Family Therapy

An Introduction to Process, Practice and Theory

Michael D. Reiter

• Publisher: Routledge
• Year: 2017
• ISBN:
  9781351617413
• Edition: 1
• Topic: Psychology
• Subtopic: History & Theory in Psychology
• Index: Psychology

Family Therapy: An Introduction to Process, Practice and Theory is a primer for students, professionals, and trainees to understand how family therapists conceptualize the problems people bring to therapy, utilize basic therapeutic skills to engage clients in the therapeutic process, and navigate the predominant models of family therapy. This text walks readers through each of these main areas viaa straightforward writing style where they are provided withexercises and questions to help them develop the basic concepts and tools of being a family therapist. Upon finishing this book, students will have the foundational skills and knowledge needed to work relationally and systemically with clients.

Part I

Thinking of a Family Therapist

Part I of this book is designed to help you think like a family therapist. This comes in the form of shifting your view of where problems are located. Most people see problems occurring within people. Family therapists acknowledge that people are distinct, but that symptoms usually happen within a context—a relational context.

Chapter 1 provides you with the foundational ideas of general systems theory, which has been the primary metaphor for understanding family process and on which many of the original family therapy theories are based.

Chapter 2 focuses on you, the family therapist. Given that there is a therapeutic system, we need to understand all components involved. In this chapter you will explore the self of the therapist and think about what role you have inside and outside of the therapy room.

Chapter 3 shifts from the therapist to a focus on the client. Client is being used in this book to describe whoever is in the therapy room (an individual, couple, or family). As chapter 1 explains, the therapist understands problems systemically, thus only one part of that system is needed for change.

Part I ends with a focus on diversity in chapter 4. Although this is a single chapter in the book, I hope you understand that it is not an isolated concept. We are always dealing with issues of diversity. The client’s culture impacts the family’s rules, which impact what behaviors are acceptable. While you read this book, use the previous chapters as an overlay for the current chapter you are reading.

1General Systems Theory

This is a book about how to think, act, and theorize like a family therapist. Family therapy is not about the amount of people in the therapy room, but rather how we understand how people function. It is a shift from an intrapersonal to interpersonal perspective. It is an understanding of people within the contexts that influence them. This is why we can do family therapy with just one person. This chapter explores this notion of context; primarily in regards to systems theory. While it is not all-encompassing, the chapter should provide you with the basic vocabulary and epistemology that many family therapists utilize.

Systems Theory

Many family therapists view themselves as systems thinkers. This is because they focus not on the individual, but the individual within context. Those contexts include the various relationships and larger systems (i.e., legal, educational, cultural, medical, etc.) the person is housed in (see figure 1.1).

Figure 1.1Relationship between an individual and larger systems

Lineal Versus Circular Causality

One of the biggest distinctions between a family therapy viewpoint and most others is the shift from a linear to circular viewpoint. The lineal view is the one more held in the Western world. It is based in quantitative science where a root cause can be found. We are trained from an early age in the linear perspective. When we think about why people behave in the ways that they do, our answers tend to focus on a fixed aspect of a person’s personality.

•Why did he hit the other boy?

Because he is an aggressive person.

•How come she is depressed?

Because she came from a broken home.

Here, there is a cause—an inherent trait (being an aggressive person), and an effect—of hitting someone (see figure 1.2). This view is an individualistic one, which does not fully consider the context of behavior.

Figure 1.2Lineal view of causality

Family therapy helped introduce the notion of circularity into the psychotherapy field. It is a notion that while we influence someone, we are simultaneously influenced by that person (see figure 1.3). Perhaps more than anyone else, Gregory Bateson helped promote circularity. This happened through his and his team’s focus on understanding communication and behaviors as interpersonal rather than intrapsychic processes. In one of the most famous and important publications in the history of family therapy, Bateson, Jackson, Haley, and Weakland (1956) introduced the notion of the double bind. They explained how the person diagnosed as schizophrenic is not dealing with a mental disorder but rather a communicational problem where the person is caught within two injunctions wherein if they interpret someone else’s (usually a parent’s) communication in one way they are punished, but if they interpret it in the opposite way they still are punished. With repeated exposure to this double bind and not being able to properly interpret messages, behavior labeled as schizophrenia may occur.

Figure 1.3Circular view of causality

Homeostasis

Much of the early systems perspective was based on the notion of cybernetics—a focus on pattern and organization and how systems self-regulate. This focus led to understanding families as operating based upon a certain level of homeostasis. Homeostasis is derived from the roots homeo—same and stasis—state. It suggests that families find a way of being and act to maintain that level. There is not a “normal” homeostasis, as each family has their own level of functioning.

One of the most recognized homeostatic processes is your home’s HVAC system: your air conditioner. You set it at a certain level; let’s say 75 degrees. The system then takes in information to determine whether it is in the desired range. During the day, sunlight might come in through the windows and heat up the house. The HVAC system will kick in to begin to cool the house when the temperature gets above a certain point—perhaps 78 degrees. The system keeps cooling down until it receives information that it is back within the normal range. If it begins to get too cold in the house, perhaps 72 degrees, that information shuts off the system so that it can heat up to the normal range again.

We can investigate this a little more complexly and look at the information the system receives. These can be seen as feedback loops: positive and negative. Positive feedback loops are interactions that lead toward change while negative feedback loops lead toward stability (see figure 1.4). [Just a note that the words positive and negative do not refer to “good” or “bad” but just a process—similar to positive and negative reinforcement not being about “good” or “bad” but ways in which a behavior is increased]. Families are always changing, while maintaining some semblance of sameness. Thus, homeostasis always involves aspects of stability and change. For instance, tightrope walkers maintain their balance (stability) by adjusting the long pole they are holding (change). Large change in family homeostasis usually comes about during transitions in the family life cycle.

Figure 1.4Negative and positive feedback cycle

Perhaps an example will help clarify this concept. The Richardson family believes the family should operate through harmony. Joe, the 15-year-old son, has started to talk back to his parents, which they denote as “disrespect.” Joe’s new behavior falls outside of the comfort zone of the family (its homeostasis), which leads to the parents attempting to get Joe to reengage with them in ways they consider respectful. To do so, they have a talk with him about “proper” behaviors, ground him, and take away his iPhone. Joe then behaves in ways the parents deem as “respectful” and stop their disciplinary actions. This would be considered a negative feedback loop. When 16, Joe pushes his parents for more independence; perhaps by wanting a later curfew or making more of his own decisions. If the parents allow this process of independence, a change in the family’s homeostasis occurs—demonstrating a positive feedback loop.

Utilizing a cybernetic epistemology was a major shift from individual to family therapy. However, therapists realized this was not a full understanding of the notion of circularity as the therapist was operating as if they were outside of the observed system. Thus, there was a movement toward second-order cybernetics, or what is called cybernetics of cybernetics where the observer and the observed system are viewed as a recursive whole—the therapeutic system (Keeney, 1983) (see figure 1.5). You are never seeing a family “as they are” because they are acting in relationship to you. Conversely, the family is never seeing you as you are but as you are in relation to them. This understanding may help to prevent viewing people, families, and self as fixed entities.

Figure 1.5The therapeutic system

Systems

A system is an organization of parts that come together to function as a whole. An individual is a system as it is a conglomeration of parts (i.e., brain, heart, blood, lungs, etc.) that all work together to keep the person alive. The United States is a system, with 50 parts that function as a whole (as well as U.S. territories, etc., but we’ll keep things simple). In this book, we are talking about two particular systems. The first is the family, more particularly the nuclear family. It is composed of parts—the different family members—that have unique ways of interaction that define them as a family. We can expand the view of system to include extended family and see that a family is one part (a subsystem) of a larger system.

The second system that we are talking about in this book is the therapeutic system. This was referenced previously in terms of cybernetics of cybernetics; understanding what happens when family and therapist come together. At that point, a new and unique system develops with its own rules and patterns.

A rule describes what is and what is not allowed in the system. Rules help to define how people can behave and communicate. Rules can be overt and covert. Overt rules are known to family member...

Table of contents

• Cover
• Half Title
• Title Page
• Copyright Page
• Dedication
• Contents
• Preface
• Part I Thinking of a Family Therapist
• Part II Skills of a Family Therapist
• Part III Theory of a Family Therapist
• Appendix: Master “Cheat Sheet”
• References
• Index