L17: Stages of the Family Life Cycle

Question 1

In terms of loose and tight boundaries, what boundaries do healthy families have?

Answer 1

• Boundaries that are flexible and neither too tight nor too loose. Support is available, but not too smothering

Question 2

Describe tight boundaries in family

Answer 2

• family disengaged, minimal contact, insufficient support, insufficient structure

Question 3

How does a pts behavior relate to a family system? Are these two things separate?

Answer 3

• No, these are not separate - Pts behavior may be indicative of things occurring in family. Family, rather than individual might actually be the pt.

Question 3

Characteristics of communication in poorly functioning family.

Answer 3

• Double bind communication, general, ambiguous and inconsistent

Question 4

Describe process of anxiety and symptom developmental at transitional points in developmental process of families.

Answer 4

• Greatest stress typically occurs at transition points in the developmental process. - Transitional points: marriage, birth, adoption, divorce, deployment, death, incarceration etc. - Heightened stress levels often lead to symptom development - Stress during earlier transition point may re-appear as symptomatology during a later transition point - In addition to stressors from life cycle transitions, also come from chronic illness, unemployment, war, economic disaster.

Question 5

Describe feedback loops seen in family systems.

Answer 5

• Positive feedback loops: behavior increases a second behavior, which in turn increases first behavior. Leads to chaos - Negative feedback loops: increase in behavior in one place causes a parallel decrease somewhere else. Leads to maintenance of balance

Question 5

Using Murray Bowen’s family systems concepts, what area are physicians sometimes implicated in?

Answer 5

• Triangles

Question 6

List subsystems within a family. List larger systems that subsume families

Answer 6

• Subsystems: individual, marital/partnership, sibling, parental - Larger systems: neighborhood, religious community, community/city, nation

Question 6

List and describe concepts from Murray Bowen’s family systems.

Answer 6

• Differentiation of self: being able to think critically about emotional issues within family rather than acting out those feelings, taking responsibility for self without blaming or making demands - Fusion: opposite of differentiation of self. Rational thinking overwhelmed by emotion, two or more individuals lack boundaries bw them, occurs when family is highly stressed - Dyads are unstable because conflicts occur. Why? No two people are identical - Triangles occur: third person brought into conflict. Normal common phenomenon, higher stress more people triangulated in, two insiders, one outsider, positions shift, stabilize relationship, but differentiation difficult because dyad relies on third party for stability

Question 8

Describe loose boundaries in family

Answer 8

• family enmeshed, subsystem boundaries weak, in-laws overinvolved, parents/children don’t have differentiated roles, individuality is met with strong resistance

Question 9

Describe triangulation/triangles according to Murray Bowen

Answer 9

• third person brought into conflict. Normal common phenomenon, higher stress more people triangulated in, two insiders, one outsider, positions shift, stabilize relationship, but differentiation difficult because dyad relies on third party for stability

Question 10

How are family systems similar to biological systems?

Answer 10

• Family systems seek homeostasis just as living organisms

Question 12

Difference between intrinsic and extrinsic religiosity. Which is associated with better health outcomes?

Answer 12

• Intrinsic: someone who sincerely believes in their religion and all its teachings and attempt to live their lives as their religion preaches they should - Extrinsic: method of using religion to achieve non-religious goals, view religion as means to end. - Intrinsic is associated with better health outcomes

Question 13

Describe differentiation of self according to Murray Bowen

Answer 13

• being able to think critically about emotional issues within family rather than acting out those feelings, taking responsibility for self without blaming or making demands

Question 14

What is double bind communication?

Answer 14

• When verbal content of a statement says one thing, but non-verbal content, or reaction if person obeys verbal content, says another.

Question 14

Describe fusion according to Murray Bowen

Answer 14

• opposite of differentiation of self. Rational thinking overwhelmed by emotion, two or more individuals lack boundaries bw them, occurs when family is highly stressed

Question 16

What is an identified pt?

Answer 16

• Person exhibiting the symptoms, but the symptoms are resulting from the family system as a whole

Question 17

Characteristics of communication in healthy functioning family.

Answer 17

• Open, honest, consistency between explicit and implicit messages

Question 19

Describe dyads according to Murray Bowen

Answer 19

• Dyads are unstable because conflicts occur. Why? No two people are identical

Question 20

Stages of family life cycle

Answer 20

• Leaving home - Joining of families - Families with young children - Families with adolescents - Launching children and moving on in midlife - Families in late-middle age - Families nearing the end of life

Question 21

What are things to pay attention to when working with pediatric, adolescent, geriatric and adult groups in terms of their families?

Answer 21

• Pediatrics: communicate routinely with both parents - Adolescents: build rapport with adolescent and parents, have time alone with adolescent - Adults: family members significantly enhance or inhibit appropriate use of medical care - Geriatrics: family involvement is often necessary for full information and treatment compliance