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)
