Friday, August 2, 2013

Bring the Family: How Family Therapy Helps

I love doing family therapy. Some pretty amazing things can get unstuck and moved forward when we have more family members to work with.

About 20 years ago, I remember watching family therapy pioneer and psychiatrist Carl Whitaker do a demonstration of how he worked with the whole family in mind. He began the session on stage with one adult client. As they began talking about the issues that were upsetting for the client, Whitaker invited other family members to join them to help solve the problem. One by one the other family members appeared on stage to join in the session: mother, father, spouse, child, grandmother, grandfather, etc.

The effect of Whitaker's demonstration made the audience full of mental health professionals laugh as the session got bigger and bigger, but the point was made effectively. There are some concerns that can be very effectively treated by bringing in other family members to help.

Whitaker felt that the therapist needs to always consider the family as the client, not just the individual. While I do individual therapy as well, I agree with Carl Whitaker that the family you live with now, and the family you grew up with, may hold a great deal of information about why individuals struggle. Most people carry some wounds from childhood. Until you're a parent yourself it's hard to fully understand how hard it is to be a "good enough" parent while also staying married, supporting a family financially, and dealing with other life challenges.

Traditionally, family therapists believe most families have an IP or identified patient, who may be seen as the one who has a problem. Part of family therapy is shifting a family out of negative or blaming patterns, and not having an IP. In treating children and teens, I often see that they are the symptom bearers for other things that are going on in the family. Children can really struggle when a parent has cancer, an eating disorder, a chronic illness, or alcohol or drug issues. Children and teens are often painfully aware of marital conflict between their parents.

Family therapy has evolved over the years. I don't always have all the family members in the consulting room with me at the same time. I like the freedom to call in different dyads from the family as I can tell that it is needed . For example, I am currently seeing several teens who are depressed and including some work with their parents to improve their parenting skills, and some work with the siblings and my patient to increase their mutual support. Involving the family strategically can really speed up the course of treatment and improve results.

Got some things to work on in your life? You can work on it alone. You might also want to consider involving your family. Your family is the source of part of your own story, your past, and how you learned to be in relationships. Some of those scripts get reenacted until they get rewritten.

"When you look at your life, the greatest happiness is family happiness."
-Dr. Joyce Brothers

"The family: we were a strange little band of characters trudging through life sharing diseases and toothpaste, coveting one another's desserts, hiding shampoo, borrowing money, locking each other out of our rooms, inflicting pain and kissing to heal it, loving, laughing, defending, and trying to figure out the common thread that bound us all".
-Erma Bombeck, humorist

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