Family Dynamics Pat Marquart, MFT ICDL Southern California Regional Institute 2009-2010
A Clinical Overview Dr. Saul Brown
• 1. Degree of organization or disorganization of client’s family system • 2. Level of sophistication about psychological and/or developmental issues and openness to professional advice
A Clinical Overview • 3. Persistence of the dysfunction, or in this case the neurological problem, in the identified client • 4. Emotional pain and interpersonal disruption caused by client’s dysfunction
A Clinical Overview • 5. The degree of consensus between the parents that professional help is needed . • 6. Availability of appropriate mental health or developmental therapy resources.
A Clinical Overview • 7. The attitudes present in the client’s school, social group, and extended family.
Developmental Cycle of Families • 1. Basic commitment to marriage • 2. Sub-systems for mutual nurturance • 3. Interpersonal Mechanisms for encouragement of each person's individuality and autonomy • 4. Facilitating ego mastery for each • 5. Maintaining family integration during adolescence and young adulthood • 6. Achieving mutual validation Dr. Saul Brown
Family Systems Theory: Murray Bowen, M.D. • Families are systems of interconnected and interdependent individuals, who cannot be understood in isolation from the system • Each member has a role to play and rules to respect
Resistance to Change • Response to the demands placed on the system • Stress of an unexpected event, placing overwhelming demands on the family system to change in order to accommodate this event
Changes in Roles • Changes in roles may maintain the stability in the relationship, but it may also push the family towards a different equilibrium • Examples: Depression Hospitalization
Triangles ( or Triads) • Murray Bowen contends that it is the building block of emotional systems. • Spreading the tension can stabilize a system, but nothing gets resolved. • Paradox: While a triangle is more stable than a dyad, it creates an “odd man out” - difficult to tolerate.
Avoiding triangulation • With families under stress, the tendency to triangulate may increase. • Families have a number of professionals working with them- the potential for triads, or triangulation, will increase. • Professionals must be aware of and not participate in alliances
Parallel Process Specific relationship issues that families bring to the intervention situation may evoke feelings that are linked to providers own personal issues and conflicts. • Professionals can become frustrated when their treatment goals are not met
Providers • Parallel process: Enacting it • In a parallel process to the issues that may impact a parent-child relationship, the provider’s own emotional reactions and background can impede their sensitivity to the very families they are trying to help
Family-Provider Relationships • DIR approach: The success of the intervention will rest on the quality of the relationships between professional providers and family members, even when this relationship itself is not the focus of the intervention Barbara Kalmanson, PhD
Ghosts in the Nursery: Dr. Selma Fraiberg
• Refers to the child’s involvement in the parents’ unresolved psychological issues • Remember: In every nursery there are ghosts. They can cause transient mischief or more serious problems
DIR Treatment Plan • The provider will formulate a treatment plan with parents that is respectful of the child’s rhythms and idiosyncrasies as well as of the parents’ care giving style.
The meaning of Children’s Behavior • When providers follow the child’s lead while observing, parents learn that the child’s behavior is important and has meaning. • The subjective experience of the parents and infants, rather than the objective experience, should be the focus of intervention
Importance of Recognizing Coping Patterns Tendency to withdraw Tendency to over-control Tendency both to over-stimulate and to withdraw Tendency to overprotect Tendency to avoid
Caregiver Patterns • • • • • • •
1. Comforting 2. Uses affect cueing and gestures 3. Expands continuous flow of interactions 4. Finds appropriate level of stimulation 5. Ability to engage in relationship 6. Can read cues and signals 7. Encourages development
DIR Parenting in Daily Living • Supporting parents to understand and be the “expert” on their child • Building DIR into their daily life • Making a plan for Floortime Sessions
REFERENCES The Child with Special Needs: Stanley Greenspan, M.D. and Serena Wieder, Ph.D “The Developmental Cycle of Families: Clinical Implications” Saul L. Brown, M.D. Engaging Autism: Stanley Greenspan, M.D. and Serena Wieder,Ph.D
“Family-provider relationships: Barbara Kalmanson, Ph.D. www.thebowencenter.org
The basis of all interventions”