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Psychoanalytical trained family therapist, who developed Contextual Therapy

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Boszormenyi-Nay

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Nathan Ackerman

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father of family therapy

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James Framo

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developing family-of-origin therapy; as part of treatment with individuals, couples, and families, he invited a clients entire family of origin in for extended sessions. (Object Relations)

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David and Jill Scharff

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developed a comprehensive model for object relations family therapy. Focused on therapy as a family unit. (ORT)

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Women's Project

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Bowenian trained social workers Marianne Walters, Betty Carter, Peggy Papp and Olga Silverstein reformulated many foundational family therapy concepts through a feminist lens. They challenged the field to examine gender stereotypes ORT

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Object Relations Therapy, first stage, holding environment

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Create a caring therapeutic relationship between client and therapist. This is a psycho dynamic tradition includes a number of different schools that share the same therapeutic process. Object Relations

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Object Relations Therapy second stage

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analyzes the intra psychic and inter personal dynamics, both conscious and unconscious, current and trans generational, that are the sources of the symptoms, OBT

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Object Relations Therapy, third stage

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is to promote client insight which requires getting through clients defenses OBT

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Object Relations Therapy, fourth stage

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once clients achieved insights into these inter personal dynamics that fuel the problem, the therapist facilitates the working through insights to translate them into action in the clients daily life. OBT

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transference

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refers to when a clients projects onto the therapist attributes that stem from unresolved issues with primary caregivers; therapists; the therapist uses this to provide insight (contextual)

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counter transference

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refers to when therapists project back onto clients, losing their therapeutic neutrality and having strong emotional reactions to the clients. (contextual)

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blank screens

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traditional psychoanalysts, who are viewed as neutral (contextual)

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contextual holding

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refers to the therapists handling of therapy arrangements; conducting sessions competently, expressing concern for the family and being willing to see the entire family. (contextual)

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centered holding

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refers t connecting with the family at a deeper level by expressing empathetic understanding to create a safe place (contextual)

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multi directional partiality

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is being "partial" with all members of the family, including those not immediately in the room and the dead. contextual

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principle of inclusiveness

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means the therapist is bringing out humanity in every family member, even the monster member contextual

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sequential siding

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involves each member empathizing with each person's position in turn (OBT)

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interlocking pathologies

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identifies how the identified patient's symptoms relate to the less overt pathologies within the family (OBT)

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Object Relations Therapy

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emphasize the basic human need for relationship and attachment to others. They assess how people relate to others based on expectations developed by early experiences with primary attachment objects , particularly mothers.

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Ideal Object

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The central ego is thought to maintain its own object, as a neutral object freed from exciting and rejecting aspects. An internal mental representation of the primary caregiver that is de-sexualized and de-aggressiveized and maintained as distinct from its rejecting and exciting elements.

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Rejecting Object

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an internal mental representation of the caregiver when the child's needs for attachment are rejected, leading to anger

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Exciting Object or overstimulating

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an internal mental representation of the caregiver formed when the child's needs for attachment were overstimulated, leading to longing for an unattainable but tempting object. (ORT)

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splitting

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the more intense the anxiety resulting from frustration related to the primary care-giver, the greater the person's need to split these objects, separating good from bad objects by representing the rejecting/and or exciting objects, thus leaving less ego, or conscious self, to relate freely. (ORT)

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To the degree splitting is not resolved,

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there is an "all good" or "all bad" quality to evaluating relationships. (ORT)

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Splitting as a couple

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in the beginning see the partner as perfect, all good; in later years "all bad" no longer meeting expectations (ORT)

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Splitting in a family

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takes the form of the perfect family verses the problem child (ORT)

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Projeoction Identification

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in couples and other intimate relationships, clients defend against anxiety by projecting certain split-off or unwanted parts of themselves onto other person, who is then manipulated to act according to these projections. "what you don't like about yourself, you project on to someone else (ORT)

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repression

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maintains that children must repress anxiety when they experience separation with their primary caregiver (attachment object), which results in less of the ego being available for contact with the out side world.

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parental interjects

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the internalized negative aspects of parents. Framo believes that the most significant dynamic affecting individual and family functioning, (OBT)

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Ivan Boszormenyi-Nagy

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conceptualized the moral and ethical system within the family as a ledger of entitlements and indebtedness, or simply a ledger of merits.(contextual)

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ledger of merits

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an internal accounting of what one believes is due and what one owes others. (contextual)

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justice and fairness

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is viewed as one of the foundational premises of intimate relationships. (contextual)

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fairness

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monitors an on going process that keeps the relationship trustworthy. (contextual)

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justice

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is a relationship that is ideal, and all relationships strive to achieve this never fully attainable goal (contextual)

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entitlement

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are "ethical guarantees" to merits that are earned in the context of relationship, such as the freedom that parents are entitled to because of the care they extend to children. (contextual)

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destructive entitlement

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result when children do not receive the nurturing to which they are entitled and later project this loss onto the world, which they see as debtors. (contextual)

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invisible loyalties

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family ledgers extend across generations (contextual)

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revolving slate of injustice

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this is a destructive relational process in which one person takes revenge (or insists on entitlements) in one relationship based on the relational transactions in another relationship. Instead of reconciling the slate in which the relationship accrued, the person treats an innocent person as if he or she was the original debtor. (contextual)

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split loyalites

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this terms refers to when a child feels forced to choose one parent over another because of mistrust between caregivers. (contextual)

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legacy

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a trans generational mandate that links the endowments of the current generation to its obligations to future generations. It is a positive force in the chain of survival. Sorting out what in life is beneficial for posterity's quality of survival (contextual)

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general goals of ORT

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increase autonomy and ego-directed action by making unconscious process conscious

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general goals of ORT

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decrease interactions based on projections or revolving slate of entitlements

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general goals of ORT

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increase capacity for intimacy without loss of sef (fusion with object)

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general goals of ORT

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develop reciprocal commitments that include a fair, balance of entitlements and indebtedness

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listening and empathy

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is an intervention to be objective, without offering advise. The therapist can help the family to hear non defensively interpretation of their unconscious dynamics. (OBT)

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interpretation and promoting insight

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an intervention that helps therapists encourage clients to interpretations, such as by analyzing self-object relations or analyzing ledgers of entitlement and indebtedness. (OBT)

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working through

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is the process of translating insight into new action in the family and other relationships OBT

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eliciting

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uses clients' spontaneous motives to move the family in a direction that is mutually beneficial and dialogical. The therapist facilitates this process by integrating the facts of the situation, each person's individual psychology, and interactive transitions to help the family rework the balances of entitlement and indebtedness. , helping each member to reinterpret past interactions and identify new ways to move forward. (contextual)

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Framo

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developed a three stage model for working with couples: first the couple alone to increase insight; second for the couple to join a couples group to receive feedback; third to have individual work a 4 hour session with history of origin without the other partner present. Object Relations Theory

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rejunctive

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creating trust; moving toward positive relationship. Trust is the fundamental property of relationships. It can be depleted or restored. (contextual)

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disjunctive

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moving trustworthy away from the relationship (contextual)

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Women's Project's

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asserted that therapists should be agents of social change, challenging sexist attitudes and beliefs in families. By: openly discuss the gender role expectation - and point out where the beliefs are unfair or unrealistic; encourage women to take private time, not to lose individual identity; use of self-of-the-therapist to model an attitude of gender equality;and push men to take on equal responsibility in both family relationships and household duties

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equitable asymmetry

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from contextual theory, the unequal, but healthy, degree of care and consideration given by parents toward children. (Contextual)

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filial loyality

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children have an inherent filial loyalty to their roots and accrue debts or filial responsibility (contextual)

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parentification

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if a child was unloved and also required to act as a caregiver to his or her parents, as an adult she might have unreasonable expectations for love and nurture from a spouse and might also parentify their own children (contextual)

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destructive entitlement must be understood and discussed to obtain exoneration is?

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when a clients ledger contains destructive entitlement, the process by which the balance is regained and trust is restored. (contextual)

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exoneration

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is a process by which the therapist attempts to help the client see the positive intent and inter generational loyalty issues behind the behavior of members of previous generations.Regardless how destructive their behavior, if their behavior can be seen in a human context, loosening the hold of the past behavior on the client. (contextual)

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two stages to de-parentify

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parents begin to attribute "parental" significance to the therapists, pressure to child diminishes; second - the parents compete for therapist's attention if the therapists were the parent; the children attempt to make their parents respond in a parental manner. (contextual)

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Object Relations family work stems from

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individual models, in treatment, the family is not viewed as a group of individuals, but as a system made up of sets of relationships that function in ways unique to that family. ORT

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General goals of Object Relations therapy

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are insight and working through. this therapy is not directed toward symptom relief, but toward helping the family move through its developmental phases with improved ability to work as a family to differentiate between, and meet the needs of each family member. OBT

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Ronald Fairbairn

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developed the ideas of Object Relations Theory.

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objects

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repeated interactions with caretakers, individuals unconsciously internalize representations of their parents. Not a literal replica of the caretaker, but incorporates distortions based on the subjective experiences and perceptions of the person. (OBT)

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Ideal object leads to

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feelings of satisfaction

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rejecting object leads to

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anger

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exciting object leads to

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longing

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Through the process of projection identification, internalized unacceptable traits - once projected on them

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are now projected onto their mates. Symptoms are a manifestation of distorted interjections.

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insight

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understanding the source of the problem (OBT)

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Framo stated, only part of the solution is insight

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but insight coupled with subsequent changes in interactions (working through) is the goal. Helping the client become more able to respond to theri spouses and children as real people and not as the targets of disowned parts of themselves. OBT

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Therapeutic technique for OBT

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are Listening - does not confront the client; empathy - support individuals to uncover difficult material and interpretation - help clients with meaningful clarifications of material presented. OBT

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Therapeutic Neutrality

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the therapist must establish an atmosphere of nonjudgmental exploration. The goal of therapy is not symptom relief or problem solving, but only focusing on insight and working through

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