PSYC 553 – Introduction to Family Dynamics

Question 1

Alignments

Answer 1

a term used in structural family therapy developed by Salvador Minuchin, alignments refer to the ways in which family members join together or oppose one another in carrying out a family activity. Forming an alignment can often be a source of power for those who have formed it. These affiliations and splits, temporary or permanent, are usually formed in the pursuit of homeostasis within the family system.

Ex:The structural family therapist determined that the stable coalition between the mother and son against the father had an undermining effect on the family functioning. The father felt disconnected from the mother and no alignment between them on key issues such as disciplining the son was formed. This enabled the son to take advantage of the mother’s easy going disciplinary style and have excessive freedoms that were disrupting the family functioning

Question 2

Bowen’s Family Systems theory (tenets of)

Answer 2

Who: Bowen What: Multigenerational Transmission of Family Problems, Eight Factor theory. Why: Created an Objective theory for taking Intuitiveness out of therapy. How: Looked at multigenerational trends by examining eight concepts of family functioning.

Bowen conceptualized the family as an emotional unit with a network of interlocking relationships tied together in thinking feeling and behavior, and best understood when analyzed within a multigenerational framework. Humans are always trying to balance two life forces – family togetherness and individual autonomy.

Currently, there are eight interlocking concepts in Bowen’s theory: differentiation of self (individual should differentiate from family), triangles (occur when a two-person system moves a third individual between them to decrease anxiety), nuclear family emotional system (individuals are attracted to mates with similar differentiation levels), family projection process (parents project level of differentiation onto at least one child), emotional cutoff (extreme emotional distancing from family of origin to decrease anxiety caused by fusion), multigenerational transmission process (in which chronic anxiety is transmitted down generations), sibling position , (personality characteristics are influemced by sibling position) and societal regression. (Coping strategies for life are passed down through generations)

EX—The family presented to therapy because daughter was being rebellious, sexually promiscuous, and failing at school. Using the Bowenian Family Systems approach, the therapist looked at fusion, triangulation, emotional cutoff, the undifferentiated family ego mass, and multigenerational transmission process to determine the chronic anxiety and resulting dysfunction that perpetuated the problems at hand. He constructed a family genogram so that the family could see a visual representation of where and how the problems had manifested themselves. The family was able to see that the daughter was not the sole problem but that the entire family unit needed to change to see systemic and lasting changes.

Question 3

Brief Solution-focused therapy (tenets of)

Answer 3

If it ain’t broke, don’t fix it:
Once you know what works, do more of it;
If it doesn’t work then don’t do it again, do something different.

based primarily on the work of social constructionist Steve de Shazer, this is a family therapy which focuses primarily on change and solutions rather than on the current problems and pathology. Based on the premise that dysfunction develops from failed attempts at problem-solving. SFBT focuses on changing the family’s cognitions, or how they view the problem. Shazer believed that clients were not naturally resistant to change but become “stuck” in their problem-solving process. Language is used to imply that change will take place, which makes the client’s expectant of change and therefore more willing to actually change.

EX—Rosie presented to therapy with anxiety. She has been a prostitute to supplement her welfare payments and believes she may have gotten pregnant from unprotected sex with a client. Using BSFT techniques, the therapist did not focus on Rosie’s problems but looked toward a solution and asked her what she would notice was different if she woke up the next morning and a miracle had occurred, solving her problems. This miracle question prompts Rosie to begin to look at what she wants changed in her life and how she can begin to attain that thru therapy.

Question 4

Circular questioning

Answer 4

an interviewing technique in family therapy, first formulated by the Milan systemic theorists, designed to elicit differences in perceptions about events or relationships from different family members. This technique allows the therapist and the family to hear the multiple perspectives of different family members, and also serves to expose recursive family patterns.

EX—During a family session discussing the teen daughter’s rebellion against curfews, the therapist asked each of the three children to compare their mother’s and father’s reactions to the teen daughter’s rebellion on a 10-point scale and then asked each spouse to rate the reactions of themselves and the other spouse. This allowed the therapist and family to see the differences in perception to the problem.

Question 5

Coalitions

Answer 5

a term used in structural family therapy developed by Salvador Minuchin: A fundamental property of triads, a coalition is an alignment between two persons or social units against a third. Coalitions may be stable, in which case they become a dominant part of the family’s everyday functioning, or detouring, in which the coalition holds a third member of the family responsible for their difficulties and/or conflicts with one another.

Ex—The structural family therapist determined that the stable coalition between the mother and son against the father had an undermining effect on the family functioning. The father felt disconnected from the mother and no alignment between them on key issues such as disciplining the son was formed. This enabled the son to take advantage of the mother’s easy going disciplinary style and have excessive freedoms that were disrupting the family functioning.

Question 6

Deconstruction in Narrative Therapy

Answer 6

term originally introduced by Jacques Derrida to refer to the fact that literary works have no single meaning, and appropriated to narrative therapy in order to remind clients that there is no one meaning or one set of assumptions that is “correct” for the same event or experience. Rather, a multitude of meanings or assumptions may be derived from the same event. Deconstruction empowers clients to deal more competently with new views of reality and lea more satisfying lives.

EX: The physician’s goal is not so much

“selling” interpretations to the patient as assisting to
deconstruct problematic behavior, note contradictory
occurrences, and wonder about their significance. The patient puts together the pieces. During a session with a family,the therapist asks a deconstructive question after hearing the boys idea of what it means to be masculine, “Who told you “real men” don’t pay attention to their health?” He then encouraged the client to see masculinity from a variety of view points so that he could understand that he has control over his definition of self.

Question 7

Differentiation

Answer 7

in the context of Bowen’s family systems theory, differentiation refers to the separation between an individual’s thoughts and feelings. The ability to differentiate between thoughts and feelings helps an individual differentiate themselves from their families, and not confuse their family’s emotions and thoughts with their own. Better differentiated individuals are less prone to dysfunction.

EX—The family presented for therapy because of the teen daughter’s rebellious b/h. The Bowenian family therapist observed an undifferentiated family ego mass that kept the family emotionally “stuck together.” The teen daughter’s attempt at self differentiation was viewed upon as being rebellious by the family. The family was shown how fused they were and prompted to begin to differentiate and gain individuality.

Question 8

Disengagement

Answer 8

in the context of structural family therapy developed by Minuchin, disengagement occurs when the boundaries in a family system are too rigid. Rigid boundaries and subsequent disengagement occur when there is over-differentiation and individuation between family members, resulting in the loss of the “we” of the family. Disengagement results in feelings of isolation and disconnectedness from each other.

In disengagement, family members’ boundaries are so closed that they avoid each other, feel unable to ask for help, and have no sense of family loyalty.

Disengagement is the exact opposite of family ‘enmeshment.”

Ex:The Brown family comes into therapy, the therapist observes that they seem to have little emotional and physical contact with each other and had their own chores in the house they were responsible for and generally kept to themselves

Question 9

Double bind

Answer 9

in the context of family therapy, a double bind occurs when an individual receives two conflicting injunctions from a person with whom they have an ongoing important relationship. The individual feels that they cannot win no matter which injunction they obey, and are also not allowed to comment on the situation in which they have been placed. Bateson and others hypothesized that this could cause severe pathology, such as schizophrenia.

A double bind is a situation in which a person is given conflicting messages and punished no matter what they do-

EX: Observing a family’s interaction, the therapist noticed that the wife was upset at the husband. “I don’t want you to do it because I asked you to; I want you to do it because you want to.” The expression of feelings is important in a relationship, but in this case the other partner is put in a double bind: if they do it the desirous partner thinks it was only done because they had spoken up, if it is not done he is not meeting his partner’s need.

Question 10

Enactment

Answer 10

Developed by Minuchin, in the context of structural family therapy, this is a facilitating intervention in which the family is asked by the therapist to spontaneously enact, or play out, their relationship patterns during the therapy session. This allows the therapist to observe the family structure and ultimately to develop a plan or new set of rules for restructuring the family’s future interactions.

Example:In effort to bring an outside conflict into therapy the therapist asks the client not to give into the child’s requests in order to see the child’s tantrum. Therapist assessed the enactment and noted behavior and the interactions between mother and child.

Question 11

Enmeshment

Answer 11

in the context of structural family therapy developed by Minuchin, enmeshment is when the boundaries between members in the family system are too diffuse. Diffuse boundaries and subsequent enmeshment occurs when there is no differentiation or individuation between family members, resulting in the loss of “I” for each member. Family members are over-involved and over-concerned with each other’s lives. Counterpart to disengagement.

Ex:The family presented to therapy because the 13 yr old daughter was suffering from anorexia. The structural family therapist discovered that the family was enmeshed with diffuse boundaries that did not allow for individual autonomy. When the daughter gets anxious and depressed her mom, in turn, gets anxious and depressed. The mom is not able to separate her emotional experience from that of her daughter Enmeshment between a parent and child will often result in over involvement in each other’s lives so that it makes it hard for the child to become developmentally independent and responsible for her choices. Need to implement boundaries.

Question 12

Entropy

Answer 12

in the context of systems theory, entropy refers to a state of chaos and disorganization due to the the lack of energy or information input.

Closed family systems lack competence in dealing with stress due to limited or nonexistent input from others outside the family unit. The family may have fearful, confused, and ineffective responses in time of crisis or prolonged stress.

Ex:A Hispanic family who recently immigrated to the US live in relative isolation, communicate only among their own cultural group, aare suspicious of outsiders, and foster dependence on the family. They hold on to tradition and avoid change. (Operat in a closed system) The children began acting out as they were trying to acculturate at school, thus resulting in an entropic family.

Question 13

Experiential family therapy

Answer 13

A form of family therapy pioneered by Carl Whitaker and Virginia Satir. Is based on Humanistic (people are innately good, creative and resourcesful) and Existentialistic theories. Therapy places an emphasis on:

1. Freedom and responsibility-freedom to be and responsibility for your own life.
2. Primacy of experience-In order for real change to occur, the family needs to engage each other emotionally. They need real experiences, not cerebral insights”
3. Emotion is regarded as the most important immediate focus of in-session therapeutic concern.
4. . here-and-now,“the immediacy of the relationship between the family and an involved therapist and the process
5. Values the inner experience of self-Experiential family therapists participate actively and personally in therapy sessions; they do not attempt to hide behind a therapeutic mask.
6. Spontaneity and creativity-therapists view any techniques that foster creative experiencing as valid and useful in the therapeutic process.
7. I-Thou relationship

One of the central goals in therapy is that members begin to experience themselves more openly and nondefensively in relationship with one another; that is, it is hoped that an existential shift will occur on a systemic level.

9.Global versus specific goals

Ex: Experiential therapist asked the family to participate in a role play of a past dispute. The purpose was to re-enact the emotional climate of the family. By re-experiencing these events/relationships, members were able to release blocked/repressed emotions. By releaseing anger, shame, and bitterness, the family was more able to live in the present and make room for healing feelings like love, forgiveness, and hope.

Question 14

Externalization technique

Answer 14

a technique developed by Michael White in the context of narrative therapy, in which the therapist personifies problems as external to the clients who are describing them. Helps the family recognize their problem as separate from themselves.

This technique deconstructs the problem as an internal deficiency or pathological condition and redefines it as an objectified external. The family is then encouraged to unite against the externalized Problem.

EX: A family came to therapy because the mother was depressed and the family was blaming her for not fulfilling her motherly/wifely duties. In an effort to externalize the problem, the therapist asked the mother, ‘What does the depression tell you about yourself?’ Her response allowed the family to see the depression as an external problem and not mother’s entire being.

Question 15

Fusion

Answer 15

in the context of family systems theory developed by Bowen, fusion is a blurring of psychological boundaries between self and others; fusion occurs when a family member or members are not differentiated from each other and therefore experience an intense sensitivity to each other’s emotional state. This increases anxiety in the relationship. Individuals who are fused with their families also have trouble differentiating thoughts from feelings, in a similar manner that they have trouble differentiating their thoughts/feelings from their family’s.

Ex: The couple was considering divorce and decided to try family therapy. After weeks of hostility and mutual blaming, the therapist invited the couple to bring in their 16 yr old son and asks the young man, “What do you think of your parents getting a divorce?” the young man, looking very sad, says, “Finally someone has asked my for my opinion.” Each parent looks at each other and realizes that in their state of fusion, they have both neglected their son. Thet begin talking more honestly about all their thoughts and feelings.

,

Question 16

Genogram

Answer 16

A genogram is a schematic diagram of a family’s relationships, and social, psychological, and medical history; it is much like a family tree or pedigree chart except it also shows relationships/patterns between family members and usually includes at least three generations. Bowen believed that families were complex social systems that could only be understood though their relationships across many generations. In order to analyze these dynamics, he had the families he treated construct a genogram.

Ex: During the initial assessment, the therapist constructed a genogram to organize the mass of information gathered. He was able to identify and explain patterns in the family system. Ex: client has a family history of women taking on caregiver roles. Client’s husband is depressed and so the wife takes on more responsibilities to maintain equilibrium. Client’s mother was the wife to an alcoholic. Therapist promotes differentiation in the client

Question 17

Homeostasis

Answer 17

a term used in family therapy to describe the dynamic state of balance or equilibrium in the family. Homeostatic mechanisms within the family work to self-regulate the family in order to maintain stability and resist change. The family therapist may have to fight against homeostatic mechanisms in order to change the family system.One reason why families and systems try to maintain homeostasis is because a change in one family member forces the rest to adapt and change also.

Ex: if a battered wife goes to therapy and learns how to stand up to her husband and take care of herself, the husband will fight against her to maintain control. (Homeostasis) This makes it harder for her to change. Therefore, family therapists propose that treating the entire family as a whole is much more effective than one member individually.

Question 18

Joining

Answer 18

in the context of Salvador Minuchin’s structural family therapy, this is a therapeutic tactic in which the therapist joins the family as a kind of “distant relative” by Accepting and accomodating to families to win their confidence and circumvent resistence. Therapist engages the family’s separate members and subsystems. Becoming a nonpermanent but concerned member of the family allows the therapist to gain access to the family system and to help modify the dysfunctional aspects of the system. In order to join, the therapist may mimic the family’s manner and style in order to build rapport.

Ex:The therapist joins with each family member by using circular questioning and addressing the beliefs which organize family relationships and behaviours. While exploring the different viewpoints of each member, the therapist employed active listening skills and empathy while maintinaing his role as leader/therapist.

Question 19

Miracle question

Answer 19

developed in the context of solution-focused brief therapy, this is a question directed to the client(s) which asks them what their lives would look like if a miracle occurred and the problem that brought them to therapy disappeared. This allows the client to essentially describe what they want out of therapy, and paints a picture for both the therapist and the client of what “success” would look like to the client. The miracle question can help in goal-setting and in finding potential solutions.

Ex:In order to help the family identify their goals and potential solutions, the family therapist asked each member to answer the question, “If tomorrow you woke up, and miraculously all of the family’s problems have disappeared, what would your day be like? What would your relationship look like with the rest of the family?” The family all agreed that there would be no yelling or hitting.

Question 20

Multigenerational transmission process

Answer 20

term developed by Murray Bowen and one of the eight interlocking concepts in his family systems theory, refers to the transmission of a family projection process. (process by which parents project part of their immaturity to one or more of their children)

The nature and degree of intensity of emotional responses are passed down from generation to generation.

Levels of differentiation are affected through generations based on levels of differentiation of partners as they marry.

Bowen believed that severe dysfunction is the result of chronic anxiety transmitted over several generations.

Ex: During family therapy, the mother, when referring to her son, says “He’s just like his cousin Mark—divorced 3 times.” The therapist recognizes this as part of the mulltigenerational transmission process–the way family emotional processes are transferred and maintained over the generations.

Question 21

Narrative Therapy (tenets of)

Answer 21

pioneered largely by Michael White, this is a form of family therapy based on the premise that our sense of reality is organized and maintained by the stories we tell ourselves about who we are and the world we live in. Narrative therapists believe that a family’s problems develop as a result of negative, self-defeating, dead-ended narratives that they tell themselves about their lives. Therapists help the family to construct alternative stories that offer new options and possibilities for the future. Narrative therapists reject the notion that the therapist is the “expert”, believing that the clients have the skills needed to construct more positive stories about themselves.

Ex:The family presented to therapy because the 14 yr old son, Harry, was depressed. The family states that “Harry has been diagnosed with depression.” This narrative of Harry’s depression is internalized by the family who views his behavior as the cause of their despair. The narrative therapist used an externalization technique to help separate Harry’s identity from the problem by changing the narrative they have been telling themselves. He changes the narrative to “Sadness sometimes overtakes Harry”. This presents the family with a nonpathological, externalized view of the problem and they are now able to co-construct with the therapist a new narrative that provides an alternate account of their lives.

Question 22

Paradoxical intervention

Answer 22

A paradoxical intervention is used in structural family therapy and strategic family therapy. It is a type of intervention or technique where the therapist’s goal is to eliminate the resistance of a client. Therapist, essentially instructs client to continue the symptomatic behavior instead of stopping it. This is done ethically and without intentional harm to the client. The result is that the client is now forced to decide what they will do. It helps the client to be in control of his/her behavior and experiences.

Ex:the client fears failure. For homework, the therapist asks the client to fail at something. When the client returns he explains that failing wasn’t sp bad and that life continued. The use of the paradoxical intervention allowed the client to see humor in the problem and to realize that he had more control in the situation than he first thought.

Question 23

Process Questions

Answer 23

in the context of Bowen’s family systems therapy, these are questions which are designed to help family members think about their own reactions to what others are doing and saying. This redirects the family members away from blaming each other and focuses them on thinking about their part in contributing to the family’s problems.

Ex: Process questions are questions designed to move people towards differentiation. They help the person think logically and less emotionally about their problems and their involvement in them.
Therapist: “When your husband doesn’t return your calls, what goes on inside you?”
Wife: “I get scared. And then I feel disrespected.”
Therapist: “And how does that manifest?”
Wife: “I withdraw from him.”
Therapist: “What are you trying to tell him when you do that?”
Wife: “That I’m hurt.”
Therapist: “Does it work?” Therapist would then ask husband in the same manner.

Question 24

Reframing

Answer 24

a therapeutic technique in which the therapist changes the original meaning of a situation or event by offering an equally plausible explanation. This alters the context in which the situation or event is perceived and invites new responses to the same behavior. The reframe may put a more positive spin on a negative interpretation, or it may simply provide the client(s) with an alternative way of viewing something.

EX: A client comes to therapy complaining about their mother, who they say is intrusive and always trying to interfere with their love life by setting them up on dates and giving them advice. The clinician reframed the situation by offering the explanation that perhaps the mother was trying to be helpful instead of just annoying.

Question 25

Scapegoat

Answer 25

this is a term used by Ackerman in the psychodynamic model of family therapy to describe the individual in the family who is blamed and punished for all of the family’s problems in an attempt to resolve tension/anxiety within the family. The scapegoat in family therapy is typically the identified patient, or the reason that the family initially comes to therapy.

Ex:When marital tension increases within the client’s marriage, the family’s anxiety increases, and they often blame their youngest son for all the tension as he doesn’t do well in school and often gets into trouble.

Question 26

Scaling Questions

Answer 26

used in the context of solution-focused brief therapy, these are questions that ask a client to quantify their perception of a situation, often by rating it on a scale from 1 to 10. Repeatedly using scaling questions can allow the therapist and the client to measure change and set goals that seem manageable. These questions help clients develop a positive outlook and move toward the achievement of it.

Ex: On a scale of 1 to 10, where 10 stands for you have every confidence that this marriage will make it and 1 stands for that we might just as well walk away right now and it’s not going to work. What number would you give your marriage?

H: I would give it a 7. (the wife flinches as she hears this)
W: (she thinks about it a long time) I would say I am at 1.1.
T: (Surprised) So, what makes it a 1.1?
W: I guess it’s because we are both here tonight.

Therapist is able to use the wife’s response to move the session in a positive direction. At the end of the session the therapist asks again and the wife’s rating goes up.

Question 27

Triangulation

Answer 27

term used by Salvador Minuchin in his structural family therapy to refer to the process in which a child becomes caught between their two parents, with both parents demanding that the child ally with them against the other parent. This process typically occurs when the parents are having trouble resolving things between themselves. It produces a “no-win” situation for the child, as siding with one parent leads to the other one feeling attacked. Triangulation is similar to Bowen’s concept of triangles.

Ex:During a family counseling session it becomes apparent that triangulation is a factor in the family’s pathology. The wife coaxes the daughter to tell the father that the mother is right and that he spends too much time at work and isn’t there for the family. Therapist helped parents work on their own problems without involving the child.

Question 28

Unbalancing Technique

Answer 28

used by therapists in the context of structural family therapy, this is a technique in which the therapist attempts to change the hierarchical relationship between members of a system or subsystem by appearing to support one member of the family. This upsets the family’s homeostasis and makes an initial move toward changing preexisting family patterns.

Ex:Unbalancing techniques may be used in a case where the therapist supports the parents to take charge of their child. After joining the family and building good relationships with both parents and child, the therapist sits next to the parents and states “Because you are the parents, I will support your rules.” This takes the power away from the child, thereby disrupting the homeostasis of the family.

Question 29

Structural Family Therapy (tenets of)

Answer 29

developed primarily by Salvador Minuchin, this model’s major thesis is that a change in family structure or organization is necessary for an individual’s symptoms to be relieved (as the symptoms are best understood in the context of family transaction patterns). The therapist must provide direct leadership in changing the structure or the context in which the symptom is embedded. In order to achieve a desired outcome within a family, structuralists believe that there must be clearly defined generational boundaries, alignments between the parental subsystem about key issues, and rules related to power and authority.

Ex:The family presented to therapy because the daughter was suffering from anorexia. The structural family therapist discovered that the family was enmeshed with diffuse boundaries that did not allow for individual autonomy. These poorly functioning subsystems had led the daughter to manifest the disorder as a coping skill to deal with the overprotective parenting that inhibited her from developing a sense of independence, competence, or interest in activities outside the safety of the family. The therapist actively guided the family to change by developing clearer boundaries.