family therapy models, diagnosis and principles are compared based upon Bowen's Transgenerationaland/Family Systems model with Minuchin's Family therapy. Later on, we will see the link between the two and the relationship of each model to divorce. In the case study, we will attempt to apply the lessons of the Bowen/Ackerman and Minuchin style approaches to get to the underlying causes of a patient's depressive disorder.
The goal of the counseling session from the family therapist would be to aid the psychiatric team. Depression is simply a condition that reflects underlying issues. In this case, the patient's past home life and separation of her parents have caused abuse and bereavement issues to be dealt with more effectively and to break the triggers that bring about the onset of depression. This is especially necessary, since the abuse issues and bereavement caused by the loss (or lack) of a caring father figure in her life have made drug therapy only marginally successful.
A.) Models, Diagnosis and Principles (Overview)
Family therapy is based upon understanding how families work and interact. To understand this basic principle is the key objective of every therapist.
During the past seventy years, the family therapy movement has tried to understand the family. Adler and Sullivan were the pioneers who laid the foundations of the discipline and began the task of applying Freud's theories in the psycho-dynamic arena (Goldenberg & Goldenberg, 2008, 150-151). Ackerman went further by attempting to more systematically apply Freud to family therapy (ibid, 155).
Psychoanalysis was taken further to try to plumb the depths of the mystery of family relations. In the light of Freud's research, Dr. Murray Bowen attempted to further uncover how unresolved conflicts from the past of a family continue to affect it in the present. The Bowen school introduced the hypothesis that many mental illnesses are simply the result of dysfunctional family system patterns. Bowen was one of the first to advocate and treat the whole family and their emotional system rather than treating a single member with his or her personal behaviors or emotions.
Beyond this, Bowen pioneered transgenerational patterns that have laid the foundation to help clients to identify the root of their family problems and search for a way to break those cycles (ibid, 175-178).
Family therapists discovered the emotional process in which a person is involved and how this matters to the patient. They focused on individual growth and the development of a person's self-esteem. This is one of the most basic and primary concepts of a human being in a family relationship.
On the other hand, cognitive-behavioral family therapists predict that illogical beliefs work as the principal triggers for a family's emotional distress
. Both schools have provided a unique advances to our understandings of interactions within the family unit (ibid).
B.) Comprehensive coverage of Transgenerational and Structural Models & Principles
In this paper transgenerational models and the structural family therapy models will be presented in more detail. First, we will consider the transgenerational model as pursued by Bowen and others. Then, we will consider the Minuchin model of structural models and principles.
Transgenerational theory contains 8 key elements. These include triangles, differentiation of self, nuclear family emotional system, family projection process, multigenerational transmission process, emotional cutoff, sibling position and societal emotional process (ibid, 178-190). Bowen stressed how important family relational patterns over time are. The relational patterns constitute a strong influence over the lives of an individual and the family that noticing them is crucial to become a differentiated person. This is by definition is a person that possesses a capacity for reflective thinking. Such a person does not respond automatically to emotional pressure, be it external or internal. Genograms are crucial to mapping these relationships so that patterns can be drawn and the patient can be effectively treated (ibid, 192). Briefly will follow some of what the author feels are the more important of Bowen's work.
Much of the therapy is based around the concept of differentiation of self. Through this concept, a therapist can assess a patient's capability to preserve their strong sense of self-
identity. This can be done while maintaining a natural attachment to his or her family system.
The term differentiation is used by Bowen as a synonym for maturity. This has been wrongly understood as meaning a person who is autonomous, disconnected or separated from others. In the post-modern critique, feminists who did not agree with Bowen's concept of differentiation and his distinction between thinking and feeling. This was as a way of trying to elevate male attributes of rationality over female expressiveness. Bowens' approach was attempting to emphasize the primary goal of the transgenerational school. This is to teach a person's mind to maintain control of their emotional reactivity so that one can control their behavior and not to think about how they want to control others (ibid, 179)
Differentiation of self is related to the notion of emotional triangles. A triangle is a 3 person relationship structure. This can be considered as the fundamental base of a larger system.
An emotional triangle is the smallest stable relationship unit that is created when a situation or an unresolved problem between 2 people cannot find a solution. In such a situation, one of the affected persons turns to a third in search for understanding, or a way to fix the crisis. In this way an individual is able to see how the interlocking triangles in his family are working and how they may have the power to resolve their feelings about the past. The ability of a person to break out of a triangle depends upon the level of differentiation of self that the person has reached (ibid, 183).
Bowen's approach can be applied by using 2 techniques. These include the genogram
(mentioned above). By using the genogram, the therapist can help the family to assess their own family of origin, discovering patterns of behavior and triangles and measuring their own self-differentiation. By doing so, the family will be able to reach the principal goals of the therapy which are the differentiation of themselves and detriangulation. A genogram is a kind of family map that goes to the third or fourth generation. A genogram is a way to map the family history which should not be treated as a form to fill out, but rather as a framework for understanding family patterns (ibid, 192).
The structure shown in the genogram can be used to understand how a specific family unit acts. This is the point where the structural family model comes into play. Even though the structural school does not focus its attention in the root and history of the problem, the conceptualization of patterns of behavior and how the family system has tried to resolve the problem, is a fundamental predicament in the theoretical framework of the structural school
Self-disclosure is a key element in Bowen's model. Self-disclosure is presented as a crucial component in the training process of future therapists and in the supervision of them. Additionally, therapists who follow
Bowen's family therapy model needed to experience emotional explorations of concepts in order to adequately understand them.
In Bowen's model, the role of the therapist is like the role of a coach, who helps the family in creating and building fair relationships. Acting in this way, the therapist avoids becoming part of any type of triangles, and helps the family to find their own way of solving the problems, instead of telling them how to do it. In the transgenerational model, the therapist is like a tutor, whose principal work is to alleviate the dyadic stress created in a triangle. The therapist intervention as a middle person-moderator-coach-tutor is an essential element in a successful therapeutic work. The process of coaching a family or a member of a family begins by helping them to become observers of their roles and behaviors in their family. Being an observer will help them to realize the patterns existing in their own family. This will then motivate them to break those patterns that weaken the family system and work together toward a pattern of behaviors that are more productive and healthiest according to their moral, family and social values (ibid. 178-190).
Salvador Minuchin's approach to family therapy stated that the focus of therapy is not the individual but the person within the family. The focus is not only in the past, how they try to solve the problem, but mainly in the present, in how the family is trying now to solve it.
According to Nichols, the structural model has three essential theoretical components: the family structure, the family subsystems and the family boundaries. Minuchin focuses his intervention not in the person who he thinks has the problem, but in the individual in his social context (ibid, 236-247).
According to Minuchin, a family is a natural association of individuals that during their lives, develops a specific structure that can be recognized by patterns of interaction. The family structure is in…