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Tuesday, December 7, 2010


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Double-bind, disqualification, mystification, and so on. These mechanism may have driven young people crazy, but they helped keep their families together.
Initially, the patterns of disturbed function observed in schizophrenia families were thought to cause schizophrenia. eventually, etiological models gave way to transactional ones. Instead of causing schizophrenia, these disturbed family interactions came to be seen as patterns of family relationship in which schizophrenia is embedded. Neither the family nor the symptomatic member is the locus of the problem-the problem is not within people, it is between them.
Today, family therapist do not think about what causes problems, they think about how families unwittingly maintain their problems. Each of the systems of family therapy have unique ideas about how pathological families fit together, but the following themes are useful to define some of the important differences of opinion in the field: inflexible system, function of symptoms, underlying dynamics, and pathological triangles.
Inflexible systems. Inflexibility is the characteristic of pathological family systems most frequently indirect. Chronic inflexibility is a striking feature of families with disturbed members; these families are so rigid that it is virtually impossible to grow up in them healthy and normal. Acute inflexibility explains why other families become dysfunctional at transitions in the life cycle; disorder breaks out in these families when they fail to modify their organization in response to growth or stress.
Early observers of schizophrenic family interactions emphasized the rigid inflexibility of these families. Wynne coined the term rubber fence to dramatize how psychotic families resist outside influence, and pseudo mutuality to describe their rigid fa├žade of harmony R.D.Laing showed how parent, unable to tolerate their children is healthy strivings, used mystification to deny and distort their experience. Communications theorist thought that the most striking disturbance in schizophrenic families was the extreme inflexibility of their rules. According to this systems analysis, these families were unable to adapt to the environment because they had no mechanism for changing their rules; they were rigidly programmed to negative feed back, treating novelty and change as deviations to be resisted. Forces of homeostasis overpower forces of change, leaving these families stable but chronically disturbed.
Explaining family pathology in terms of rigid homeostatic functioning is today one of the cornerstones of the strategic school. Strategists describe dysfunctional families as responding to problems within a limited range of solutions. Even when their attempted solutions do not work, these families rigidly keep trying; thus the attempted solutions, rather than the symptoms, are the problem. Behaviorist use similar idea when they explain symptomatic behavior as a result of faulty efforts to change behavior. Often when parents think they are punishing their children, they are actually reinforcing them with attention.
Psychoanalytic and experiential clinicians have identified pathological inflexibility in individuals and couples, as well as in whole families. According to these two schools, intrapsychic rigidity, in the forms of conflict, developmental arrest, and emotional suppression, are the individuals contributions to family pathology. Psychoanalysts consider pathological families as closed systems that resist change. According to this line of thought, symptomatic families are rigid in the they treat the present as though it were the past. When faced with a need to change, dysfunctional families regress to earlier levels of development where unresolved conflicts left them fixated.
Experientialists often describe pathological families as chronically resistant to growth. The symptom bearer is seen to be signaling a family pattern of opposition to life forces. Unfortunately this model makes the family the villain, and the individual the victim. The experiential model of inflexibility is fairly simple, and is primarily useful with minor forms of psychic difficulty.
Structural family therapists locate the inflexibility of dysfunctional families in the boundaries between subsystems. Disturbed families tend to be either markedly enmeshed or markedly disengaged. Young therapists who have trouble diagnosing family structure are at first happily surprised when confronted with a profoundly disturbed family. The structure is so easy to see. Unfortunately, families with an unmistakably clear structure are extremely deviant and very difficult to change.
Structural family therapy also identifies acute inflexibility in symptomatic families. Minuchin (1974) stresses that otherwise normal families will develop problems if they are unable to modify a previously functional structure to cope with an environmental or developmental crisis. Family therapists should be very clear on this point. Symptomatic families are often basically sound, they simply need help adjusting to a change in circumstances.
The function of symptoms. Early family therapists described the identified patient as serving a critical function in disturbed families, detouring conflict and thus stabilizing the family. Vogel_dan_Bell (1960) portrayed emotionally disturbed children as family scapegoats, singled out as objects of parental projection on the basis of traits which set them apart from other members of the family. Thereafter, their deviance promotes cohesion. Communications theorists thought that symptoms were trough with meaning – functioning as messages – and with consequences – controlling other family members.
Today, many family therapists deny that symptoms have either meaning of functions. Behavioral and strategic therapists do no assume that symptoms are necessary to maintain family stability, and so they intervene to block the symptom without being concerned about restructuring the family. Behaviorists have always argued against the idea that symptoms are a sign of underlying pathology or that they serve any important function. Behavioral family therapists treat problems as the uncomplicated result of faulty effort to change behavior and lack of skills. Restricting their focus to symptoms is one of the reasons why they are successful in discovering the contingencies that reinforce them; it is also one of the reasons why they are not very successful with cases where a child is behavior problems function to stabilize a conflicted marriage, or where a couple is arguments protect them from dealing with unresolved personal problems. Strategic family therapists recognize that symptoms may serve a purpose, but deny that it is necessary to consider that purpose when planning therapy. Instead of trying to figure out what function may be served by symptoms, they concentrate on understanding how the pieces of the system tit together in a coherent fashion. Members of this school take the modest position that if they help to free families from their symptoms, then the families can take care of themselves.
Some of the other schools of family therapy continue to believe that symptoms signal deeper problems and that they function to maintain family stability. In families that cannot tolerate open conflict, a symptomatic member serves as a smokescreen and a diversion. Just as symptomatic behavior preserves the balances of the nuclear family, so may problems in the nuclear family preserve the balance in the extended family. In psychoanalytic, Bowenian and structural formulations, a couple’s inability to form an intimate bond may be ascribed to the relationship between their parents. In this way, symptomatic behavior is transmitted across generations, and functions to stabilize the multigenerational family system.