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How Loss and Interpersonal Conflict Become Dysfunction

Family Therapy Basic Concepts Nov 2016

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Page 1: Family Therapy Basic Concepts Nov 2016

How Loss and Interpersonal Conflict Become Dysfunction

Page 2: Family Therapy Basic Concepts Nov 2016

I. Developmental Tasks

II. Family Organization

III. Triangles, Triads and Triangulation

IV. Conflict & PowerV. Trauma: Anxiety and Depression as expressions of

Anger, Shame and Guilt

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Adaptation to Normative Social Change

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Developmental Tasks 

Individuals and Families transform over time as they accommodate to the natural processes of developmental social growth .

Needs

Skill Development Tasks

Growth and psychological health occur as a natural consequence of skill development in each of the three major tasks of life:

1.Adaptation to normative (and para-normative) change, an inherent condition of life (Life-cycle)

2. Satisfying the needs of living and belonging in a socially meaningful way (Maslow Hierarchy of Needs; Adler, Social Interest/Tasks of Life); and

3. Resolving the emotional pain caused by trauma

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Structures for Accomplishing Tasks, Functions and Needs

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People meet their basic needs, social responsibilities and child-rearing functions through defined roles, rules, boundaries, subsystems, and hierarchies.

  roles: tasks, responsibilities, and power associated with certain functions (identities)

  rules: beliefs governing transactions and behaviors towards each other (who does what and how) and others

  patterns: purposive interactional transactions that acquire meaning, concreteness and history

  sub-systems: association by common role or function; ie. the “parents”, “siblings”, or “men”

  hierarchy: distribution of power (the ability to influence outcome) and responsibility, typically

by age, experience, role or function

boundaries: the term has two, related meanings, both regarding the degree of emotional fusion within a relationship:

o a marker of the degree of flexibility within a relationship system. Flexibility, is a necessary condition for adaptation to change; it is measured as “rigid” (too inflexible), “clear” (appropriate) or “diffuse” (too vague) and illustrated by family mapping.

o the term “boundary” also refers to the degree of emotional proximity or reactivity within a relationship, sometimes understood as the degree of separateness or independence of thought, feeling and action (fusion). This is best illustrated by use of the genogram.

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Triangles: Problem Solvers and Creators

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You Are Here

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dyad

third person or subject of mutual, concern or interest

anxiety

closeness may increase as anxiety is reduced

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dyad

third person or subject of mutual, concern or interest

Anxiety decreases in dyad

Third party helps mediate conflict or remedy problem in the two-person relationship (dyad). For example:

siblings cease their disagreement over chores to actively chide their younger brother co-workers are unclear on best approach to an issue and seek guidance from their supervisor

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1. Greater anxiety = more closeness or distance

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dyad

third person or subject of mutual, concern or interest

Alliance increases trust and intimacy

Two members (or all three) are drawn closer in alliance or support. For example:

Separated or divorced husband and wife come together as parents for their child in need

sisters share greater intimacy after one has been the victim of a crime (the triangulated my be a person or an issue, such as “work”, the “neighbors” or in this example, the “crime”)

closeness may increase as anxiety is reduced

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Over time

Triangulation begins as a normative response due to stress or anxiety caused by transition, change or conflict

The pattern habituates, then rigidifies as a preferred transactional pattern for avoiding stress in the dyad

The IP begins to actively participate in maintaining the role due to primary and secondary gains

The “problem”, that serves the purpose of refocusing attention onto the IP and away from tension within the dyad, becomes an organizational node around which behaviors repeat, thereby governing some part of the family system’s communication/function

Overtime, this interactional sequence acquires identity, history and functional value (Power), much like any role, and we call it a “symptom” or the symptom-bearer “dysfunctional”

A key component in symptom development is that the evolving pattern of interaction avoids more painful conflict

This places the IP at risk of remaining the “lightning rod” and accelerating behaviors to maintain the same net effect.

When this occurs it negates the need to achieve a more effective solution (adaptive response) to some other important change and growth is thwarted. The ensuing condition is called “dysfunction”.

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Minuchin and Bowen

Detouring and Cross-generational Coalitions are two types of triangulation described by Salvador Minuchin (1974) that lead to problematic behavior patterns.

“When parents are unable to resolve problems between them, they may direct their focus of concern away from themselves and onto the child, perhaps reinforcing maladaptive behavior in the child. The child may then become identified as the problematic member of the family. Detouring occurs when parents, rather than directing anger or criticism toward each other, focus the negativity on the child and the parent-child conflict thus serves to distract from the tension in the marital subsystem. This type of triangulation also is sometimes referred to as scapegoating as the child's well-being is sacrificed in order that the marital conflict might be avoided (Minuchin 1974).

Cross-generational coalitions develop when one or both parents trying to enlist the support of the child against the other parent. Cross-generational coalitions also exist when one of the parents responds to the child's needs with excessive concern and devotion (enmeshment) while the other parent withdraws and becomes less responsive. In the latter situation, the attention to the child is supportive rather than critical or conflictual. Minuchin believed cross-generational coalitions to be particularly associated with psychosomatic illness (Minuchin, Rosman, and Baker 1978) and recent research also shows associations with marital distress (e.g., Kerig 1995; Lindahl, Clements, and Markman 1997)”. -Courtesy of http://family.jrank.org/pages/1707/Triangulation-Systemic-Structural-Family-Theories.html">Triangulation - Systemic And Structural Family Theories

These processes are the mechanics by which the family “projects” their anxieties unto a member (see Bowen, 1966, 1972)

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Bowen: relationship fusion, which leads to triangling or triangulation, fuels symptom formation which manifests itself in one of three categories. 1) couple conflict; 2) impairment or illness in a partner or spouse; or 3) projection of a problem onto one or more children (family projection process).

* “The family projection process describes the primary way parents transmit their emotional problems to a child. The projection process can impair the functioning of one or more children and increase their vulnerability to clinical symptoms. Children inherit many types of problems (as well as strengths) through the relationships with their parents, but the problems they inherit that most affect their lives are relationship sensitivities such as heightened needs for attention and approval, difficulty dealing with expectations, the tendency to blame oneself or others, feeling responsible for the happiness of others or that others are responsible for one’s own happiness, and acting impulsively to relieve the anxiety of the moment rather than tolerating anxiety and acting thoughtfully. If the projection process is fairly intense, the child develops stronger relationship sensitivities than his parents. The sensitivities increase a person’s vulnerability to symptoms by fostering behaviors that escalate chronic anxiety in a relationship system.

The projection process follows three steps:

(1) the parent focuses on a child out of fear that something is wrong with the child;

(2) the parent interprets the child’s behavior as confirming the fear; and

(3) the parent treats the child as if something is really wrong with the child.

These steps of scanning, diagnosing, and treating begin early in the child’s life and continue. The parents’ fears and perceptions so shape the child’s development and behavior that he grows to embody their fears and perceptions. One reason the projection process is a self-fulfilling prophecy is that parents try to “fix” the problem they have diagnosed in the child; for example, parents perceive their child to have low self-esteem, they repeatedly try to affirm the child, and the child’s self-esteem grows dependent on their affirmation.

Parents often feel they have not given enough love, attention, or support to a child manifesting problems, but they have invested more time, energy, and worry in this child than in his siblings. The siblings less involved in the family projection process have a more mature and reality-based relationship with their parents that fosters the siblings developing into less needy, less reactive, and more goal-directed people. Both parents participate equally in the family projection process, but in different ways. The mother is usually the primary caretaker and more prone than the father to excessive emotional involvement with one or more of the children. The father typically occupies the outside position in the parental triangle, except during periods of heightened tension in the mother-child relationship. Both parents are unsure of themselves in relationship to the child, but commonly one parent acts sure of himself or herself and the other parent goes along. The intensity of the projection process is unrelated to the amount of time parents spend with a child”.

` - courtesy The Bowen Center

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Conflict in the dyad goes unresolved as attention is drawn

away from important issues

child

# 2. Collusion and Cross-generational Coalitions

# 1. Detouring or “Scapegoating”

Collusion: Two members ally against a third, such as when a friend serves as a confidant with one of the partners during couple discord or siblings ally against another. The third member feels pressured or manipulated or gets isolated, feels ignored, excluded, or rejected as a result of being brought into the conflict

Cross-generational Coalition: The third party is a child pulled into an inappropriate role (cross-generational coalition) such as mediator in the conflict between two parents. This could include parent-child-parent and parent-child-grandparent triangles.

Two Problem Triangles

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# 1

# 2

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Emotional Fusion and the Power Dimension

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Unresolved Emotional Pain & Treatment

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Common Signs and Symptoms of Psychological Trauma Cognitive/Behavioral:

Intrusive thoughts, images, smells and sounds of the event Nightmares Disorientation, confusion, loss of memory or ability to concentrate Mood swings, especially fear, sadness and anger Avoidance or lack of interest in activities or places that trigger memories Social isolation and withdrawal

Physical:

Fatigue and exhaustion Tachycardia; irritable or edgy, nervous or easily startled Insomnia or difficulty sleeping; loss of appetite of eating problems Sexual dysfunction Hypervigilance; preoccupation with safety, danger or risk

Psychological:

Feeling overwhelmed or fearful; feeling anxious, vulnerable and unsafe; panic attacks Ritualized behavior, obsessive and compulsive behaviors; rumination Depression or detachment from others Failure or self-defeating behavior Blaming, shaming or feelings of guilt Anger

Untreated Psychological Trauma, may include

Addiction, Alcoholism or Substance abuse Sexual problems or dysfunctions Distrust/Issues with intimacy, closeness or trust Hostility or rage Combativeness, pervasive irritability or social withdrawal Self-destructive behaviors including self-injury and suicide

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"There is no coming to consciousness without pain” 

-Carl G. Jung  22