Lecture 2 core concepts in systemic therapy


Published on

Describe the family life cycle
Distinguish the shift from linear to circular thinking.
Describe the influence of Bateson
Describe the core concepts of systemic therapy: phase 1 & 2

Published in: Education, Business, Technology

Lecture 2 core concepts in systemic therapy

  2. 2. LEARNING OUTCOMES Describe the family life cycle  Distinguish the shift from linear to circular thinking.  Describe the influence of Bateson  Describe the core concepts of systemic therapy: phase 1 & 2  
  3. 3. Carr, A (2012) Family therapy: Concepts, Process and Practice (3rd edition) London, Wiley Blackwell. Chapter 1: Goals of family therapy across the life cycle
  4. 4. The family systems approach basic assumptions  Each family is unique, due to variations in personal characteristics and cultural styles;  The family is an interactional system whose component parts have constantly shifting boundaries and varying degrees of resistance to change;
  5. 5. The family systems approach basic assumptions  Families must fulfill a variety of functions for each member, both collectively and individually, if each member is to grow and develop;  Families pass through developmental and non-developmental changes that produce stress affecting all members.
  6. 6. Family System  Family structure consists of the descriptive characteristics of the family: the nature of its membership; cultural and ideological style. They are the resources and the perception of the world that shape the way in which the family interacts.  Family interaction is the hub of the system.  The process of interaction among family members determines the rules by which the family is governed. This is the family’s level of cohesion, its adaptability, and its communication style. These interactions work together to serve individual members and collective family needs.
  7. 7. Family System  Family function is the output of the interactional system. Utilizing the resources available through its structure (input), the family interacts to produce responses that fulfill its needs.  The family life cycle introduces the element of change into the family system. As the family moves through time, developmental and non-developmental changes alter the family structure and/or the family’s needs. These, in turn, produce change in the way the family interacts.
  8. 8. Family life cycle stage (simple model) Unattached young adult Family in later years Newly married couple Launching family/leaving home Family with young children Family with adolescents
  9. 9. Principles of family systems The family is not just a collection of individuals. It is a whole larger than the sum of its parts.  A Delicate Balance: A change in the family situation means readjustment of the total system and can pose problems and challenges for every single member. 
  10. 10. Principles of family systems   A Stable But Open System: Every family is faced with the test of allowing for growth and change while maintaining the integrity of the system. Characteristics of the Family System:  External and internal family boundaries;  Family rules;  Family role organization;  Power distribution among family members; and  The communication process.
  11. 11. Big concept: The Family is a System  The family system is more than a collection of individuals  It is an organic whole with its own identity and dynamics  Members function in the system differently than they do in isolation
  12. 12. Family is the system problem is not “in the person” but “between persons”.  problems are created by the interactions between family members.  The therapist is interested in what happens between family members,  how they communicate and how they express their feelings.  the
  13. 13. Big Concept: Circular Causality  Based on the idea that we are in a constant feedback loop with the persons in our lives : “cybernetic loops,” or “synchronous feedback.”  Linear causal explanations try to find who is at fault, or to blame.  Circular causal explanations try to understand what each person is doing that sustains the problem, and what they can do differently to change the situation.
  14. 14. Circular Causality Problems are created by a series of cause to effect events.  For example:  Paul is a 12 year old who gets very angry at home. His parents have been advised to seek help.  Linear explanation: Paul has difficulties managing his emotions and has learnt that anger is the only response when he is frustrated (the problem is “in Paul”). 
  15. 15. Circular Causality  Circular explanation: Paul gets angry -> shouts at his dad -> his dad gets angry -> blames Paul's behavior on his wife -> he shouts at his wife -> Paul's mother gets tearful and depressed-> Paul gets angry to see his mum depressed -> Paul blames his dad -> Paul gets angry and shout at his dad. And it goes round again
  16. 16. Big concept: Reality is constructed: there is no truth Reality is a social concept, fluid, not fix. We are all in a different chair, so we have our own perspectives of reality. We perceive things differently (filters). We have inner belief that we believe the same thing but there is nothing such as a reality.  The therapist has a view of what the problem is and his view determines how he organizes the therapy, who is involved and what intervention he will be doing. 
  17. 17. Group Theory: The Basis for Family Therapy Group theory provided a foundation for understanding the family  Lewin  group is more than sum of parts  interaction could be curative  a focus on the here and now; ahistorical  Groups are inherently tense as members vie for freedom and services  Process dimension became more important than content: how, not what 
  18. 18. How Groups differ from Families Group members come to therapy to find a sanctuary in which to discuss problems vs. families bring their problems into the office  Group members can be assured that what they say in therapy won’t follow them home vs. families have to live with the consequences of their disclosures  Groups are comprised of equals without a past vs. families are comprised of unequal members who have a past and future together 
  19. 19. Bateson’s Key influences A Cambridge anthropologist, central aim was to develop a unified or eco-systemic framework within which mind and material substance could be explained.  formed the Palo Alto group in 1950  Influenced key family therapy members: Jay Haley; Don Jackson; John Weakland; Watzlawick, who formed the Mental Research Institute (MRI) and brief strategic therapy 
  20. 20. Bateson’s Key concepts 1.   The double-blind theory: schizophrenic behaviour occurs in families characterised by rigid and repetitive patterns of communication and interaction. The double bind involves issuing the symptomatic child with a primary injunction, typically verbal, whilst concurrency issuing a secondary injunction that contradicts the primary injunction “I love you but don’t come close for a hug” Repeated exposure to double binds resulted in a particular pattern of interaction
  21. 21. Bateson’s Key concepts The family is a system with boundaries and is organised into subsystems 3. the boundary around the family set apart from the wider social system of which it is one subsystem 4. the family must be semi-permeable to ensure adaptation and survival 5. The behaviour of each family member, and each family subsystem is determined by the pattern of interactions that connects all family members 2.
  22. 22. Bateson’s Key concepts 6. 7. 8. 9. Patterns of family interaction are rule governed and recursive (repeats itself) Circular causality should be used when describing family interaction Family systems attempt to maintain homoeostasis within a system one member (the identified patient) develops problematic behaviour when homoeostasis cannot be maintained
  23. 23. Bateson’s Key concepts Positive and negative feedback is new information; involves news of difference and therefore change 11. A distinction is made between first and second order to change 12. change in one part of the system will lead to change in other parts 10.
  24. 24. The First Family Therapists: The Palo Alto Group  Bateson’s work with communication in schizophrenic families led to some of the first important contributions the the field.  rules  Metacommunicaton (report and demand)  double binds  feedback, or cybernetics  homeostasis (Jackson)
  25. 25. Negative and Positive Feedback When a family’s rules are challenged, the family usually treats this challenge as “negative feedback,” that is a reason to reassert its rules  Positive feedback is information that a family perceives as a call to change its rules. 
  26. 26. Families Break down under Stress Normal families need help when they can’t adjust to stress  Family rigidity, or a refusal to alter rules, keeps a family from adjusting to change  Life changes bring about   developmental stressors  environmental stressors
  27. 27. Big Concept: Families resist change Homeostasis means that families resist change  Direct attempts to foster change will evoke resistance  Insight is unnecessary, and can even get in the way.  Therapist must take an indirect approach in order to succeed 
  28. 28. Relationships are Symmetrical or Complementary Symmetrical relationships have a lot of similarity and equality -- common ground, comfortable  Complementary relationships are based on differences, opposite attraction -- not much common group, very dynamic  The pursuer-distancer dynamic grows out of complementary roles 
  29. 29. Triangles are a basic structure in dysfunctional families  Triangles form when a person seeks out a substitute for relating to a person with whom he has difficulties  Cross-generational coalitions are a triangle between two generations; that is one parent joining with a child against the other parent.
  30. 30. Palo Alto Brief Therapy School Based on the idea that families resist change  Assumed that a direct approach would only provoke resistance  downplayed importance of insight; in fact, considered insight to be an obstacle at times 
  31. 31. Milton Erickson’s influence on Jay Haley Erickson mastered techniques for circumventing resistance in hypnotic subjects.  Symptom prediction, symptom prescription (paradoxical or strategic)  Indirect methods  Reframing 
  32. 32. Bowen’s Systems Family Therapy differentiation of self is central concept  triangle is smallest stable unit of relationship.  cross generational transmission of patterns; focused on the family of origin, not the nuclear family  genograms as a way of assessing generational patterns 
  33. 33. Origin of Family problems As already stated, families break down when unable to adjust their rules to accommodate new developments  Family therapists are interested in what was happening when the problem arose  But more interested in what the family is doing to perpetuate the problem  The family’s “solution” is often the problem -- the reassertion of old rules 
  34. 34. The attempted solution is often the problem The attempted solution maintains the problem and makes the problem worse. It’s a vicious cycle. Change must be of the second order to break the pattern.  We draw from our past something that worked before. People with difficult problems have a hard time in finding a new coping.  What’s important is to give up the old coping: 180° turn is not the opposite but a significant shift in another direction. 
  35. 35. Process is Everything  As mentioned earlier, a therapist must focus on what is going on between members, not the specific problem  If a therapist tries to solve the problem as it’s defined, rather than looking at the way the family sustains the problem through their interaction, there will be no progress.
  36. 36. The therapist enters the client’s world  Through attentive observation of verbal and non verbal behavior, the therapist tries to understand the client’s language, perception, beliefs, values in order to find motivation for change.
  37. 37. . The therapist changes the meaning by reframing      He reframes the problem situation so that the values and motives of the client will allow him to accept the change. He uses the belief system and the social context of the client to disrupt his pattern. He changes the perception by reframing. For instance: “ Anxiety is an important function. It is your body’s signal that something is wrong. It’s a protective signal”. What do you need to do to answer the signal? Learn how to use it and to lower it. In understanding the situation, the therapist assumes that any behavior is protecting a person in the system. He rewrites the story.
  38. 38. What you do depends on Your style and theory Some therapists will openly point out the problems in relating, in order to bring about insight.  Some therapists will actively manipulate the family (move them around, get them to interact, etc.) to bring about change in the session, without worrying about insight.  Some will do both. 
  39. 39. Readings Dallos, R. & Draper, R. (2010) chap 1 & 2  Metcalf, L. (2011) chapter 1  Sexton (1994) Systemic Thinking in a Linear World  Flaskas (2011) Frameworks for Practice part 2  Keeney & Keeney (2012) What Is Systemic About Systemic therapy Advanced reading  Brad Keeney (1983) Aesthetics of change  Watzlawick, Weakland & Fisch (1974) Change: Principles of Problem formation and problem resolution Norton & Company London  Carr, A (2012) Family therapy: Concepts, Process and Practice (3rd edition) chap 1 & 2 