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Psychopathology 11/15/2006

Family Systems
- Family is seen as a system
o Has a wholeness, boundaries, hierarchies, controls (homeostasis)
o Always trying to get back to homeostasis
 Doesn’t mean healthy, could have a problematic homeostasis
- Structural Model by S. Minuchin
o Views family as interrelated system
o Focuses on
 clarity & firmness of boundaries
 subsystems
o Boundaries
 Serve to protect subsystems & differentiation
• Subsystems – parental & sibling subsystems
• Subsystem demands its own unique function, greatest
development of interpersonal skills develops when
there is not a lot of interference from other subsystems
o Children work out differences without parental
involvement
o Healthy families have hierarchy with strong parental system on top,
boundaries are clear & firm but not ultra rigid
o Too strong boundaries – disengagement in members of family
o Clear boundaries – clear relationships
o Imeshed boundaries – no boundaries
o Boundaries around the family (instead of w/in)
 Abuse  secrets, not a lot of contact with outside people
 Can lead to fear of outside world, live in isolation
o Need enough flexibility to allow autonomy & interdependence
o Pathological development in families develop from structural issues
 Often in divorced families, children become referees
 Boundaries btw child and family are not clear
o Chronic boundary problems  rigid triads
 Triangulation
• Child caught in middle of parent conflict
o Each parent demands child side with her or him
o Child is viewed as attacking other parent if side
with one
 Can never win & becomes paralyzed &
torn
 Detouring
• Parents express distress through one child and becomes
the identified patient (symptom bearer)
• Child is acting out symptoms for whole family, often
takes on the role given to them
• False sense of harmony created btw the parents
o Developed bc they are united in blaming child
or helping child
 Stable Coalitions
• One parent unites with a child against the other parent
o Goal is to balance and reorganize structure
 Clear & firm boundaries with parents & children
 Good for anorexia, asthma, adults w/ drug addictions

- Communication Model by the MRI Group (Satir, Waltzlawick, Bateson,


Jackson & Haley)
o Focus is on communication and its impact on the family’s functioning
o No such thing as a non-communication
o Most communication and symptoms occur at the non-verbal level
o Mssg of communications have impact on family as a whole
 A fight btw two members has impact on all
o Double bind – maladaptive communication that has at least 3
elements:
 Injunction that telling the person if they do or do not do
something they will be punished
 Secondary injunction, usually non-verbal, conflicts with 1st
injunction but at a more abstract level, enforced by punishment
 Third injunction, prohibits the victim from escaping the field
(can’t point out the inconsistency)
 Ex: a son sees mother, hugs her, feels shoulders stiffen, son
quickly withdraws, she asks “don’t you love me anymore?”,
she scolds him for blushing when she says that
• Wrong either way he reacts
o Paying attention to the syntax of communication
 What are the channels of communication? A lot or a little
variability?
 Notice the family’s capacity for information
• Same conversations regardless of what has happened in
the lives of the family
o How’s school? How’s the weather? Or stuck
somewhere else in time
 Look at the clarity of language being expressed
 Look at ability of receiver to process what is being said
o Pragmatics
 Look at what are the behavioral affects of the communication
• Acknowledge or disavow?
• Supportive or conflictive?
 Look at if communication is contradictory
 Are verbal & behavioral mssgs contradictory
 Pathology develops if communication is poor or mssg isn’t
understood