Family therapy is usually initiated because of psychological or emotional problems of a single family member (Gale Encyclopedia of Psychology, 2001). In many cases, the family member is a child or adolescent. These problems are treated as symptomatic of dysfunction within the family system. The therapist analyzes the interaction between family members, to determine the role played by each member in maintaining the family system.
Family therapy is often helpful for dealing with problems that surface in response to a particular event or situation, incusing divorce or remarriage. It is also a good way to draw individuals who feel threatened by individual therapy into a therapeutic environment and get help with their issues.
There are numerous approaches to family therapy. Perhaps the best known family therapist is Salvador Minuchin. Minuchin, who still lives and works in the United States, grew up in a large rural family in Argentina (Moloney, 1994). As a result of working with underprivileged and dysfunctional families in New York and Philadelphia, he founded a theory that is now known as 'Structural Family Therapy' (Minuchin 1974). His theory and his work were important and innovative in at least two senses.
First of all, they presented the possibility of working not only with the people in the family, but also with the spaces between them and the structures these spaces developed (Moloney, 1994). Secondly, Minuchin did not make any formal assumptions about developmental blocks, pathology or faulty learning. Symptomatic behavior was interpreted as being in the service of family preservation. The symptom was viewed as a sign that the family system had reached an deadlock. By working with spaces and structure, the system could readjust without assigning blame.
Although it represented somewhat of a departure from an exclusive focus on the individual, family therapy maintained much of the thinking that existed within traditional medical style interventions (Moloney, 1994). In short, the medical model assumes that there is something wrong with the family system, which requires repair through the intervention of a third party -- often a counselor.
Structural family therapy is a short-term method that concentrates on the present rather than the past (Gale Encyclopedia of Psychology, 2001). This model views a family's Lack of communication often plays a key role in continuing dysfunctional interactions within families, including the formation of alliances among some family members against others.
According to the Gale Encyclopedia of Psychology (2001): "The goals of structural family therapy include strengthening parental leadership, clarifying boundaries, enhancing coping skills, and freeing family members from their entrenched positions within the family structure. Minuchin divided families' styles of interacting into two basic types-enmeshed and disengaged, considering behavior at either extreme as pathological, with most families falling somewhere on a continuum between the two. Minuchin believed that the functioning of family systems prevented individuals from becoming healthier emotionally, because the family system relied on its troubled member to play a particular role in order to function in its accustomed way. This stability is disrupted if an individual changes significantly."
In the world of therapy, family plays a dominant and important role (VanKatwyk, 2001). The family represents an individual's earliest and most important connection to the world. Therapists are likely to locate the cause of their patient's pressing problems or misery in the family connection; whether the more distant family by birth or the immediate family by marriage.
Psychological assessments frequently focus on what was traumatic in the patient's early family experience, something so long-standing that it gets re-enacted in the present (VanKatwyck, 2001). Family theory describes how, in the first few years of life, family relational dynamics shape and determines the inner world of the psyche. Early family experiences are internalized as personalized maps of orientation, guiding individuals in all subsequent interactions with the world and in their relationships.
Salvador Minuchin describes family emotional connections through interpersonal boundaries (VanKatwyk, 2001). For instance, if boundaries are inappropriately rigid, there is disengagement. If boundaries are diffuse, there is enmeshment. On the continuum between these two extremes is the mid-range of specific boundaries where family members can be close yet maintain a sense of personal identity and agency (Minuchin, 1974).
The concept of boundaries is particularly important in family therapy when it applies to generational distinctiveness. Some of the unhealthiest family interactions take place in cross-generational alliances that violate boundaries that protect the integrity and safety of children or the solidarity of the parental and/or marital relationship.
A structuralist like Minuchin can look at a family dealing with an anorexic daughter and "see" the same family he has seen many ties in the past (Peacock, 1998). His view puts out of awareness issues other than enmeshment, cross-generational coalition, conflict avoidance and over-protection (Minuchin et al., 1978). His theory of deep structures within in the family system includes both the blueprint for therapy and its goal. His strong leadership of the family system is important for the problem to be solved.
Destructive triangles represent parent-child alliance pitted against the other parent, often posing loyalty conflicts for the child in which the love of the one parent comes at the cost of hurting the other parent (Boszormenyi-Nagy and Krasner, 1986). On the other hand, when boundaries are overly strict, interpersonal connections are also destroyed, frequently resulting in feelings of isolation and alienation.
It is more than three decades since counselors, therapists and researchers began to react to the dominant individual focus by systematically exploring ways of working directly with families (Moloney, 1994). Family therapists, as they are now known, developed theories aimed to shed greater light on what had always been intuitively understood - that in matters of personal health, humans are not only affected by but in turn have an effect on our family members.
When Minuchin published his early material, others, including Virginia Satir, were working with families in a way, which focused more on the recursive nature of the individual relationships between family members (Moloney, 1994). However, the flood of writing in family therapy in the 1970s and 1980s increasingly focused on finding keys - or even a single key to the family system. Where other counseling and therapeutic models had neglected context in the past, particularly the reality of an ongoing family context, family therapy underwent a period in which the individual basically became lost. According to Goding (1992): 'Many therapists were becoming increasingly alienated from the families with whom they worked. [They] increasingly came to stand above the family as if they could perceive what was really happening out there.' (p.23)
It is important to understand the family process of enmeshment when considering family therapy (Rybicki, 2001). The term enmeshment has been widely used in the family therapy literature since it was popularized by the work of Salvador Minuchin (1978). Describing psychosomatic families, Minuchin described the impact of four disruptive family dynamics: enmeshment, overprotectiveness, rigidity, and lack of conflict resolution methods.
The offspring in these types of families included anorexic girls who were so wrapped up in the family pathology that they could not differentiate themselves and were enveloped by an illness that reflected the family dysfunction (Rybicki, 2001). They felt consumed by rigid roles with their other family members and were treated in such an overprotective manner that they were essentially cut off from the outside world. Attempts to break through these protective walls were rebuffed, leaving little opportunity for corrective feedback, learning, or breaking the suffocating bubble that held the family members captive.
Enmeshment refers to an extreme form of proximity and intensity in family interactions (Rybicki, 2001). In a highly enmeshed, overinvolved family, changes within one family member or in the relationship between two family members reverberate throughout the system...On an individual level, interpersonal differentiation in an enmeshed system is poor...in enmeshed families the individual gets lost in the system. The boundaries that define individual autonomy are so weak that functioning in individually differentiated ways is radically handicapped (Minuchin, et al., 1978, p.30)."
Minuchin pinpointed the lack of clear ego boundaries between family members that produced fusion, a condition that interfered with a concise sense of self as apart from the family while still being part of the family (Rybicki, 2001). Interested in the family failure to have viable means for conflict resolution, Minuchin studied how the family system contributed to the production of psychopathology in the members and how it had difficulty moving forward to more healthy and adaptive roles. From Minuchin's seminal work, a great deal of literature has emerged that has been very influential in the family therapy world.
As with parental alienation, various levels and degrees of enmeshment may occur, ranging from mild and isolated elements of enmeshment to more pathological and pervasive features (Rybicki, 2001). In divorced families, the impact of enmeshment is typically more pronounced as the normal balancing influence of the other parent is slowly diminished. Similar to parental alienation, the phenomenon of enmeshment can be found in various degrees of intensity, with parallel degrees of negative impact on child development. Research…
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