Week Nine

Question 1

intra psychic paradigm

Answer 1

• Problems and Pathology are formed within Individuals and are a function of internal processes.
• Resolution of these problems or pathology is via alteration of internal processes
• Based in the cartesian & Newtonian world view, that we can understand a thing in isolation by reducing it to its parts.
• Focus on CONTENT
  
  • Took people outside of their culture and looked at them individually.
  • Looks at what is happening rather than how it is happening.

Question 2

interpersonal paradigm

Answer 2

• Problems and Pathology are a Function of context, relationship and Interactions between parts of a system.
• Resolution of these problems is via alteration of the context, relationship interactions between parts of a system.
• Based on the Systemic world view and founded in the understanding that no thing can be understood in isolation from its context.
• Focus on PROCESS
  
  • Focus on the way we see things rather than how they are.

Question 3

family systems

Answer 3

• Systems theory is a broad way of understanding how systems work.
• The system is an interactional unit
• “The whole is greater than the sum of its parts”
• Any influence on one part affects other parts
• Change in one area of life can effect another.
• i.e. a bad day at work, take it out on family
• Individuals are best understood through assessing the interactions within the family
• Look at the rules that govern the family (culturally).
• Focus on interaction patterns rather than content
• E.g. couple has a conflict.
• Fight over the correct way to squeeze toothpaste.
• Systemic therapist realizes that while the next fight may not be about toothpaste, the same process is used for the fight.
• Focus on ‘circular causality’
• Things inform one another.
• If one person reacts a certain way, the other will react based on that.
• Families tend to self regulate to resist change – homeostasis
• Feedback provides homeostasis.
Symptoms are often functional for the system as a whole.

Question 4

basic assumptions

Answer 4

A family member’s problematic behavior may:
• Serve a purpose or function within the family
• Symptoms are often functional for the system as a whole.
• i.e. self harm as a result of parental conflict, when discover harm, conflict stops and thus homeostasis.
• May be a symptom of the family’s inability to function effectively in times of crisis/transition
• Different when a child comes into the family.
• Rules in the family need to change dependent on the situation.
• May be unintentionally maintained and/or exacerbated by the family
• i.e. teenager seeking out, parents punish, behaviour excalates, increases punishment.
• Attempted solutions often maintain the problematic behaviour.
• Circular causality
• e indicative of dysfunctional interaction patterns handed down across generations

Question 5

causality

Answer 5

• Linear causality: A causes B which causes C.
Eg. Husband with alcoholism blames his wife because she nags. He gets bored and drinks to reduce his stress. It’s her fault. She must change her behaviour.
• Circular causality: A causes B which causes C which Causes A.
• Eg. The husband drinks, so the wife nags him. The wife is always nagging the husband so he continues drinking. This together with other causes influences their problems. However, if the wife changes but the husband does not it will create a pressure that hinders the wife from changing.
• Systemic view realises that all people must alter behaviour to solve a problem.

Question 6

history

Answer 6

• Adlerian Family Therapy (1927). Noticed that child’s development with family constellation (system) heavily influenced by birth order.
  
  • Idea that when we are born influences the way we behave.
• Dreikurs (1950, 1973). When children don’t “belong” (socially) they subscribe to a “mistaken goal” – undue attention, power, revenge, avoidance (inadequacy) – which manifests as misbehaviour
• Murray Bowen (1978) – main stream FT
• Virginia Satir (1983) – conjoint FT
• Carl Whitaker (1976) – symbolic-experiential FT
• Salvador Minuchin (1974) – structural FT
• Jay Haley and Gregory Bateson (1963) – strategic FT
• () – MRI (Mental Research Institute)
• Boscolo, Selvini-Palazzoli & Prata (1971) – Milan Systemic FT
• Cloé Madanes (1981) (with Haley) – Brief Problem-Solving therapy.
• “The overall goal is to help family members become ‘systems experts’ who could know their family system so well that the family could readjust itself without the help of an expert.”
• Murry Bowen

Question 7

multigenerational family therapy

Answer 7

Murray Bowen 1913-1990
• Bowenian Family Systems Theory/Therapy is considered the most elegant approach among systemic theories
• Families are emotional systems.
• Bowen was a psychiatrist who did pioneering work with families of individuals diagnosed with schizophrenia
• His research with families at the Menninger Clinic demonstrated the presence of intense emotional patterns
• He focused on the analysis of the process of differentiation drawing on his personal family experience
• Bowens focus on inceasing differentiation.

Question 8

central constructs

Answer 8

• Differentiation of self (low differentiation = need for approval/permission/people pleasers)
• Low levels of differentiation means that we will react to everything due to increased anxiety.
• Primary goal of this therapy is to increase differentiation.
• When we are born, values are identical to families. We need to become individuals
- emotional separation
○ We are able to tolerate the emotional experiences of others.
○ Do not need to react to other people having feelings.
- autonomous functioning
○ We don’t need others, but can connect with them deeply.
- balance of togetherness - separation
○ Being able to maintain a sense of who we are, not loosing ourselves in relationships.
○ Being able to have time apart.
- validation of difference
○ Understanding that others have different opinions to us and being able to tolerate this.
- adult to adult communication
○ Being able to communicate what our needs are.
- Emotional regulation
○ Ability to cool down
○ Able to measure and manage our emotional experiences.

Question 9

anxiety and anxiety contagion

Answer 9

Anxiety & Anxiety contagion

• Moves across families and between generations.

Question 10

triangulation

Answer 10

(deliberately shifting focus to a third party)
• Calling a parent or friend after a fight with partner.
• Could be helpful but often is detrimental to the relationship.
• Should not be a need to go to a third person, should be able to manage the situation between themselves.

Question 11

Multigenerational transmission of communication patterns

Answer 11

• Trauma can travel across generations through communication patterns.
Anxiety is transmitted across generations and manifested with different symptoms.

Question 12

therapeutic process

Answer 12

• Emphasises insight
• Therapist as a ‘coach’ to
• enhance differentiation
• change emotional reactivity
• facilitate de-triangulation
• Uses genograms to map interactive patterns over generations
• Directs clients to take the ‘I position’ in communication
• Uses circular, process oriented questions
• Therapist is supportive but remains de-triangled

Question 13

virginia satir

Answer 13

• “Feelings of worth can flourish only in an atmosphere where individual differences are appreciated, mistakes are tolerated, communication is open, and rules are flexible - the kind of atmosphere that is found in a nurturing family.”
Virginia Satir
• Focus on how to create a context in which people floourish.
A relationship that leads to growth.

Question 14

human validation process model

Answer 14

Virginia Satir 1916-1988
• Career in family therapy
• Worked at Mental Research Institute & Illinois State Psychiatric Institute
• Association with human potential movement
• Idea that humans have unlimited potential, that must be facilitated by context.
• Felt unappreciated and marginalised by male family systems ‘experts’
• Created ‘Avanta’ The Virginia Satir Global Network (formerly AVANTA) stated mission is: “To further the creation of healthy and just relationships with self and others based on the teachings of Virginia Satir.

Question 15

central constructs of human validation

Answer 15

• Role of the family in enhancing individual self-esteem
(self esteem impacts individual and group interactions)
○ The way we think and feel about ourselves influences how we react and interact with others.
• The significance of effective communication
○ Quality and style of communication.
○ Incongruent communication leads to dysfunction.
• Family roles
• Functional family rules
• The five freedoms

Question 16

congruent and incongruent communication

Answer 16

• Incongruent communication is communication where verbal and nonverbal communication do not match. This is seen as allied with distress and dysfunction in both Individual & Family systems.
• Types of incongruent communication could include:
• Incomplete Communication
• When people start to talk but stop before finishing.
• Assumptions
• Ambiguous communication
• Double messages
(digital & analogue communication do not match)
- Saying one thing but non-verbals say something else
- Incongruent.

Question 17

roles and communication styles

Answer 17

The Blamer: This person acts as if he has the power in the relationship, blames others for things that go wrong. This position is designed to show dominance and is actually based on fear.
The Distracter/Irrelevant:This person does and says things that take the focus off the issue of the moment. This position highlights the power of irrelevance, in that it serves a useful purpose, in spite of its apparent absence of value.
The Placator:This person overtly agrees with people whether he does or not, even if he is furiously angry. This “whatever you say” position devalues self in relation to the other.
The Super Reasonable: This person lacks emotion, presenting himself in a very logical way. Being cut off from feelings, which have no bearing on the facts, drives this position.
The Congruent:This person expresses feelings in congruence with what is being said. The body language as well as the verbal languageall match the feelings.

Question 18

family roles

Answer 18

• What roles were there in your family?
- Different roles in different systems.
• What role did and do you play?
• How does this impact on your current intimate relationships?

Question 19

family rules

Answer 19

• Overt and covert rules
- Explicit and implicit.
- Some rules for children are express and told, some are not.
• Flexible and rigid rules
- Rules need to be flexible around transitional points.
• Co-constructed/negotiated and imposed rules
- Perhaps need a re-negotiation of rules.
• Do-able and humanly impossible rules
• Rules that validate difference
- Allow people to be who they are.

• What were the major rules that operated in your family?
• What were some of the unspoken rules/ (secrets)?
• What rules governed appropriate gender role behavior?
• How do these family rules affect your interaction patterns
in intimate relationships today?

Question 20

therapeutic process

Answer 20

• Creating an environment where all members of a family feel valued and respected
• A non-judgmental and genuine approach
• Develop awareness through Experience
• Modeling congruent communication
• Enhancing individual self-esteem
• Transforming extreme rules to make them more functional
• Restructuring family roles to create better balance

Question 21

therapeutic techniques

Answer 21

• Family sculpting- physically arrange seating to represent the person’s symbolic view of family relationships
• Family Maps: Like genograms - over 3 generations.
• Ropes: The binds and pulls of ropes are used to provide concrete representations of family dynamics.
• Family Life Fact Chronology: A complete family history, from the birth of the oldest grandparents to the present
• Drama: Family members enact significant events in the family’s history, (opportunity for new perspective/insight.
• Family Reconstruction: Like drama, this enactment involves events based on information, not direct experience.
• Reframing: A reinterpretation of a situation to create a shift in perceptions. The therapist decreases the threat of blame by accentuating the idea of puzzlement and the idea of good intentions.
• Verbalizing Presuppositions: Overtly stating presuppositions that are evident in a family’s behavior. Eg, being in therapy = strong familial desire for change.
• Denominalisation: Therapists asks someone to provide behavioral examples of “concepts” (eg, love, respect). Answer is then linked to that person’s primary sensory-based representational system (i.e., visual, auditory, kinesthetic). * “love languages”.

Question 22

structural family therapy

Answer 22

alvador Minuchin 1960
• Son of Russian Jewish emigrant in Argentina
• Imprisoned because of Zionist activities
• Served in Israel army in its fight for independence
• Obtained a medical degree in USA
• Worked with poor African families of ‘Delinquents’
• Director of Philadelphia Child Guidance Clinic
• Developed Structural FT with Haley and Mentalvo
• Worked with psychosomatic families

Question 23

structural concept of the family

Answer 23

• He would assess and map the family and provide interventions for restructuring.
• Family viewed as a structural unit
• When there is dysfunction in the organization or structure of the family then pathology will arise within an individual or relationships.
• family structure composed of many interlocking components
• In healthy families these components work in synchrony
• Crises arise when the family structure is unable to cope with change/stress usually at family lifecycle transitions.

Question 24

structural components

Answer 24

nmeshed and Disengaged families
• Subsystems: used to differentiate roles and functions
- Parental subsystem: to bring up the children
- Partner subsystem
- Children subsystem.
• Boundaries – Ridged/Diffuse
- Not clear/very clear
- Rigid = inflexible
- Diffuse = roles are not clear and communication is always open.
• Hierarchies: power dynamics
- Power needs to rest with the parents.
- Triangulation can be an issue here as it crosses boundaries.
• Coalitions: alliances
- Can result in problematic behaviour in the child. If the parents fight and one goes to talk to the son, can result in problematic behaviour.
• Detouring: detracts attention from the real source of conflict (scapegoating)
- If parents are fighting and notice problematic behaviour, often blame the child.
- However the symptom is not the issue but rather the family problem itself.
• Parentification: child taking on a parenting role

Question 25

therapeutic process

Answer 25

• Therapist joins family system in a flexible way
- Talks to the parents first to maintain hierarchy
• Therapist maintains strong, active leadership role
- Expert position
• Engages in Family Mapping or structural Diagnosis
- Gain idea of the structure and see what the issue is.
• Reframing problems as systemic
• Highlighting problem maintaining interactions
• Restructuring boundaries and re-balancing hierarchies
- Getting parents to talk between themselves without getting the children involved.

Therapeutic Techniques

Question 26

therapeutic techniques

Answer 26

• Joining Accommodating Techniques  
		○ Maintenance 
		○ Tracking
		○ Mimesis 
• Re-structuring Techniques
		○ Enactment 
			§ Invite families to re-enact fights etc. 
			§ Interested in seeing how they relate to each other. 
			§ The way families sit reflects how they feel. 
		○ Boundary Marking 
		○ Escalating Stress 
		○ Assigning Tasks 
			§ homework
		○ Paradoxical Injunctions 
		○ Utilizing symptoms - Reframing