Nagy Flashcards
Theory Development: influences
- Fairburn’s Object Relations Theory
2. Sullivan’s Interpersonal Psychiatry
Theory Development: New theory of motivation
Not based only on needs and internal drives, but based on what is owned both to and by the individual
Object Relations Theory
- explains motivating factors behind use of defense mechanisms
- people don’t seek pleasure (like Freud thought) they seek objects (relationships)
Therapists motivation for object relations theory
people have a need for satisfying relationships
Nagy’s view of the family
- Facts (roots and events)
- Psychology
- Transactions
- Relational ethics
Facts (roots and events)
1 of Nagy’s view of the family
- roots = geneology, SES, culture, etc.
- events = traumas
Psychology
1 of Nagy’s view of the family
- how family members regard relationships in the family’s development
- “The intrapsychic structure of individual family members”
Transactions
1 of Nagy’s view of the family
- family structure/patterns of family organization
Relational ethics
1 of Nagy’s view of the family
- Explains motivating factors behind defense mechanisms or cross-generational coalitions in terms of imbalances in ledger
The Ledger
- Legacy
- Merit
- Issues of entitlement and indebtedness occurs when the ledger is not balanced
Legacy
Acquired by birth into a family and by taking one’s place in the family
- SES, religious beliefs, health issues, wealth, last name, role acquired by certain familial expectations
Merit
Accumulate merit through contributing to welfare of others. What an individual feels like s/he deserves.
- a parent might feel like their children owe them
Trust and the ledger
relationships become trustworthy when there is equal give and take (a balanced ledger)
- a wife can rely on the fact that her husband will be there for her and vice versa
How symptoms develop
- trustworthiness breaks down (unequal give and take)
- No valid substitutions (if you have a needy mother, you can’t substitute your need of affection by getting it from someone else)
Examples of symptom patterns
- split filial loyalty
- revolving slate
- relational stagnation
- negative loyalty
split filial loyalty
An example of a symptom pattern
- a child becomes more loyal to one parent than the other. Happens often in divorces.
Revolving slate
An example of a symptom pattern
- negative family legacy. Problems occur from one generation to the next.
Relational stagnation
An example of a symptom pattern
- lack of growth in a relationship.
- a child feels so loyal to the parents that the kid doesn’t make any outside friends.
Negative loyalty
An example of a symptom pattern
- scapegoating
Goals of Contextual Therapy
- Face the invisible loyalties within the family
- the scapegoat needs to speak up - Recognize unsettled “accounts”
- figure out who is owed what and why - Rebalance one’s obligations and relationships
- this rebuilds trust among members
Therapy set-up: Who is seen?
The whole family - kids, extended family, etc.
Why? Rework trust (balance ledger) so that children don’t pass down the unbalanced ledgers
Therapy set-up: role of therapist
co-therapy teams presents balanced relational model
- co-therapists can model what fairness looks like in a relationship
Sullivan’s Interpersonal Psychiatry
How personalities develop
Therapy Process: Assessment
- What is the relative balance and imbalance in family relationships?
- How are family members addressing separation-individuation of members v. family loyalty issues (loyalty issues often arise when kids try to differentiate)
Therapy Process: Interventions
- multi-directed partiality
2. transference relationships created
Multi-directed partially
Co-therapy team is empathic for each client member but also holds them accountable. Family members should hold each other accountable while being empathic.
Transference relationships created
Clients adopt therapists as “parents” to have a working model of fairness. As therapy progresses, the therapists let go (reduce transference) and the family takes over more responsibility.
Therapy Process: Termination
Therapy ends when future families are safe
- therapy process of rebuilding trust is referred to as “rejunctive process”
Nagy on IPCM…
Starts at organization of mind/object relations on the matrix
