We all start this life with a family, whether that family is composed of blood relatives, adopted parents, a close-knit neighborhood, or a foster family. This family that we acquire when we are born influences every aspect of our lives, from our first moments to our last. Our family affects who we are and who we become, for better and for worse. We learn our vocabulary, our habits, our customs and rituals, and how to view and observe the world around us.
We also learn how to love and how to interact with others from these first important relationships.
If we are born into a healthy family with healthy relationships, we are likely to learn how to maintain healthy relationships. If we are born into a dysfunctional family that struggles to connect, we may also struggle to connect with others.
While it is certainly unlucky to be born into the second kind of family, it’s not an unchangeable situation. Nearly all families deal with some sort of dysfunction at one time or another, yet most families retain or regain a sense of wholeness and happiness. Family therapy offers families a way to do this—a way to develop or maintain a healthy, functional family.
So, What is Family Therapy / Family Counseling?
Family therapy or family counseling is a form of treatment that is designed to address specific issues affecting the health and functioning of a family. It can be used to help a family through a difficult period, a major transition, or mental or behavioral health problems in family members (“Family Therapy”, 2014).
As Dr. Michael Herkov explains, family therapy views individuals’ problems in the context of the larger unit: the family (2016). The assumption of this type of therapy is that problems cannot be successfully addressed or solved without understanding the dynamics of the group.
The way the family operates influences how the client’s problems formed and how they are encouraged or enabled by other members of their family.
Family therapy can employ techniques and exercises from cognitive therapy, behaviour therapy, interpersonal therapy, or other types of individual therapy. Like with other types of treatment, the techniques employed will depend on the specific problems the client or clients present with.
Behavioural or emotional problems in children are common reasons to visit a family therapist. A child’s problems do not exist in a vacuum; they exist, and will likely need to be addressed, within the context of the family (Herkov, 2016).
It should be noted that in family therapy or counseling, the term “family” does not necessarily mean blood relatives. In this context, “family” is anyone who “plays a long-term supportive role in one’s life, which may not mean blood relations or family members in the same household” (King, 2017).
Many forms of family therapy are based on family systems theory. Family systems approaches generally fall under the categories of structural, strategic, or intergenerational:
Structural family therapy, designed by Salvador Minuchin, looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family. Employing activities such as role play in session, therapists also examine subsystems within the family structure, such as parental or sibling subsystems.
Strategic family therapy, developed by Jay Haley, Milton Erickson, and Cloe Madanes, among others, examines family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session. Therapeutic techniques may include reframing or redefining a problem scenario or using paradoxical interventions (for example, suggesting the family take action seemingly in opposition to their therapeutic goals) in order to create the desired change. Strategic family therapists believe change can occur rapidly, without intensive analysis of the source of the problem.
Intergenerational family therapy acknowledges generational influences on family and individual behavior. Identifying multigenerational behavioral patterns, such as management of anxiety, can help people see how their current problems may be rooted in previous generations. Murray Bowen designed this approach to family therapy, using it in treatment for individuals and couples as well as families. Bowen employed techniques such as normalizing a family’s challenges by discussing similar scenarios in other families, describing the reactions of individual family members instead of acting them out, and encouraging family members to respond with “I” statements rather than accusatory statements.
As the different types of therapy described above show, a family therapist may be called upon to take on many different roles. These many roles require a family therapist to undergo a great deal of training, formal education, and testing to ensure that the therapist is up to the task.
Eight Interlocking concepts of family systems theory
Eight major theoretical concepts form the foundation of the Bowenian approach. These concepts are interconnected, and a thorough understanding of each may be necessary in order to understand the others.
These theoretical constructions include, in no particular order:
Differentiation of self, the core concept of Bowen’s approach, refers to the manner in which a person is able to separate thoughts and feelings, respond to anxiety, and cope with the variables of life while pursuing personal goals. An individual with a high level of differentiation may be better able to maintain individuality while still maintaining emotional contact with the group. A person with a low level of differentiation may experience emotional fusion, feeling what the group feels, due to insufficient interpersonal boundaries between members of the family. Highly differentiated people may be more likely to achieve contentment through their own efforts, while those with a less-developed self may seek validation from other people.
An emotional triangle represents the smallest stable network of human relationship systems (larger relationship systems can be perceived as a network of interlocking triangles). A two-person dyad may exist for a time but may become unstable as anxiety is introduced. A three-person system, however, may provide more resources toward managing and reducing overall anxiety within the group. Despite the potential for increased stability, many triangles establish their own rules and exist with two sides in harmony and one side in conflict—a situation which may lead to difficulty. It is common for children to become triangulated within their parents’ relationship.
The family projection process, or the transmission of a parent’s anxiety, relationship difficulties, and emotional concerns to the child within the emotional triangle, may contribute to the development of emotional issues and other concerns in the child. The parent(s) may first focus anxiety or worry onto the child and, when the child reacts to this by experiencing worry or anxiety in turn, may either try to “fix” these concerns or seek professional help. However, this may often have further negative impact as the child begins to be further affected by the concern and may become dependent on the parent to “fix” it. What typically leads to the most improvement in the child is management, on the part of the parent(s), of their own concerns.
The multigenerational transmission process, according to Bowen, depicts the way that individuals seek out partners with a similar level of differentiation, potentially leading certain behaviors and conditions to be passed on through generations. A couple where each partner has a low level of differentiation may have children who have even lower levels of differentiation. These children may eventually have children with even lower levels of differentiation. When individuals increase their levels of differentiation, according to Bowen, they may be able to break this pattern, achieve relief from their symptoms of low differentiation, and prevent symptoms from returning or occurring in other family members.
An emotional cutoff describes a situation where a person decides to best manage emotional difficulties or other concerns within the family system by emotionally distancing themselves from other members of the family. Cutting emotional connections may serve as an attempt to reduce tension and stress in the relationship and handle unresolved interpersonal issues, but the end result is often an increase in anxiety and tension, although the relationship may be less fraught with readily apparent conflict. Bowen believed emotional cutoff would lead people to place more importance on new relationships, which would add stress to those relationships, in turn.
Sibling position describes the tendency of the oldest, middle, and youngest children to assume specific roles within the family due to differences in expectation, parental discipline, and other factors. For example, older children may be expected to act as miniature adults within the family setting. These roles may be influenced by the sibling position of parents and relatives.
The societal emotional process illustrates how principles affecting the emotional system of the family also affect the emotional system of society. Individuals in society may experience greater anxiety and instability during periods of regression, and parallels can be noted between societal and familial emotional function. Factors such as overpopulation, the availability of natural resources, the health of the economy, and so on can influence these regressive periods.
The nuclear family emotional process reflects Bowen’s belief that the nuclear family tends to experience issues in four main areas: intimate partner conflict, problematic behaviors or concerns in one partner, emotional distance, and impaired functionality in children. Anxiety may lead to fights, arguments, criticism, under- or over-performance of responsibilities, and/or distancing behavior. Though a person’s particular belief system and attitude toward relationships may impact the development of issues according to relationship patterns, Bowen held them to be primarily a result of the family emotional system.
How can family systems therapy help?
In a nutshell, the goal of family therapy is to work together to heal any mental, emotional, or psychological problems tearing your family apart (Lee, 2010). To guide a family towards a healthy life, family therapists aim to aid people in improving communication, solving family problems, understanding and handling family situations, and creating a better functioning home environment (Family Therapy, 2017A).
The goals of family therapy depend on the presenting problems of the clients. For example, goals may differ based on the following scenarios: A family member is suffering from schizophrenia or severe psychosis: The goal is to help other family members understand the disorder and adjust to the psychological changes that the patient may be undergoing; Problems arising from cross-generational boundaries, such as when parents share a home with grandparents, or children are being raised by grandparents: The goal is to improve communication and help the family members set healthy boundaries; Families deviating from social norms (unmarried parents, gay couples raising children, etc.): The goals here are not always to address any specific internal problems, but the family members may need help coping with external factors like societal attitudes; Family members who come from mixed racial, cultural, or religious backgrounds: The goal is to help family members further their understanding of one another and develop healthy relationships.
One member is being scapegoated or having their treatment in individual therapy undermined: When one family member is struggling with feeling like the outcast or receives limited support from other family members, the goal is to facilitate increased empathy and understanding for the individual within their family and provide support for them to continue their treatment; The patient’s problems seem inextricably tied to problems with other family members: In cases where the problem or problems are deeply rooted in problems with other family members, the goal is to address each of the contributing issues and solve or mitigate the effects of this pattern of problems; A blended family (i.e., step-family): Blended families can suffer from problems unique to their situations. In blended families, the goal of family therapy is to enhance understanding and facilitate healthy interactions between family members (Family Therapy, 2017B).
A family who is struggling with a situation that brings added stress, such as the death of a family member, addiction, or dire financial straits, may benefit from counseling to help them through their struggles to emerge on the other side as a stronger and more cohesive unit. If a family is struggling with more chronic mental or behavioural problems, such as a father dealing with schizophrenia, a mother fighting depression, or a child who has been abused, psychotherapy is likely the better choice.
What are the Benefits of Family Therapy?
This more holistic approach to treating problems within a family has proven to be extremely effective in many cases. In family therapy, families can work on their problems with the guidance of a mental health professional in a safe and controlled environment.
The benefits of family therapy include:
- A better understanding of healthy boundaries and family patterns and dynamics;
- Enhanced communication;
- Improved problem solving;
- Deeper empathy;
- Reduced conflict and better anger management skills (10 Acre Ranch, 2017).
- More specifically, family therapy can improve family relationships through:
- Bringing the family together after a crisis;
- Creating honesty between family members;
- Instilling trust in family members;
- Developing a supportive family environment;
- Reducing sources of tension and stress within the family;
- Helping family members forgive each other;
- Conflict resolution for family members;
- Bringing back family members who have been isolated (American Addiction Centers, 2017).
Family therapy enhances the skills required for healthy family functioning, including communication, conflict resolution, and problem-solving. Improving these skills also increases the potential for success in overcoming and addressing family problems.
In family therapy, the focus is on providing all family members with the tools they need to facilitate healing
(Teen Treatment Center, 2014).
Sources: Good therapy and Positive Psychology