PPT 14 Family Therapy Methods – Flashcards

There are certain predictable forces that act on and shape the behaviors of all living systems. Individuality and togetherness are counterbalancing forces crucial in shaping human behavior. There is a relation between family anxiety and level of differentiation. Family w/ low differntiation does NOT need a lot of anxiety to become symptomatic. Highly differntiated families still become symptomatic if stress is high enough.

Differentiation of self, triangles, nuclear family emotional system, family projection process, multigenerational Transmission process, emotional cutoff, sibling position, societal emotional process

The innate tendency for the person to grow to be an emotionally separate person. People can become too emotionally separate or connected. Fusion: losing ones' down individuality/ too connected to another person. Differentiation is distinguished along a continuum in their ability distinguish between their feeling system and thinking system.

Higher differentiation-higher access to thinking Lower differentiation - inability to access thinking system and over-reliance on feeling system

According to Bowen 3-person system is the most stable, in the absence of anxiety 2-person system is fine. Once anxiety increases in 2 persons relationship 3rd person is recruited (triangulated) to offset anxiety. Alcohol and drugs can be 3rd portion of triangle. De-triangulation is goal of therapy over time. 2 forms: education about triangulation, joining a dyad as a non reactive third party to lower anxiety

How families impact one another. 4 basic relational patterns: 1. illness in a spouse (under functioning of one partner/addiction mental illness - symptoms occur with person who makes the most adjustments to their thoughts and behaviors. 2. Marital conflict occurs when couple looks to the other person for reasons of conflict and try to control one another. Both think the other needs to change 3. Impairment in one or more child. Parents focus their energies and anxieties on under functioning child which increases anxiety. 4. Emotional distance- individuals may distance themselves because of not knowing how to balance engagement while being an individual.

Parents focus on child's behavior thinking something is wrong with them them whatever child does is confirmation of this belief, and parents behave towards the child as if their fear for child was actually real.

Person denies attachment and over compensates by being super-independent. May over function in home or work. Person has an over attachment issue to parents. Emotionally fuses w/ parent and do not become distinct self. Tend to not function well/often social outcast- alcohol or drugs may fill the void of connection

This concept explains how over time there comes to be small differences in individuals and nuclear family differentiation levels: partners have similar differentiation levels, children function at same level as parents do, fixation on one child may drive down level, over generations there may be different levels of higher or lower

When pull for togetherness is so strong individuals fear loss of self they engage in emotional cutoff / move away ( emotionally reactive response not a chosen one)

An individuals personality is somewhat shaped by their position in the family. Role may be forced by pre-conditions of the family, and family projection such as previous generations valued oldest male child the most.

Everything that happens in natural systems theory happens in systems other than the family. Therapy focuses on helping individuals take an "I" position to increase differentiation

Focused on differentiation and creating a genogram showing multigenerational substance abuse, explore family disruption from system events, explore family history of mental health, suicide. Gear family toward facts versus reactions by using factual questions, orient family to triangulation, discuss codependency to the family

Resolve conflicts from past, restructure family power system, family encouraged to give up inter-generational intimidation and dependency, encourage individual self-loyalty , gain a clear clean title to their own destiny

Involves give and take, partners go out of their way for each other. Partner may give more at times but knows partner will reciprocate. You do not have to give until it hurts. Codependent relationship one person does all the giving while other does all the taking

Family member may take addicted person's role, which allows the members to maintain their roles. Family may dissolve into parts. Other parent may divorce recovering parent, family has incurred so much pain and grief they reach out for help/recovery as a unit, family may undertake deep work to heal and develop new set of family rules

Stress self-focus and health to keep family system calm, make small, practicable manageable goals during initial crisis, make referrals when necessary, address lack of trust and fear of relapse. Teach new coping skills

Focuses on how past issues of relational ethics (fairness) impact current transactions, which when placed in balance aid future generations in having more trustworthy interactions

Facts: gender, birth order, race, physical history, SES, ethnicity -things you cannot change. Facts may lead us to be productive/unproductive Individual psychology: how person functions as a distinct entity. Intelligence, developmental capabilities, life goals, motivations, ego defense mechanisms, individuals desires System of transactional patterns: family system comes together from members own facts and individual psychology to form family system Relational Ethics: what is needed to earn merit, how trustworthy relationships are, relational ledgers where transactional circumstances are weighed by each partner The Ontic: this the self in relation, I-though relationship, we develop our identity by distinguishing ourselves from the other person.

Ledger is based on indebtedness (what we owe others) and our entitlement (what we are owed). When debt and merit are in alignment we have a balanced ledger, problems develop when ledger is out of alignment.

Vertical loyalties: between generations -child pays debt to parents Horizontal loyalties: occurs in the nuclear family such as between partners Split loyalties: occurs when child is forced to choose between two parents Destructive entitlement: when people have given due consideration to someone and not received it back and looks to others or society to pay back the debt. SUBSTANCE ABUSE is usually based on destructive entitlement

Attempts to stop cycle of destructive entitlement. Multidirected partiality: when therapist helps family members explore position of each person in therapy. Side with each person sequentially demonstrating inclusiveness discovering what credit each person can be given. Exoneration: one of the outcomes in multi-directed partiality. Explores how family members can understand how/why that individual (addict) acted the way they did.Therapist explores how addict may have contributed positively to the family in the past

Focus on here and now and also how past is manifesting in the present. Personal growth supported and how person may have been stifled by family process, interventions are not premeditated, based on premise people develop symptoms because of emotional suppression which causes disconnection from others, encourage self-actualization in Therapy, and allow themselves and others to be unique

Her work focuses on validating themselves and others, encourages person to appreciate uniqueness each person brings to encounter, goal is not to eliminate problems but learn how to cope with them, therapist helps people take: self- responsibility, valuing of self and others, and move toward congruent communication. If the family tightens up living more rigid rules, with a foundation of low self-esteem, one or more members will most likely become symptomatic

We learn about our connection to self, other, and context via our connection with others usually in our family of origin (primary family triad)

Functional: When partners respect each other as unique beings, they allow the child to develop a unique self. Dysfunctional: occurs when partners have low-self esteem and are not honest in their communications- they do not allow themselves or others to be real in their transactions

Focuses on the other person and the context and discounts the self, will give into others easily to appease them and not try to get their needs met. They feel bad as they are not stepping up and getting their position across. May feel weak and develop a type of learned helplessness where they do not believe in themselves

When conflict happens they usually blame the other person so they don't have to accept their own faults, they come across strong but are quite scared. The self sits at the forefront for the blazer and they do not honor the personhood of the person they are in contact with

Focuses on context and discount self and the other. Talks about facts and concepts using them to prevent a focus on inner feelings. Sometimes called "the computer" and may be cold, intellectual and distant. Emotional distance protects them from connection, disappointment, and anger.

Person discounts self, the other, and the context. Attempts to change topic of discussion so they do not have to experience initial topic in hopes person may forget or give up trying. In serious discussions people may feel distant from them.

Person honors self, the other, and context. Are able to express ideas and feelings honestly and are open and reciprocate to others, are able to stay in a transaction even when there's conflict. What's happening inside the person comes across outside. Takes into account other people's feelings.Therapist encourages all members to function from the congruent position

In The Satir model the therapeutic task is to find the thread that leads back to the "original" systemic crisis. The addiction may have been result of this crisis creating new problem and focus tends to be on this. What is usually present in families dealing with addiction is a process of protection. This may occur through denials or excuses or presenting some other symptom (child misbehavior).

Stage1: making contact, where therapist connects with each family member and highlights their uniqueness Stage2: chaos, where family members are challenged to experience themselves and others in a different way than before - deeper level rather than surface Stage3: Integration, family members take their experiences from chaos stage and integrates them into their lives in a positive way with themselves and others

The therapist gets one member of the family to move other family members into physical and spatial positions, including themselves that represent what it is like to be in the family

A technique in which a person relives formative experiences that were influenced by three or more generations of his or her family. Entails 4 Acts: sculpting the family of origin, sculpting family of origins of the person's parents, sculpting the meeting and courtship of the individual's parents, then resculpting the individual's family of origin, thus historical past is reconstituted into the present where the person can tune into themselves and resolve unfinished business

Goal of therapy for family members to engage one another in more genuine ways, therapist needs to have human encounter w/ family. The primary tool to this method is therapist by being impacted by those in session and evoking interaction

Therapist sets stage for therapy, what is going to happen in therapy, who they address first, what definition of the problem the therapist accepts and what techniques are to be used. Family must understand they will have to play by someone else's rules and cannot use their normal coping strategies to survive in the seasion

Battle for Initiative:: This one family must win and make the choice of how to live their lives. And not depend on therapist to tell them what to do

Looking at history for inter generational patterns and to understand what may be situated below the surface in current family members. This suggest therapist does not except there offering up of a scapegoat but that larger family systems view is important. Therapist is to be able to move back and forth from being joined and connected to the family to backing out and individuating therefore demonstrating to the family the freedom to join and individuate