Behavioral Health Types Of Therapy
Family systems theory
Family systems theory posits that each family member is most importantly part of the larger system and the system is a sum of the interrelated parts. Just as an individual is made up of systems of cells and organs working together to maintain function, a family is made up of individuals working together to maintain their own idea of function.
Family systems theory is mostly used when working with individuals with addictions or children who are seemingly acting out for no apparent reason. Often the underlying problem is not an individual problem, but an entire system problem. Family systems therapists believe that the best way to improve the individual is to understand and help the entire system as much as possible. If this is not possible, then helping the individual learn why they do what they do in terms of family roles helps them make necessary adjustments to be healthy.
History and Development
Family Systems theory was initially developed in the 1950’s by a psychiatrist, Murray Bowen. He worked with the National Institute of Mental Health and practiced with families in various clinics. His theory was radically different from anything that preceded it as all theories before centered around the individual on their own.
Bowen believed that a family was tied together emotionally in the same way that other systems were interrelated and that a change in one member of the family would affect the family as a whole. Previous theories were well versed in the fact that many psychological and emotional struggles and disorders are rooted in relationships and events from early childhood and our family of origin. However, Bowen looked at this as a snapshot of a larger problem rather than just an individual’s problem.
Family System Therapy Processes
Emotions play a large role in family dynamics. Family members sense and react to each other’s emotions, whether good or bad, and this creates an interdependency which affects all members of the system. Bowen divided this into eight main concepts which can be used to analyze family interactions.
Triangles
Triangulation occurs when three people are in a relationship and typically leads to two of the three being the ‘insiders’ and one being in the uncomfortable position of outsider. In healthy families these insider/outsider roles shift dynamically as life changes occur, but pathology can develop if one person is continually in the outsider position in family relationships.
Differentiation of Self
The ability to retain the unique self while being involved in intense relationships is the key to a healthy person. Bowen noted that the individual who lacks differentiation will conform to any pressures and expectations of others they are involved with. The undifferentiated individual is also susceptible to taking attacks by others personally instead of recognizing the effects that the other person’s self esteem and emotions play into such interactions.
Family Emotional Processes
This concept refers to the idea of patterns that relationships display in the areas of conflict, dysfunction, impairment, and emotional distance.
- Conflict refers to a partner's attempts to change, control, and criticize each other.
- Dysfunction relates to a situation where one partner accommodates the unreasonable demands or criticisms of the other partner.
- Impairment occurs when children lack self-differentiation due to emotional damages because of parental projections of anxiety or other pathologies on the child or children.
- Emotional distance occurs when some family members cause such anxiety or tension that other family members choose to remove themselves from having to deal with certain situations.
Family Projection Process
Projection is a process where one individual looks through their faulty lens and assumes the cause of another person’s actions and then changes how they interact with that person based on their own projection. They rarely ask for clarification or look for other possibilities. This may lead to parents that are overly harsh because they assume a child acting out is just a ‘brat’ and not considering that the child may be having some emotional, physical, or sensory problems. Occasionally, this leads to the other parent struggling to overcompensate and the child learning to get around consequences. This may also lead to inappropriate attachment or dependency issues.
Multigenerational Transmission
Multigeneral transmission is a situation where behaviors and reactions modeled by parents are transmitted through generations due to children picking up, adopting, and then passing along those behaviors to their children. This can refer to unhealthy parenting techniques, coping strategies, or roles. This concept has been widely adopted as the reason behind many disorders or disordered behavior that is transmitted through families.
Emotional Cutoff
When a family member emotionally cuts off other members of their family it provides immediate relief from stress, however, it doesn’t fix the problem. This can become a pattern for how family members deal with anyone who may cause stress or trouble, but can also be used to ‘punish’ those trying to step out of their prescribed roles and expectations.
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Dysfunctional Family Roles
In all family systems, individuals take on roles. However, unlike in healthy families where roles may change as people grow, in unhealthy systems individuals are stuck in their roles and any attempts to change or challenge their role may be met with serious resistance from everyone else in the family. This resistance occurs even when the change is for the best, such as when an addict tries to get clean. This attempt at improvement or advancement may trigger pushback from the family.
The Enabler/Caretaker
The enabler of the family is the one that takes on the problems and responsibilities of the problem parent. This role is typically seen in families where one parent has a significant mental health problem or addiction. They often do everything they can to ensure that the parent never faces any consequences. Of course the problem with this is that nobody gets better without facing consequences for their actions.
The Hero/Golden Child
The hero is the family member that works hard to make the family look normal. They work hard to succeed and are often the confidante of one of the parents. They feel the need to always be strong and brave. Their compulsive need to be successful and perfectionistic personalities tend toward stress-related illness and overwork as well as anxiety from trying to live up to these expectations.
The Scapegoat
This is often the one that will come into therapy as the identified patient. They are the troublemaker or the rebel. In reality, the scapegoat is often the one being the most truthful and honest about the family situation. They are defiant and angry and will talk about or act out about the problems that the family is attempting to cover up. Unfortunately, since they are often, at the minimum, emotionally abused, they tend to end up in relationships that are shallow and seek attention in a negative manner because that is the role in their family.
The Lost Child
The lost child is sometimes known as the quiet one or the dreamer. They try to escape by being very quiet and staying out of the way. They avoid family interactions to stay away from the chaos. Because they tend to withdraw from others and be very shy and lonely, they often lack good communication skills, struggle with intimacy, and deny that they have strong feelings or that they get upset. Their method of coping is to withdraw.
The Family Mascot
The mascot may also be called the clown. They use humor to entertain, interrupt tension, and make others feel better, but not to actually repair damage done. Instead, it deflects from what is going on temporarily. Often as these individuals grow up, they become involved with others in need of ‘saving’ and try to overcome their guilt and low self-worth by pleasing people.
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By learning and exploring family roles through family systems theory, individuals can learn how to change roles and have a healthier family system. Family members may work both individually and as a unit in therapy to uncover these patterns and improve relationships throughout the family. Utilizing a foundation of family systems theory in therapy can greatly assist therapists in teaching individuals how to understand some of their relational patterns.
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