Counseling and Psychotherapy Theory. Week 8. Family/System Approach

Transcription

1 Counseling and Psychotherapy Theory Week 8. Family/System Approach

2 Contents Major Concepts and Propositions 1 Overview 2 Major Concepts and Propositions I 3 Major Concepts and Propositions II Change Mechanisms & Intervention Methods 1 Moving from the Problem State to the Changed State 2 Strategies and Techniques Theory s Current State and Prospect 1 2 Current State and Prospect Implications

3 Ⅰ. Major Concepts and Propositions Overview Main Assumptions Characteristics by Subtype Approach

4 Main Assumptions Individual counseling theories Acknowledges that family affects an individual's well-being However, the target of the intervention is the individual individual & family are changed Family counseling Acknowledges that family affects an individual's well-being. But the intervention is on the family system individual & family are changed

5 Main Assumptions Intervene in the family system? intervene in the family structure Hierarchy within family Boundaries between members Subsystems within family

6 Main Assumptions Intervene in the family system? intervene in interactions Dual, triangular interaction style A B

7 Characteristics by Subtype Approach 4 subtype approaches Psychoanalytic multigenerational approach Structural approach Strategic approach Experiential approach

8 Characteristics by Subtype Approach Psychoanalytic multigenerational approach (M. Bowen) Assumptions Parents' inappropriate nurturing style triggers problems Dysfunctional interactions within the original family are transferred throughout generations. Problems Maladaptive defense mechanisms (not genuine interactions) interaction between defense mechanisms Parents function as good/bad objects Triggers/worsens children s splitting [ex] splitting, projective identification, various defensive interactions Interventions Understanding & insight Preventing dysfunctional interaction Insight on dysfunctional family dynamics Insight on multi-generational dysfunctional family dynamics Holding, containing Integration of splitting

9 Characteristics by Subtype Approach Structural approach (S. Minuchin) Assumptions family structure and system determines an individual's well-being Problems inappropriate family structure and system family hierarchy, subsystems, withinfamily boundaries, within-family alliance, etc. Interventions modifying incorrect structures and systems

10 Characteristics by Subtype Approach Strategic approach (J. Haley) Assumptions The purpose of every interaction within a family is acquisition of power Problems Implicit strategy taken when making explicit efforts to acquire power and secure control within a relationship seems impossible Interventions Counterstrategy to disempower the implicit strategy Making the implicit strategy explicit Paradoxical intervention, etc. Jay Haley

11 Characteristics by Subtype Approach Experiential approach (V. Satir) Assumptions Family is a system that seeks to maintain balance and homeostasis Problems Individual s cost of maintaining balance and homeostasis Hinders individual s growth Interventions Breaking the family s balance and homeostasis that stayed as a symptom Recognizing and explicitly expressing/conveying individual s inner experience V. Satir

12 Characteristics by Subtype Approach Experiential approach (V. Satir) Communication pattern Problems Indirect, ambiguous Interventions Direct Family rules Rigid, absolute Flexible Family function Individual s value Emotional shutdown, defensive Neglect of positive self or value Emotional openness, not defensive Identify self worth

13 Ⅰ. Major Concepts and Propositions 2 Major Concepts and Propositions I Systems Theory Related Family Genogram Classical Concepts

14 Systems Theory Related Feedback loop an automatic control process where an input results in an output, which again affects the input. Input Process Output Feedback

15 Systems Theory Related Feedback loop Positive Feedback the output goes through the loop in the same direction as the initial input. Sharp increase in the nonlinear distortion Microphone Arguments within family Negative Feedback the output goes through the loop in the opposite direction as the initial input. Decrease in the nonlinear distortion Thermostat Parent s homeostatic function

16 Systems Theory Related Cyclical interaction Change in one member affects other member and the family as a whole, and such influence affects that one member again Oppressive parent Child s defiance Parent becomes more oppressive

17 Systems Theory Related Homeostasis Tendency of the system to stay in the original, familiar state and function Thus, systems tend to resist change. A child s behavior that is about to bring change to the system Parents control gets stronger due to the anxiety that the family system might collapse

18 Family Genogram Family Genogram Expresses family structure, relationship, dynamics 85ms unemp 83gr unemp (lawyer) 80 co unemp (reporter) Includes 3 generations Age, job, education level must be included 59co unemp 57hs house wife 55 co entrepre neur 53gr professor 50co doctor 47gr doctor Ms: middle school grad Hs: high school grad Co: college grad Gr: graduate school grad Unemp: unemployed 27 co business man 24 stude nt 18 hs

19 Classical Concepts Double bind Two contradictory messages No satisfactory conclusion either way - A nonverbal message signaling go away - A verbal message saying, Come here. You need my love. - You interpreted my message wrong

20 Classical Concepts Double bind [Ex] A young man was recovering from schizophrenia Situation: His mother visited him at the hospital, and he was glad to see her. Mother appears tense, so he backs off. Mother : You don t love me anymore. Son : (blushes) Mother : Son, you shouldn t get so easily embarrassed or fearful of your emotions.

21 Classical Concepts Marital schism Broken marital relationship Marital skew One spouse overwhelms the other in a marital relationship

22 Ⅰ. Major Concepts and Propositions 3 Major Concepts and Propositions II Multigenerational Approach Related Structural Approach Related Experiential Approach Related

23 Multigenerational Approach Related Self-differentiation A state in which one has accepted that one s thoughts, feelings, or language can be different from that of other family members. A state in which emotion and thought process are differentiated from each other within an individual in emotions buried When one cannot accept that one can be different from other members, one is restricted about what to think and feel. [Ex] A client who has difficulty making choices freely based on his thought and emotions

24 Multigenerational Approach Related Triangulation Bringing in a third person in order to reduce a conflict, anxiety or tension between two other members within a family. Typically, a person with low self differentiation is taken in as the third person. [Ex] Mother who complains to her son after fighting with her husband

25 Multigenerational Approach Related Family projection Parents projecting their own stress to their children [Ex] A parent who gets angry at his child because of his own anxiety

26 Multigenerational Approach Related Emotional cut-off When a child is overly stressed due to excessive meddling from family, she separates herself emotionally from the family [Ex] A son who never visits his parents

27 Structural Approach Related Family subsystems The spousal subsystem or sibling subsystem within a family system Are sometimes formed based on emotional proximity [Ex ] - Parent/child system - Father/daughter vs. mother/son subsystem

28 Structural Approach Related Boundary Boundaries are set between members or between subsystems Boundaries are established through certain rules regarding information influx shared by individuals or subsystems or rules regarding participation. Clear boundary Diffuse boundary Rigid boundary Alliance/Overinvolvement =================

29 Structural Approach Related Coalition Two people teaming up against a third member Stable coalition Detouring coalition Triangulation Cross-generational coalition

30 Experiential Approach Related Family rules Internalized behaviors, attitudes, relationship responses that were experienced among family members [Ex] Taboo topics within the family

31 Experiential Approach Related Communication Every interaction people use to exchange messages including implications and symbols Reveals the relationship level of the interactions as well as individual characteristics

32 Experiential Approach Related Communication Communication types Placater Blamer Computer Distractor Leveler

33 Experiential Approach Related Communication Placater Blamer Computer Conveys to others that one is not so important by denying oneself Tries to please others Self-centered, self-righteous, dominant, and slighting others Aggressive, controlling, easily angered Cool-headed; regards being rational, objective, and logical important Self and others don t matter; logic and situation are considered important

34 Experiential Approach Related Communication Distractor Leveler The opposite of the computer type Talks and acts inappropriately to particular topic or situation Interferes with deep communication Internal emotions and thoughts are consistent with what are externally expressed Sensitively aware of and expresses one s own thoughts, emotions, and desires

35 ⅠI. Change Mechanisms & Intervention Methods 1 Moving from the Problem State to the Changed State 1 2 Problem State vs. Changed State Change Facilitating Factor

36 Problem State vs. Changed State Approach type Problem state Changed state Psychoanalytic multigenerational Structural Strategic Experiential Maladaptive dynamics repeated within and between generations Inappropriate family structure, system Implicit strategies for exercising power and control are fixated and are shown through different symptoms Pursuing family balance to the point of blocking individual members' experiences and communication Dysfunctional dynamics or defense mechanisms incapacitated Appropriate family structure, system Explicit strategies and clear communication A new dimension of family balance that reflects individual members experiences and communication

37 Change Facilitating Factor Approach type Change Facilitating Factor Psychoanalytic multigenerational Structural Gaining awareness/insight into maladaptive dynamics and defense mechanisms within and between generations Contacting internal experiences Choosing new method Practicing and solidifying new behavioral style Gaining awareness/insight into inappropriate family structure Modifying into appropriate, functional family structure Choosing new method Familiarizing with the new structure

38 Change Facilitating Factor Approach type Strategic Experiential Change Facilitating Factor Weakening the implicit strategies through explicit communication Taking root in clear communication Becoming aware of private experiences that had been blocked Directly communicating about experiences Taking risks and choosing direct communication Practicing and familiarizing with direct communication

39 Change Facilitating Factor Recognizing defense mechanisms Recognizing crossgenerational patterns Recognizing inappropriate family structure Awareness, understanding, insight Recognizing implicit strategies Recognizing that personal experiences are blocked for family balance Recognizing individual member s experiences

40 Change Facilitating Factor Reenact/practice/solidify a new behavioral style Reenact/practice/solidify behavioral style within an appropriate structure Reenact/ practice/ solidify Reenact/practice/solidify direct/explicit communication method Solidify behavioral style that expresses personal experiences

41 ⅠI. Change Mechanisms & Intervention Methods 2 Strategies and Techniques 1 2 Overview Specific Strategies and Techniques

42 Overview Purpose of techniques and strategies Bringing about change in an individual through transforming family structure and within-family communication Approach type Psychoanalytic multigenerational Structural Change in the individual dimension Insight into individual s inner dynamics and structure Insight into individual s inner dynamics and structure and modifying them Change in the family dimension Insight into family dynamics and structure Insight into repeated patterns across generations Awareness/insight into inappropriate family structure and modifying it

43 Overview Purpose of techniques and strategies Bringing about change in an individual through transforming family structure and within-family communication Approach type Strategic Experiential Change in the individual dimension Change in the individual through explicit communication (not symptoms) Change in the individual through awareness and communication of personal experiences Change in the family dimension Change in the communication within through explicit communication (not symptoms) Moving to a new level of family balance through awareness and communication of personal experiences

44 Specific Strategies and Techniques Psychoanalytic multigenerational approach Explain and interpret (family genogram) Empathize and hold Contain

45 Specific Strategies and Techniques Structural approach Changing boundaries Rearrange seating Empower Reconstruct the way family members agree or make alliances

46 Specific Strategies and Techniques Strategic approach Instructing [Ex] instruct a child to use honorifics (in Korean) to her parents. Paradoxical intervention [Ex] tell the father to become more demanding to the son who has run away from home Ordeal therapy [Ex] tell a client with insomnia to wipe the floor instead of trying to sleep

47 Specific Strategies and Techniques Strategic approach Restructuring [Ex] label anorexia not as a disorder but as stubbornness Exaggerating [Ex] tell a child who frequently throws a fit to act like a Hulk in front of his mother. Metaphorical task [Ex] When a client has a hard time talking about sexual issues, ask her to metaphorically talk in terms of eating food.

48 Specific Strategies and Techniques Experiential approach Family sculpting Role play Family picture

49 ⅠII. Theory s Current State and Prospect 1 1 Current State and Prospect Current State and Prospect 2 Implications

50 Current State and Prospect Characteristics of Korean families Mix of various value systems - from familyism to individualism - from paternalism to gender equality - values of men and women are in conflict family problems are increasing

51 Current State and Prospect Characteristics of Korean families Adequate individuation between parent and child is difficult - Children are still thought to be face-savers for parents. From extended families to nuclear families. - Both cultures and value systems coexist. Indirect and nonverbal communication method - Indirectness or nonverbal communication due to hierarchies - Expressing emotions is not valued; it s indirectly done.

52 Current State and Prospect Increasing multicultural families International marriages between a Korean and a foreigner are reported to be 7% or 10%. Foreign women Foreign men China, Vietnam, Philippines China, Japan, U.S.A.

53 Current State and Prospect Increasing multicultural families Inflow of North Korean defectors Currently, about 28,000 North Korean defectors live in Korea. Similar language and looks, but culturally different.

54 Implications Intervening in family systems, structures, and interactions Create insight/understanding/narrative : dynamics, patterns - Ex: I now realize that our family had such and such dynamics and patterns. This is why I felt so suffocated. Recognize/contact/familiarize : needs, emotions - Ex: Getting in contact with the needs and emotions within the family and getting used to them

55 Implications Intervening in family systems, structures, and interactions Choose: new behavior - Ex : Taking the risk of trying out a new behavior Practice/solidify: thoughts, behaviors - Ex : having honest conversations; engaging in interactions without using symptoms or being defensive

56 THANK YOU