, and Haley studied schizophrenia and family interactions, communication, and cybernetic theory
- emphasized process and interactional sequences rather than structure
- distinguished between first-order and second-order change
- developed a version of brief family therapy based on the notion that the “problem”, or treatment focus, stems from the failed solution already attempted by the family
- Later MRI added Watzlawick, Weakland, and Fisch
The Pioneers: Salvador Minuchin
- Founder of the structural model
- worked with Ackerman
- influenced by Harry Stack Sullivan
- Learned from Jay Haley the importance of sequences and the value of the paradox in family therapy
- hypothetical structures both influence how families operate and make them resistant to change
The Pioneers: Virginia Satir
- a therapist at MRI who concentrated on feelings/affect in her work
- used warmth and acceptance
The Pioneers: Milton Erickson
- hypnotist
- influenced the MRI group
- believed people could make rapid, dramatic changes if they could be induced to try something new.
- Haley and Weakland consulted with him regularly.
- therapy was done to, not with, families (like Haley)
The Pioneers: Frieda- Fromm Reichmann
1940s
- searched for onset of schizophrenia in parent-child dynamics
- coined the term “Schizophrenogenic mother”, which blamed mothers for their children’s symptoms
The Pioneers: Theordore Lidz
- Thought fathers, not mothers, were to blame for schizophrenia in children
- found the “marital schism” and “martial schew” that contributes to the development in children’s dysfunction
Marital schism
- Lidz
- parents are overly focused on their own problems - undercut each other, do not accommodate to one another, and compete for children’s attention while failing to attend to the child’s needs.
- high levels of conflict and threats to the continuation of the family unit
Marital skew
- Lidz
- one parent dominates the family, and the other is dependent
- children are torn between parents
- profound deficits in addressing their developmental needs that dysfunction and schiz. may develop
The Pioneers: Lyman Wynne
- 1940s
- applied psychoanalytic ideas to his work with families with sever mental and physical disorders in Boston
- concentrated on “how pathological thinking is transmitted in families”
- worked at National Institute of Mental health (NIMH) in the 60s
- coined “pseudomutuality”, “pseudohostility”, “rubber fence boundary”
- noted that alliance and splits help families maintain equilibrium
MFT in the beginning was seen how?
- brief therapy to fix damaged relationship
- worked in the here and now and didn’t talk about the past
- Once GST and family research was introduced, marriage counseling focused on system as context for behavior
- initially was practiced either collaboratively (each partner had his/her own therapy), or concurrently (1 therapist sees both partners but separately)
- Don Jackson created conjoint therapy in 1959 - partners seen together
Pseudomutuality
- coined by Wynne
- collusive family maneuver for the purpose of maintaining homeostasis - families present a falsely harmonious picture, masking dysfunction
Pseudohosility
- From Wynne
- describes the chronic conflict to create a somewhat superficial alienation of family members, thereby masking an individual’s need for intimacy and affection.
Rubber Fence Boundary
- from Wynne
- term to describe type of boundaries around some families that may appear open and flexible but in fact permit little information from the outside to penetrate. In these families, rules are in constant flux
(reminds me of my in-home families)
The Pioneers: Murray Bowen
- studied schizophrenic families
- at NIMH
- realized that families were the unit of disorder and began treating whole families (1955)
- patients lived with their families in the hospitals
- “emotional divorce” = the cool distance between parents.
- interested in transgenerational of problems and differentiation from FOO
- his model centers around “Differentiation of self” = the ability to differentiate one’s thoughts from one’s feelings, and to become autonomous from one’s family
- in therapy he remained neutral and nondirective and was not drawn into the “undifferentiated ego mass” of the family
- in therapy he lowered emotional reactivity of the clients
- coined the term “triangulation”
- worked with couples and helped them differentiate from their families
- thought the most important quality of successful therapy was differentiation of the therapist
Undifferentiated Family Ego Mass
- Bowen
- phenomenon in which family members are emotionally fused, highly reactive, and structurally chaotic.
- emotions overwhelm the intellect and interfere with individual functioning in the family
Differentiation of self
- Bowen
- the ability to differentiate one’s thoughts from one’s feelings, and to become autonomous from one’s family
Carl Whitaker
- heightened emotional intensity in therapy
- symbolic-experiential family therapy
- supported and goaded his clients
- encouraged co-therapists,
which let his use his own “craziness” as a therapeutic technique
Ivan Boszormenyi-Nagy
- psychoanalytically trained and the son of a judge, which impacted his work
- concepts of justice and fairness influenced his model - “contextual therapy”
- focused on multigenerational ethical accountability and relational ethics
- thought family members are bound across generations by loyalty and trust
- created a system of internal moral accounting in which people balance the ledger of accountability and the ledger of indebtedness
- sponsored James Framo who created a treatment model for couples
- sponsored Ross Speck and Carolyn Attneave who developed model of “network therapy”
contextual therapy
- Nagy
- Based on ethical dimension of family relationships
- The family maintains invisible, intergenerational loyalties
- members hold personal ledgers
- problems in relationships are thought to result either from an attempt to maintain or change the balance sheet of what members owe to one another.
- the therapist must exemplify ethical accountability
- core of treatment is “multidirectional partiality”
ledger
- Nagy and contextual family therapy
- internal system in which the relative balance of debts and entitlements is kept
- ideally, there should be a balance between the repayment of the person’s debt to the FOO and self-fulfillment
Multidirected Partiality
- Nagy and Contextual Family Therapy
- T is accountable to and supportive of every relevant family member, even if that means accepting contradictory positions within a conflict
- T strives for neutrality, joins with each family members, and keeps communication open with all members.
Network Therapy
- created by Speck, Attneave, and Ruevini
- treatment includes people from client’s social network
- often a large group with family friend and neighbors
- team of therapists come together to solve the client or family problem
- 6 phases: retribalization, polarization, mobilization, depression, breakthrough, exhaustion-elation
Structural Family Therapy
- Minuchin
- T attempt to understand and alter structures that influence behavior and cause problems
- pay attention to family boundaries
- 2 types of families: enmeshed (tightly connected and chaotic. boundaries are diffuse), and disengaged (members are too uninvolved and distant. Boundaries are rigid)
- Used variety of techniques to join with clients
Fred and Bunny Duhl and David Kantor
- combined techniques from several models and created expressive, experiential, and nonverbal techniques, including spacialization and family sculpting
modernism v. postmodernism
modernism = “truth” consists of a tangible, knowable set of observable or deductive facts (feminist family therapists)
post modernism = there are no universal truths, only POVs. emphasis on language v. meaning Therapists don’t act as experts but work with the families to find a new meaning, or a more useful epistemology (way of knowing) through language.
postmodernism v. feminism
feminists argue that the patriarchal social system is a real structure with negative consequences and support a modernist view - the female therapist should give more weight to the woman’s perspective to offset the power imbalance.
postmodernists believe in neutrality
Who developed narrative therapy?
Michael White and David Epston
Who developed solution-focused therapy?
Steve de Shazer and Insoo Berg
Field Theory
- From Lewin
- the theory that the individual’s field or “life - space” is psychologically and emotionally constructed of objects that are perceived to have either positive or negative valence.
- positively valued objects are approached, while negatively values ones are avoided
- closely related to Gestalt psychology in its interest in how attention to objects is determined
