The history of the development of systemic family psychotherapy shows that this area of practice has developed differently than most psychotherapeutic schools and approaches. Many psychotherapeutic approaches describe cases of working with married couples or with child-parent conflicts. The “Manual of Family Counseling and Psychotherapy” (Horne, Ohlsen, 1982) describes work with families within the framework of various psychotherapeutic schools: transactional analysis, Gestalt therapy, client-centered approach, Adlerian and rational-emotive psychotherapy, behavioral psychotherapy and NLP.
At the same time, the development of systemic family psychotherapy is not associated with the development of individual psychotherapy. “The study of the family as a system has no history, no generally accepted concepts, no established discoveries” (Spiegel, Bell, 1959). In their monograph, Erickson and Hogan (1972) state that their review of the literature did not reveal any evidence that systemic family psychotherapy “grew” out of any pre-existing theoretical positions in psychotherapy.
The conceptual basis of systemic family psychotherapy was cybernetics, or more precisely, general systems theory. One of the founders of the general theory of systems, L. von Bertalanffy, showed that the concept of a system follows from the so-called “organismic view of the world.” This view is characterized by two provisions: a) the whole is greater than the sum of its parts; b) all parts and processes of the whole influence each other and determine each other. Thus, the basic idea of systemic family psychotherapy is that the family is a social system, that is, a complex of elements and their properties that are in dynamic connections and relationships with each other. A family is “a living organism that resembles a flame rather than a crystal” (Chernikov, 1997).
The family system is an open system; it is in constant exchange with the environment. The family system is a self-organizing system, that is, the behavior of the system is expedient, and the source of transformations of the system lies within itself (Chernikov, 1997). Based on this, it is clear that the people who make up a family act one way or another under the influence of the rules of functioning of a given family system, and not under the influence of their needs and motives. The system is primary in relation to the element included in it. It is clear that the object of psychotherapeutic influence is the entire family system as a whole, and not an individual person, an element of this system. Let's consider the general principles of the functioning of family systems.
Laws of functioning of family systems
The life of a family system is subject to two laws: the law of homeostasis and the law of development. The law of homeostasis says: every system strives for constancy, for stability. For a family, this means that at every given moment of its existence it strives to preserve status quo. Violation of this status is always painful for all family members, despite the fact that events may be joyful and long-awaited, for example, the birth of a child, the breakup of a painful marriage, etc. The law of constancy has enormous power. As research by Jay Haley (1980) has shown, due to the desire to prevent the matured child from leaving the family and thereby preserving the family structure, parents are able to tolerate any psychopathological behavior of the adolescent to the complete amazement of all outsiders. At the same time, the law of development operates: every family system strives to go through a full life cycle. It was noticed that the family goes through certain stages in its development, associated with some inevitable objective circumstances. One of these circumstances is physical time. The age of family members changes all the time and necessarily changes the family situation. As shown by Erik Erikson, each age period in a person’s life corresponds to certain psychological needs that a person seeks to realize. As you age, your demands on life in general and on loved ones in particular change. This determines the style of communication and, accordingly, the family itself. The birth of a child, the death of an old person - all this significantly changes the structure of the family and the quality of interaction of family members with each other.
Family is like a river that you can never step into twice. A version of the typical American family life cycle has been proposed (Carter & McGoldrick, 1980).
1. The first stage is the life of a lonely young man, practically financially independent, living separately from his parents. This stage was called the “time of the monad.” It is very important for the formation of independent views on life, independent of parents.
2. The second stage begins at the moment of meeting the future marriage partner. Falling in love, romance, the emergence of the idea of a marriage union, that is, a long-term, stable relationship - all this applies to her. If this stage of the life cycle proceeds successfully, then the partners manage to exchange expectations regarding their future life together, and sometimes even agree on them.
3. The third stage is marriage, the union of lovers under one roof, the beginning of a joint household, a common life. This stage has been called “dyad time.” This is the time of the first family crisis. Young people must make an agreement on how to live together. In order to organize life, wittingly or unwittingly, it is necessary to decide how functions are distributed in the family, who comes up with and organizes entertainment, who makes decisions, what to spend money on, which spouse works and which doesn’t, when to have a child, what kind of behavior and appearance are sexually attractive and, and many similar equally important things. Some issues are easy to discuss and agree on, but some are difficult to discuss openly because preferences are often not clear and unspoken. This especially applies to sexual behavior. The young wife grew up in a family where external relaxation was not welcomed. Mom didn’t wear a robe, she wore shoes at home and put on makeup for dad’s arrival. Dad appreciated it. The young husband could not stand his wife in high heels. In his memories, high heels were worn by a teacher he hated. He loved his mother, who did not work and wore a robe and slippers at home. The wife, wanting to please her husband and dreaming of spending an evening of love at home, meets him on the doorstep wearing makeup and high heels. He, seeing her, thinks that she is ready to go out. He may have thought of spending a quiet evening at home, but, loving his wife and understanding her without words, he immediately goes with her to a restaurant, for example, or to see friends. She is perplexed. My wife has a terrible thought: “He doesn’t want to be with me.” But she got sick and, full of self-loathing, walks around the house in a robe and slippers. The husband is burning with passion at this time. The wife is not ready to comply: she feels bad and is disgusted with herself. My husband has a terrible thought: “He doesn’t want to be with me.” This could be the beginning of sexual disharmony.
4. The fourth stage occurs if the crisis of the third stage has been overcome, the marriage has been preserved and, most importantly, the first child has appeared. The crisis that arises at this stage is even more serious. A third family member appeared and the family structure changed. It has become, on the one hand, more stable, and on the other, the members of this new system have become more distant from each other. A new agreement is needed, as there is a need to redistribute roles, time, money, etc. Who will get up to the child at night? Will the parents stay at home together or take turns visiting, or will the wife be with the child, and the husband will live as a bachelor? If the baby did not bring alienation into the marital relationship, moreover, brought the parents together, this stage has been completed successfully. It may also be that the child brings a sense of routine and monotony to life; it seems to the spouses that youth and celebration are over and endless everyday life has begun, the husband feels abandoned and suspects that his wife is cheating on him with the baby. The wife knows for sure that she is abandoned with a child in her arms, and suddenly realizes that she is married to a frivolous teenager and that the hardships of family life are about to break her back. All these are signs of unsuccessful passage of the fourth stage. This does not necessarily lead to divorce, but usually the law of homeostasis provides the family system with complex and elaborate stabilizers. For example, regular infidelities are suitable, which are carelessly hidden so that scandals and subsequent reconciliations create the illusion of intimacy and preserve the family. A chronic illness in one of the spouses or any other forms of personal inability to live are also suitable - alcoholism, inability to achieve professional success, etc.
5. The fifth stage of the family life cycle is characterized by the appearance of a second child. It is quite simple, since there is no need to conclude a new agreement on how to live with children and who is responsible for what, as was the case at the previous stage. Of course, there can be much more than two children, but using a model of two children one can show all the necessary patterns of development of the family system. There is evidence of the relationship between family role and child birth order. For example, often the eldest girl in the family becomes an ersatz mother or nanny for the next children; she is responsible for the younger ones and is often deprived of the opportunity to live her own life, and besides, she does not know how to be responsible for herself. The middle child is often the most prosperous in the family, free from family scenarios and debts. It is believed that rivalry between children is inevitable. Parents are faced with problems of childhood jealousy and must somehow solve them. At this point there is a connection between times, because it is when solving this problem that parents often project their childhood experience into the present day. Over-control over children's relationships, the constant position of an arbitrator reveals the need for confirmation of one's own importance and, consequently, the experience of humiliation in childhood. With the advent of children, a new subsystem arises in the family system. In the case of a functional family, a marital subsystem and a children's subsystem will be distinguished in its structure. In a dysfunctional family, there may be “wrong” subsystems: coalitions of mother with one child against father with another, or mother with children on one side and father on the other. The boundaries between family subsystems are an important point in the organization of life and mental health of system members. If the boundaries of the subsystems are very strict (for example, after the child is put to bed, no one approaches him until the morning, no matter what), then psychosomatic diseases can arise in children, since only very strong stimuli (diseases with spectacular manifestations) can cause them cross the border of your subsystem and get closer to your parents. If the boundaries of the subsystems are very permeable, then all members of the system are deprived of the opportunity to live their private lives, what in English is called privacy, unity arises, enmeshment, role confusion, “nurturing” children and infantile parents. It is not clear who makes decisions, who is responsible for whom, and much more.
6. The sixth stage is the school years of children. At this time, the family comes face to face with the rules and norms of the outside world, which are different from the rules of family life. Here the questions are resolved about what is considered success and what is failure, how to become successful, what price a family is willing to pay for external success and compliance with social norms and standards. For example, a hypersocializing family does not consider any price too high for success, and the loser, of course, cries and loses family support. A hypersocializing family is a family with very permeable external boundaries. The more permeable the external boundaries, the less permeable the boundaries of family subsystems. Relationships between family members are spontaneous and are regulated mainly by norms, rules, and traditions, which are very difficult to change. A dissident family, that is, a family that stands in opposition to external norms and rules, has closed external boundaries and often very permeable internal boundaries. In such families, a problem of fidelity may arise, and not marital fidelity, but fidelity to family norms and values, a kind of guild or aristocratic brotherhood, violation of the rules of which threatens ostracism.
So, at this stage of the family life cycle, the boundaries of the family system, the exportability of norms, myths, rules and games are tested.
7. The seventh stage of the family life cycle is associated with the time of puberty of children. It begins with puberty in the first child. The child’s leading need at this time is to build his own identity, to answer the question: who am I and where am I going. The answer “I am the child of my parents” is not enough to build an identity. Examples are sought outside the family, among peers and unrelated adults. At this time, the family must solve the most important task: prepare the child for separation, for independent life. This is exactly the point where the viability and effectiveness of the functioning of the family system is tested. If the family successfully copes with this task, then it passes between Scylla and Charybdis and emerges into the calm expanse of life's voyage.
Let's take a closer look at this period of family life. Typically, a child's puberty coincides with a parent's midlife crisis. This means that at a time when a child strives to break free from family influence, wants a change in his destiny or at least the course of his life, his parents really need to maintain their usual stability. A midlife crisis occurs when a person understands that certain events and facts of his life are irreversible: a profession has been chosen and certain results have been achieved or not achieved in the professional field, a family has been created, children have been largely raised, it is time to draw preliminary results. It's scary to do this because they can be disappointing. At the same time, it becomes clear that there is not much time left for life, strength is diminishing, admitting oneself as a failure seems fatal and incorrigible. Unsuccessful children are a good excuse: “I didn’t have a significant career because I had very difficult (sick) children and spent a lot of time on them.” To preserve parental self-esteem, it is better for children to be non-viable. As you can see, at this stage of the life cycle, the interests of children and parents are directly opposite.
Very often, the stability of the family system directly depends on whether children continue to live in the parental family. Often, during their time together, children learn to perform certain psychological functions in the family, for example, they become mediators between parents. If children leave the family and, even worse, become independent and successful, that is, they do not need the attention and help of their parents, then parents are faced with the need to communicate directly with each other, face to face. In order to live, it is necessary to solve a lot of problems that accumulated while there were children in the family.
Many scandals were postponed and turned into monuments to themselves, sexual problems were not resolved for years, and much more. If there is no excuse in the form of children, then all these problems will have to be solved, which is painful and unpleasant and, in addition, may lead to divorce. It is much easier to avoid separation or to allow it formally. For example, a child formally lives separately, studies at college somewhere in another city, even got married, but according to the criteria of the parental family, he has not yet gotten back on his feet, has not reached the required level of income, or does not work where the family believes he should would work. His failures are a wonderful stabilizer for the family. They also divert the time and energy of other family members and prevent other family problems from being addressed. If a child nevertheless persistently moves towards success, then there are many ways to force him to turn away from this path. This is the subject of Jay Haley’s book “Leaving Home” (Haley, 1980). Its main thesis is that the maladaptive and eccentric behavior of a young man is of a protective nature. As soon as the parent family is faced with the fact that the child is ready for separation, it becomes unstable and disorganized. Conflicts become more frequent and the well-being of family members worsens. This is a signal for the young man, which tells him that his family is in danger of collapse or, at best, a change in the structure and usual ways of interaction. In order to keep things the same, he develops eccentric and maladaptive behavior. Jay Haley believes that any member of any organization in a similar situation is ready to take on the role of stabilizer with the help of disrupted behavior. In addition to specific behavioral disorders, chronic diseases, sometimes mental, can develop. If we take into account that children normally outlive their parents, then the problem of stabilizing the family, at least as long as the parents are alive, can be solved.
So, this stage of the family life cycle is the most difficult for all family members, the most problematic and painful. Here the family must rebuild its external and internal boundaries, conclude a new agreement between all members, and learn to live in a changed composition.
8. The eighth stage is a repetition of the third stage, only the members of the dyad are at a different age. The children have grown up and live independent lives; the parents are left alone. This stage is often called the “empty nest stage.” It’s good if the family has reached this stage of the life cycle without major losses and people enjoy spending time with each other, maintaining the joy of mutual communication.
9. The ninth stage of the life cycle is the life of the monad, loneliness; the spouse has died, the person lives out his life alone, just as he lived in his youth, before creating his own family, only now he is an old man with a lived life behind him.
The life cycle of a Russian urban family is significantly different from that of an American family. These differences are associated primarily with economic reasons, but the cultural characteristics of the consciousness of Russian residents are also significant. The main difference is that in Russia there were practically no nuclear families living separately: firstly, because the majority of the population does not have the money to buy a separate apartment or build a house; secondly, life with a large family is not considered difficult and unpleasant. The value of family relationships is very high, and you can address any elderly woman as “granny” - this will be both appropriate and polite. The words “Son, help” or “Daughter, thank you,” which we hear from strangers, simply cause an uninvited tear. The famous Stalinist “Brothers and Sisters!”, which replaced the ideology of class struggle, gave rise to an explosion of patriotism during the Great Patriotic War.
Let's consider the life cycle of a Russian family.
1. The first stage of the life cycle is a parental family with adult children. Young people do not have the opportunity to experience independent living. All his life, a young man is an element of his family system, a bearer of its norms and rules, a child of his parents. Usually he does not have a clear idea of what he personally has achieved in his life, and it is difficult for him to develop a sense of personal responsibility for his destiny. He cannot test in practice the rules of life, standards and norms that he received from his parents, and often cannot develop his own rules. Self-made-man, that is, a person who made himself, is a rare phenomenon.
2. At the second stage of the family life cycle, one of the young people meets a future marriage partner, marries and brings him to his parents’ house. This is a significant break in the rules of the parental family. The task is very difficult - to create a small family inside a large one. Young people must agree not only with each other on how they will live together, by what rules (cf. the second and third stages of the nuclear family). They still have to come to an agreement with their parents, or rather, re-negotiate how they will get along with each other. Patriarchal rules offer a variant of such an agreement: a young husband or wife enters a large family as another child - a son or daughter. The parents of the husband or wife are asked to be called “mom” and “dad”. Then the young spouses are not really spouses, but newly found brother and sister. Not every young family is ready for such a relationship scenario. It’s good if the spouses are not ready for this together, it’s much worse when one is not ready for this alone. Then one member of the couple wants to be a husband or wife first, and a son or daughter second, while the other spouse has the opposite priorities. The conflict that arises in this case is known to everyone and often looks like a quarrel between a mother-in-law and a daughter-in-law or between a son-in-law and his wife’s parents. In fact, it is based on the conflict of role priorities among spouses.
The new subsystem first of all needs separation, the old system, obeying the law of homeostasis, wants to keep everything as it was. Thus, a paradoxical situation is created: marriage seems to exist and at the same time it seems to not exist. The situation is painful for everyone. For example, in one family, the husband's mother kept her things in the closet of the room where the young man lived since he was a child. When he got married, she did not change her habits, and there was nowhere to put a new wardrobe, and there was no money for it. The mother came into the newlyweds’ room at any time to get her things. It is not surprising that the young people were unable to save their marriage. Intrusion into the lives of young spouses is not necessarily accompanied by conflicting, bad relationships in the family. One tender mother was very happy about her son’s marriage and came into the young couple’s room at night, without knocking, of course, “to admire these lovebirds.”
3. The third stage of the family cycle is associated with the birth of a child. This is also a period of crisis for the entire system. Again, it is necessary to agree on who does what and who is responsible for what. In families with blurred boundaries of subsystems and unclear organization, family roles are often poorly defined. For example, it is not clear who is the functional grandmother and who is the functional mother, that is, who actually cares for, cares for, and raises the child. Often these roles are confused, and the child is more likely the son or daughter of the grandmother, rather than the mother. The child's own parents are more like an older brother and sister. Mother and father work, and grandmother is retired. She spends a lot of time with the child, and at the same time the relationship between mother and grandmother may not be good at all. This circumstance cannot but affect the child. Often he joins the fight. My colleague M. Harutyunyan told a case from her practice that perfectly illustrates this point.
The family contacted us about the bad behavior of an eleven-year-old girl who was acting aggressively towards her grandmother. The family consisted of three women: a grandmother, a mother and a girl - the identified patient. The grandmother and mother had a difficult conflict relationship. One winter, the girl locked her grandmother on the balcony and did not let her into the room for a long time. After this episode, the family decided to see a psychotherapist. When the mother told how her daughter offended her grandmother, her eyes glowed with triumph. The daughter did something in life that her mother could not afford.
4. At the fourth stage, a second child appears in the family. As in its Western counterpart, this stage is quite mild, since it largely repeats the previous stage and does not introduce anything radically new into the family, except childish jealousy.
5. At the fifth stage, the ancestors begin to actively age and get sick. The family is going through a crisis again. Old people become helpless and dependent on the middle generation. In fact, they occupy the position of small children in the family, encountering, however, more often with annoyance and irritation than with love. Old people make unwanted and unloved children, while throughout the course of their previous lives they were accustomed to being in charge, making decisions for everyone, and being aware of all events. This is the stage of the next revision of the treaty, painful for everyone. In culture, there is a stereotype of the “good daughter (son)”: this is the one who, in his old age, will bring his parents a glass of water. Old people who have no loved ones are worthy of pity, since “there is no one to give them a glass of water.” Reproach to bad children: “There is no one to ask for a glass of water.” That is, in the public consciousness there is no model of lonely and independent life for old people. It is considered unworthy to allow one's old people to die outside the home, to be placed in a nursing home; during illness, it is considered a special virtue to treat an old person at home and not send them to the hospital.
Often this period in the life of older family members coincides with the period of puberty of children. In such a family it occurs differently than in a nuclear one. Coalitions of old people with teenagers against the middle generation may arise; for example, old people cover late absences and school failures of teenagers.
At the same time, the middle generation has good control over teenagers. Sick old people in the house require care and supervision. This responsibility can easily be transferred to teenagers, tying them to home, depriving them of harmful street company, and slowing down the process of building their identity.
6. The sixth stage repeats the first. The old people have died, and before us is a family with adult children. This is often the minimum possible size of a Russian family.
Many stages of the life cycle of an American family are present in the life cycle of a Russian urban family, for example, the stage of courtship, the conclusion of an unspoken (or partly public) marriage contract between two partners, the birth of children, the stages of their psychological development, etc. But they are present in a modified form, in context of a large three-generation family. The main features of the Russian family are that
· the family, as a rule, is not nuclear, but three generations;
· the material and moral dependence of family members on each other is very great;
· the boundaries of the family system have some features; as a rule, they are not adequate to the requirements of an optimal organization;
· often all of the above leads to the phenomenon of unity, confusion of family roles, unclear division of functions, the need to negotiate all the time and the inability to agree for a long time, substitution, when everyone in the family can functionally be everyone and at the same time no one. For example, in a family where the grandmother is raising a child, she is actually the functional mother to her grandson; husband and wife share a bed, are intimately connected, but may not be connected by a relationship of care and intimacy, because the husband is spiritually and emotionally closer to his mother. He looks out for her interests first. Functionally, this man is the husband of his mother and the lover of his wife. The family lives mainly on the husband’s money, but the family budget is distributed by the same grandmother, so functionally she is the head of the family;
· individuality and sovereignty are practically absent. The younger generation is much more closely and rigidly connected with the previous generation than in the West; traditionality, continuity and at the same time conflict are expressed very clearly. Each family member is in daily contact with a large number of close people. He is involved in various difficult relationships, and simultaneously performs many social roles, which often do not fit well with each other. Social literacy, in a certain sense resourcefulness and at the same time dialogicality, is something that a child learns very early. With such a family organization, the main issue is often the issue of power. It is decided in the context of any communication: dad prohibits, and mom allows the child something; All this is done in front of the child and the message is: “The child listens to me, not you, which means I am more important.”
Thus, any family system strives to go through its life cycle in accordance with the law of systems development. At the same time, each stage of the family life cycle tends to stop forever, never to change, according to the law of homeostasis.
Properties of the family system
The family system can be described in several ways. There are six informative parameters:
· features of relationships among family members;
· public and unspoken rules of family life;
· family myths;
· family boundaries;
family system stabilizers;
· family history.
Let's look at the first parameter. Peculiarities of relationships between family members are manifested in communication; Communication here means absolutely any event occurring in the family. Lateness and silence, frank conversations and general fun, shopping and cooking - all this is informative, special, unique communication for this system. Even the seemingly lack of communication, silence, has a powerful informative message. You can stop talking to a person (child, spouse), and it will be clear to everyone that this is an expression of disapproval and dissatisfaction and a desire to ostracize the perpetrator.
Communication can be verbal and non-verbal; most often it happens to be both at once. Impetuous, sudden movements, the slamming of a door, the rattling of pots, express without words both the mental state of a person and what he wants his family members to know about this state. Perhaps this is a call for help, a complaint or a reproach: “Look what you have brought me to,” etc. If this is accompanied by appropriate text, the picture will become complete and complete. The verbal and non-verbal parts of the message complement each other and are in harmony.
It often happens that these parts of the message are not at all in harmony, in fact, they contradict each other. Such situations occur at every step. For example, flirting. People seem to be talking about serious and quite decent topics, even business ones. At the same time, nonverbally, with their glances, postures, gestures, and interpersonal distance, they are having a completely different “conversation.” The situation is exciting and safe precisely because it is possible to ignore non-verbal text or not pay attention to verbal messages. This incident is harmless. As soon as contradictions between verbal and nonverbal plans enter the family context and become the rule of communication there, serious disturbances in the behavior and well-being of family members, especially children, arise. In his famous work “On the Communication Theory of Schizophrenia,” G. Bateson and his co-authors showed how autism develops in a child in situations where he is systematically confronted with conflicting messages in his family. In a situation of such communication, the child cannot behave adequately, since a reaction to one part of the message automatically leads to the fact that the second part of the message is not taken into account and the child is blamed for this. No matter how he behaves, he is inadequate and cannot adapt to reality, cannot behave correctly. The work gives a striking example: a boy suffering from schizophrenia is in the hospital. Mom comes to visit him. The boy comes out into the hall and sits next to her. Mom moves away. The boy freezes dejectedly and remains silent. Mom asks displeasedly: “Aren’t you glad to see me?” This communication situation has been called the “double trap”: no matter what the child does, he will be reprimanded. It is impossible to adapt to reality - it is better to withdraw into oneself, to become autistic, because a child cannot get out of a communication situation in reality, for example, to arbitrarily change family.
So everything that happens in a family is a message. Illness, for example, is a strong and very informative message that effectively regulates the family situation. Let's say a dad wants his son to be strong, brave, that is, a real man. He believes that a real man is one who takes risks, is independent, etc. Mom doesn’t want her son to risk his health and be independent. She feels better when he is at home, in plain sight. She cannot openly contradict her husband. The boy, of course, also wants freedom. At the same time, he is a little scared to take off on a free flight. How to be? A boy is going to the mountains with a group of youth. Dad is happy and supports his son's intentions. The boy both wants and doesn’t want. Mom is categorically against it. If she openly protests, a scandal is inevitable. Quite by accident, on the eve of her son’s departure, she falls quite seriously ill. The boy is forced to stay. Everyone is happy. Diseases thus become a way - and a worthy way - to solve many problems. This could not happen if they were not methods of communication. All games, beautifully described by E. Berne, are some behavioral stereotypes that are forms of communication; they carry certain messages that are not spoken, but are clearly understood by everyone.
The second parameter is the rules of life of the family system. The rules can be set by society and culture, and then they are shared by many families, or they can be unique for each individual family. Everyone knows the cultural rules of family life: for example, everyone knows that parents should not make love in front of their children. The unique rules are known only to family members.
Rules are the family’s decision about how to relax and run the household, how to spend money and who exactly can do this in the family and who cannot, who buys, who washes, who cooks, who praises and who mostly scolds who prohibits and who allows. In a word, this is the distribution of family roles and functions, the distribution of places in the family hierarchy, the decision about what is allowed and what is not, what is good and what is bad.
In a large family consisting of only adults, a late and dearly beloved child is growing up. The most frequently followed rule of this family is: never scold the child for anything, but praise him at every opportunity, admire and be touched silently and out loud, individually and in groups. This behavior, according to the rule of this family, is an expression of love for the child. If someone, a guest or a distant relative, breaks this rule - does not praise, does not admire, or, worse, makes a remark to the child, then he will break an essential rule in the life of this family, put everyone in an awkward position and will not be a welcome guest in the future. The law of homeostasis requires maintaining family rules in a constant form. Changing family rules is a painful process for family members.
“The village of Stepanchikovo and its inhabitants” is a wonderful, artistic example of what happens when family rules are violated. The rule was very simple: everything in the house should go the way Foma Fomich Opiskin wants. This is the rule for constructing a family hierarchy and arranging statuses. What happened when this simple rule was broken is described in the wonderful story of F. M. Dostoevsky on many, many pages. In fact, in families there are many complex, ornate rules, public (such as: “If you are late, warn us”), unspoken, permeating our lives. A family psychotherapist must be able to quickly calculate some important rules for the functioning of the family system. Of course, all parameters of the family system are interconnected. In particular, the rules are directly related to, and often dictated by, family myth.
So, the third parameter of the family system is a myth. A family myth is a kind of formative idea or image, or story, if you like, that unites all family members. This is knowledge shared by all members of the family system and answers the question: “Who are we?” For example, a common answer is: “We are a close-knit family.” This means that there cannot be open conflicts in this family, especially in front of children. Dirty linen is never washed in public. Relations are not clarified openly, all contradictions are covered up. It is customary to go everywhere together, since the myth requires dissemination in society, a kind of publication. Any behavior of family members towards each other, whatever it may be, is understood as a manifestation of good feelings. “I wish you well,” or “It’s me who loves,” or the classic: “He hits - it means he loves.” Myth sets the norm of feeling. In a “friendly family” it is customary to love, feel sorry and feel gratitude. Other feelings - resentment, anger, disappointment, etc. - are ignored or repressed. Problems begin when someone in the family is unable to ignore their normal and inevitable negative feelings towards relatives. He becomes the identified patient. Anxiety and depressive disorders, aggressive behavior, anorexia are typical problems of a “close-knit family.”
Myth gives rise to rules and rituals. Breaking the rules, especially systematically, can destroy the myth. A myth is a banner under which a family gathers, it is a motto, it is a faith. If someone in the family does not share the family myth, he cannot be a member of this system; the system expels him. The only time this is possible is if the family has a rebel myth. Then disagreement with the main myth confirms another myth, and the system remains unchanged.
Another example of a family myth is the myth of the savior: “What would we do without...” There must be a certain person in the family who holds the whole family at arm's length. It is clear that in order to help everyone, it is necessary that they all be slightly disabled, otherwise it will turn out that no one needs a savior. The Savior can be in a moral form, or maybe in a physical one, however, it can be both together. A moral savior needs sinners. His family should consist of people who often do something bad: drink, steal, party, get into bad stories. The Savior helps out, and only in this case can he feel like a savior. Sinners thank, promise to improve and... sin again. The physical savior nurses, heals, feeds, brings food, etc. Therefore, his family consists of sick, helpless, crippled people, otherwise how could he save them?
Let me give one case as an example.
A middle-aged man asked about a difficult relationship with his wife. They were in their first marriage, which was concluded out of great love. After three years of marriage, they had a child, unfortunately, with a severe birth injury. The wife quit her job and devoted herself entirely to the child. My husband devoted himself entirely to earning money. Together they built a family, adored their boy and generally lived together in harmony. The boy grew up, was constantly observed by doctors, did not go to kindergarten or school. At the time of his appeal, he was twelve years old, he did not go to school, and his mother did not work. Some doctors said the boy could go to school, while others advised him to be home-schooled if possible. In a word, mother and son were always together, father worked a lot. As long as dad saved only his son, the situation was bearable. A year before his conversion, the grandmother, the mother of our hero, was widowed.
She was left completely alone, and her son tried to provide her with a calm old age. One winter, my grandmother almost fell on the way to the bakery, after which it was decided that her son would bring her all the food. She stopped leaving the house completely. They lived separately, and my client had to travel quite a distance to visit his mother. It was now impossible to go anywhere for the summer. Telephone contact was carried out twice a day, morning and evening, absolutely strictly. After about six months of living like this, my client began to notice that for some reason he had little strength, and his wife was irritated all the time.
He was a wonderful husband and father, now he has become a selfless son. His wife was also a wonderful mother and homemaker. For the sake of their loved ones, they denied themselves everything, lived to the max and... preserved, and in some ways even gave rise to, the “disabled self-awareness” of the child and grandmother. To be a selfless mother, the child must be dysfunctional. If the child is healthy, you will have to be an ordinary mother, you won’t have to save or sacrifice. In exactly the same way, to be a good son, it is necessary for the mother to be helpless. The more helpless an old person is, the closer he is in his status and way of life to a dead man: no activity - no life. The paradoxical logic of the savior: I am such a good son that I help my mother die.
Another frequently encountered myth is the myth of heroes. “We are a family of heroes.” As a rule, family history contains stories about the heroic deeds of ancestors. There you meet old Bolsheviks, partisans, people who survived famine, were subjected to repression, raised children in difficult conditions, etc. In other words, people who have overcome serious obstacles and achieved results.
The myth of heroes sets a certain standard of feeling and worldview. Where there is a hero, everything is on a grand scale: there is no joy - there is happiness, no love - there is unearthly passion, no life - there is fate, no sadness - there is tragedy. This is why in the family of heroes people can quarrel for life, not talk to each other for years, and attempt suicide. In the family of heroes, there are often chronic, untreated diseases - heroes do not go to the doctor, this is so understandable. There are many difficulties and problems in their life. Heroes always have a high standard of achievement, they are principled and unapologetic people.
So, we see that all three parameters of the family system described above are closely interrelated. The family myth dictates the rules, and the rules, in turn, largely determine the characteristics of communication between members of the system with each other.
Family boundaries are the fourth parameter in describing the family system. Each person living in a family has an idea of who else is part of his family. This idea sets the boundaries of the family. People living in the same family may have different ideas about its boundaries. For example, a man married a woman with an adult child; they live together. The man believes that his family consists of two people - himself and his wife. The wife believes that her family consists of three people - herself, her son and her husband. Conflicting ideas about family boundaries can be a source of serious disagreement.
Family boundaries can be very porous or more closed. The permeability of boundaries determines the style of life in the family. An open family is full of people, guests who come without warning, and out-of-town relatives. There are no special treats prepared for guests; children are strictly separated from adults; for example, they, as a rule, go to bed on their own, do their homework themselves, and generally live their own lives. This is understandable: adults have no time for them. With more closed family boundaries, guests come only by invitation; there is a special ritual for receiving guests, for example, refreshments, festive dishes, and cleaning the day before. In such a family, children are usually less independent, adults are more included in their lives. As you can see, there is a certain pattern: the more closed the external boundaries of the family system, the more open the boundaries of intrafamily subsystems. The placement of the boundaries of family subsystems determines the coalitions that exist in the family.
Functional coalitions are the marital subsystem and the children's subsystem. Other coalition options are usually dysfunctional. Dysfunctional coalitions that indicate the presence of problems in the family are, for example, the subsystem of mother and children, on the one hand, and father, on the other. Or a mom with one child versus a dad with another child. Or a wife with her parents in a coalition against her husband with her parents. There are many examples. Family coalitions indicate structure and hierarchy in the family, as well as a family problem. Coalitions are the central concept of the structural approach in systemic family psychotherapy (Minukhin, Fishman, 1998). Example:
A mother contacted us about her ten-year-old son. The boy refused to go to school and stay alone at home. Mom had to leave work to sit with him. Moreover, after some time the boy moved to spend the night in his parents’ matrimonial bedroom. There has always been a mother-son coalition in the family. Dad was on the periphery of the family system, he worked a lot, sent his wife and son to rest abroad, but he did not go with them - there was not enough money for three. Dad went grocery shopping after work and cooked at home on weekends. His weight and position in the family were very insignificant. The little tyrant - his son - rightly judged that he would easily take his father’s place next to his mother. The required impact in this case is a change in family coalitions and giving the child his rightful place. The father's position must be strengthened, the mother-son coalition must be destroyed. This is necessary because the boy will soon be faced with the task of overcoming an identity crisis, which is very difficult to do without going through separation from his family.
The fifth parameter of the family system is the stabilizer, that is, what holds the system together, what helps people stick together. Generally speaking, all of the above are stabilizers, especially the family myth. In a sense, a family is a group of people who share a common myth. A common myth or common myths is a condition necessary for the existence of a family, but not sufficient. At different periods of a family's life, there are different stabilizers. Common affairs: housekeeping, distribution of functions, common budget, common children, fear of loneliness - these are common stabilizers that are naturally present in every family. The external macrosystem is also a good stabilizer, especially in those societies where the value of marriage is generally recognized, where single women or single men are perceived as failures. There, the very fact of divorce is negative, and public opinion is a family stabilizer.
In the practice of working with families, one has to deal with unique stabilizers. For example, often deviations in the behavior and development of a child become a powerful stabilizer of the family system. “We cannot get a divorce because we have a difficult and/or sick child.” I will offer a diagram of how the stabilizer works, using the example of nocturnal enuresis in a child.
In a dysfunctional family, where spouses have difficulty getting along together, a child appears. It is known that a difficult marriage always means difficult sex. In our culture, involuntary night urination is considered normal until about two and a half to three years of age. It so happened that during the first two years of the child’s life, the relationship between the spouses deteriorated; Sexual relationships became especially disharmonious. So, sexual relationships were not easy, but otherwise marriage was valuable for the spouses. A difficult task arose - to maintain good relationships, but avoid intimacy. Concern for the child: how is he doing, is he wet, is he not dilated - a good reason to go to the crib and refer to your anxiety as the reason for your unpreparedness for sex. It’s not you who is a bad lover or a bad mistress, but simply an anxious parent’s heart that distracts you. And here it’s time for the child and his age to start asking, but he doesn’t ask, and this is no coincidence.
Parents (or one of them) begin to drop the child off at night, and also clearly react to a wet bed. For a child, such parental behavior is positive feedback, reinforcement of a wet bed, because for him, any, even emotionally negative, attention to him is a significant signal. A wet bed for a child becomes the way to the heart of the parents. Time passes, the child grows. Now bedwetting is classified as enuresis. He occupies a worthy place in the family system.
I remember one family where an eleven-year-old boy suffered from enuresis. The family lived in a three-room apartment. There was a children's room with books, a desk and toys, a living room with a sofa and TV, and a bedroom with a double bed and dressing table. Mother and son were sleeping in the bedroom. Dad was sleeping on the sofa in the living room. The mother explained that it was easier for her to drop the child off at night if he slept nearby. The couple did not maintain an intimate relationship for more than seven years. Their son's enuresis began to be used by them as a worthy way to avoid sexual intimacy with each other without conflicts and painful showdowns and at the same time not destroy the family.
Considering all of the above parameters of the family system, we involuntarily implied a certain history of the formation of the family. In other words, to successfully work with a family, it is necessary to know not only the current situation, which is described by the previous parameters, but also how the family got to this position. Family background consists of the past life experiences of family members, from what they experienced in their family of origin and in past marriages or extramarital affairs. From the past, a person brings into his family, firstly, the rules and myths of his parental family, unchanged or in a negative reflection; secondly, expectations and needs that were formed under the influence of past experience. The rules and myths of the parental family are present in the form of habits and rituals, in the form of a feeling of comfort that arises when the usual lifestyle is carried out, of course, in those cases when a person had a good time in the parental family and wants to repeat the pleasant experience. However, it is not even necessary that it be good, since much happens without awareness. For example, sleep patterns. The habit of going to bed early or late depends on the lifestyle in the parental family. If the partner had a different regime, then there may be problems. In any case, this issue will have to be resolved, a compromise will have to be found, or one partner will have to change his usual regime. The same applies to eating habits or habitual ways of sorting things out: in one family they shout during disagreements, in another they stop talking, etc. The more complex the behavior patterns, the more difficult it is to negotiate. For example, sexually attractive appearance and behavior, signs of love and attention, ways of expressing guilt and regret are complex and poorly understood behavioral sequences that are very difficult to change.
In addition to habits and patterns, a person brings expectations and a lot of unfulfilled needs into a marriage. Strictly speaking, a successful marriage is one in which needs and fantasies can be realized. If essential needs cannot be fulfilled in a marriage, then it usually experiences a serious crisis or falls apart. Love is the most selfish feeling. Already at the stage of choosing a partner, the probability of satisfying psychological needs in a relationship with this person is calculated. The only catch is that needs change. There is a natural change of needs; if some needs are satisfied, then others take their place. Let's say, if it is important for a person to be a rescuer and benefactor, if by saving he feels his importance and increases his self-esteem, then he falls in love with a person in a relationship with whom these needs can be realized.
One of my clients always fell in love with unhappy, suffering men, and those who suffered in childhood: one was left by his mother, the other’s mother died when he was little. She tried to be a good mother to them - care and pity “triggered” her sexual behavior. Men also saw her as a mother and, at the beginning of the relationship, gladly took advantage of her pity. However, over time, they satisfied their need to have a good mother and were ready to see in her either an equal partner or even a daughter; She still continued to see children in them. The mismatch of these important psychological needs destroyed the relationship of the spouses. This situation was repeated to the smallest detail twice in my client’s life. Where did this need come from? In this case, it arose because of her peculiar relationship with her mother and, in general, from the mother’s intra-family status in the client’s parental family. There the mother was the emotional center of the family, she was always right, she made decisions, she was a benefactor for both family and strangers. At the same time, it was known in the family that children should know their place, not get in the way, and when they grow up, they will understand. My client learned that adulthood begins with motherhood, at least for a woman. By becoming a mother, a woman gains much meaning in her life, as well as many rights and opportunities. The relationship with his mother was not easy in the future. By the time she got married for the first time, she was a girl with an urgent need to assert herself. It was known how to do this. It was not possible to give birth right away, but it was easier to find a “son” for a husband, which is what happened.
Often one’s own family life is arranged in order to solve the unresolved problems of the family of one’s childhood. The partner for this is located as a sniper. The prince from “Cinderella,” apparently an often humiliated young man, was very eager to prove to his parents that he was already an adult. Realizing his low value in the grooms market (due to his low self-esteem), he chooses a simple girl as his bride, without any risk of being rejected, and gets married, thereby getting a ticket to real adult life. Cinderella marries him primarily in order to leave her stepmother's family. Guessing the opportunity to realize cherished needs in these relationships is what makes young people love each other. Unfortunately, they are trying to realize these needs simply through the act of marriage, which in no way guarantees the longevity of the union.
Often in marriage a person tries to achieve what is required for his normal mental development, but which, however, was not achieved in the parental family. In every family, a necessary stage is the separation of children from parents. Every child must go through the process of separation in order to become an adult, independent, responsible, in order to be able to create his own family. It is known that going through the separation stage is one of the most difficult tasks in family development. Often, unable to find another stabilizer like the children, the family does not allow the children or the child to separate. However, for normal mental development, the child must experience the separation process. If this fails with mom and dad, then it should work with your husband or wife. In these cases, the marriage is concluded for divorce.
In childhood, we all receive certain instructions and recipes on how to live. This is called education. In order to understand the laws of life of the family system, it is necessary to know the instructions that people received “on the path” in their parental families.
Family history can be conveniently and effectively traced using the genogram technique (McGoldrick and Gerson, 1985). This technique allows you to trace the stereotypes of interaction of all branches of the family in three generations, calculate the scenarios and pitfalls of family life. The psychotherapist asks the family about relatives and builds a family tree of the family in three generations. Then it is necessary to find out the peculiarities of the relationship of family members with each other, family legends, stories that are passed down from generation to generation. The psychotherapist asks about the characters of people, the history of their acquaintance, the history of the birth of children, moves and other changes in destinies. From all this, a family history is formed, which the psychotherapist then interprets to the family, showing the connection of the problem that the family has addressed with the past of this family. Let me give you an example.
A family with a three-year-old boy came forward. He suffered from fears, did not like to walk, was afraid of the dark, and did not sleep alone in the room. The parents were teachers, that is, they had a fairly free schedule, so they kept the boy at home, did not send him to child care institutions, and took turns caring for him. They contacted us about their son’s fears. During the conversation, it became clear that their marital relationship is also not in the best shape. Trust and mutual understanding disappeared, they were always dissatisfied with each other, instead of conversations, claims and reproaches were expressed. Of course, the child was an indispensable witness to these quarrels. Before the birth of the child, the couple lived together for thirteen years and were happy with their marriage.
It is noteworthy how much effort the family spends to constantly be in parental roles. She, Nina, grew up in a single-parent family. Her grandparents divorced before the war, when they had four children: two boys and the last two girls, twins. The older children died of illness before the divorce. Then one girl from the couple dies, and the grandmother is left with her only daughter. The father dies at the front. The daughter grew up and fell in love with a married man. From this novel a girl, Nina, was born. The marriage did not work out, but the daughter remained. When analyzing her genogram, Nina said that it now seems to her that her mother gave birth to her for her grandmother, in order to soften the pain of losing her children. Perhaps my mother herself wanted to recreate her sister for herself. One way or another, the grandmother took care of the girl and the house; she was a functional mother to her granddaughter, and the mother worked. In her family, Nina received an order: “You don’t have to be married, but you need to have a child.” In addition, she grew up in a situation of confusion and replacement of family roles. She herself took the place of a daughter for her grandmother and a sister for her mother. She did not have a model of married life and did not know how to be a wife, since she did not see how this was done in her family.
He, Petya, on the contrary, grew up in a complete, traditional, patriarchal family in an ancient Russian town. He is the youngest child, he also has an older sister. Dad earned money, fixed everything and carried heavy loads. Mom washed, cleaned and cooked, and besides, she grumbled at her husband. The family lived without grandparents, Petya was quite spoiled. He had clear models of maternal and paternal behavior, and had a good understanding of what it meant to be a husband and what a wife should do. Petya grew up and went to university in Moscow. By this time Nina had already studied at the university for three years, but in a different department. Petya missed his family and felt quite lonely in the hostel. They met by chance, the four-year age difference did not bother them, and after a short romance they got married. The couple lived in marriage for thirteen years, did not have children, and focused on their careers. During this time, they defended their Ph.D. theses, received Moscow registration and exchanged their room in a communal apartment for a small two-room apartment. They were happy with each other. What needs did they satisfy in this marriage?
Nina got married and got a son instead of a husband. She thus fulfilled her instructions. She is older and more decisive, she arranged Petya’s career and her own at the same time, she made decisions, and, according to Petya, “was the spiritual leader in the family.” Petya asserted himself in this marriage. In his parental family, he was the youngest, on the one hand, beloved, and on the other, he had to obey everyone who was older, including his sister. His character is domineering and proud. In relation to his parents, he remained a respectful son, but he was picky and demanding of his wife.
So, the roles in this family were distributed not by chance, but successfully. The problems began when the long-awaited child was born. Nina became a mother to her biological son and stopped being a mother to her husband Petya. Petya at the same time became a father to his son and was ready to finally become a husband to his wife, but she was not ready for this, she did not have a model of a wife’s behavior. When they took care of their son and exercised parental functions, the relationship remained conflict-free. As soon as the spouses were left alone, a feeling of emptiness and meaninglessness arose, and mutual claims and reproaches began.
Methodological principles of systemic family psychotherapy
The most well-known and widely used heuristics are circularity, neutrality, and hypotheticality (Palazzoli et al., 1980).
· Circularity. This principle states: everything that happens in the family is subject not to linear, but to circular logic. Let us consider the process of transition from considering a case in linear logic to considering a case in circular logic.
A mother complains that her nine-year-old son is not doing well at school. In linear logic, the cause of a child's disorder is seen in the child. The child does not study well because he has developmental disorders of higher mental functions, and he simply cannot cope with school requirements due to impairments in memory, attention, thinking, etc. Or the child does not study well because he has school neurosis. Perhaps both.
Psychological diagnostics make it possible to test both linear hypotheses. Notice that linear logic is guided by the question “why” and assumes the answer “because”. In very many cases, we see that academic failure is not related or entirely explained by the above possible reasons. Let's take the first step towards circular causation. After questioning those who contacted us, we find out that the mother does her homework with her child all the time. Consequently, the child did not develop independent work skills that he could use when working in class. It is a rare mother who does not understand this, but nevertheless spends hours doing homework with her child. At this stage, the question “why” is meaningless. It makes more sense to ask yourself the question: “Why?” Why does a mother make her child helpless in class? Why does she need to spend so much time studying? Because at this time she feels needed and necessary. Why does mom need to feel this? Because mom and dad don’t have a very good relationship, mom often feels unnecessary to her husband, she has an emotional vacuum, and she fills it in communication with her son. If everything is fine with the son, the intensity of scandals between mom and dad will increase simply due to the fact that mom will have more time to think about the problems of her family. Scandals are a threat to family stability. Nobody wants them.
So the circle is complete. The worse a boy does at school, the more time mom and son spend together in homework, the less mom and dad sort things out, the more stable the family. It is clear that only a psychologist sees this circular dependence at the beginning of therapy. Gradually, with the help of a specially developed circular interview method, everyone begins to see this dependence. As soon as this has happened, changes become possible in the family, the family becomes available for psychotherapeutic influence. If the psychologist remains in linear logic, then either he can improve the child’s schooling for a short time, or the child will develop another behavior disorder that will stabilize the family system instead of academic failure. In the worst case scenario, the child's success will lead to the breakup of the family. These processes have been described repeatedly and in detail by authors such as Jay Haley and Clu Madaness (Haley, 1980, Madaness, 1984).
In my experience of many years of teaching systemic family therapy, the most difficult thing is to teach how to use circular logic, see the circular causality of events, and note the circular interactions of family members with each other. As soon as circular logic arises in the psychotherapist’s head, choosing a method of influencing the family system becomes a simple technical task.
· Neutrality. The principle of neutrality states that effective psychotherapy requires the therapist to maintain a neutral position. He sympathizes equally with all family members, does not internally align himself with anyone, and provides all family members with equal opportunities to speak and be heard and understood.
This principle is not easy to follow. The most common variant of its violation is that female psychotherapists fall into the position of supermother. In a dysfunctional family, everyone suffers, but the suffering of children is seen vividly, especially in our child-centered culture. It seems that negligent parents are unfairly hurting their children. The psychotherapist takes a position of protecting the small and defenseless, thereby informing the parents or mother of these children: “I would be a better mother to these children than you.” This message is very easy to read, and the mother naturally becomes defensive and resists. This resistance, provoked by the therapist's behavior, often nullifies all his efforts. The family interrupts therapy.
· Hypothetical. The main purpose of the therapist's communication with the family is to test the hypothesis about the purpose and meaning of family dysfunction. As noted above, the main questions that a family psychotherapist asks himself are: why is what is happening in the family? How is the observed dysfunction exploited by the system?
The therapist's primary hypothesis determines his conversation strategy with the family. In cases where the therapist does not formulate a primary hypothesis, his conversation with the family is chaotic; Often the most motivated family member takes the initiative in conducting the conversation. It should be remembered that it is not easy to have a conversation with the whole family at the same time. A conversation in individual therapy (dialogue) is not the same as a conversation with the whole family (polylogist). It is also not a model to work with a group, since when working with families we cannot rely on ordinary group dynamics. The only opportunity to build effective communication with such a formal group of different ages, which is the family, is to rely on a certain meta-goal provided by the primary hypothesis.
Practice of psychological assistance to families
Reception design. Organization of the work of a family psychotherapist
Systemic family psychotherapy is carried out with the entire family at once. All family members living together are invited to the reception, regardless of age: both the elderly and infants. This is especially important at the beginning of work, as it makes it possible to directly see the nonverbal aspects of people’s relationships, family coalitions, communication stereotypes, and family rules.
A family came to the reception: grandmother (maternal), mother, father and a three-month-old child. There were complaints about frequent conflicts between young spouses. In the office, the family sat down as follows: grandmother and mother are nearby, grandmother is holding the baby in her arms, dad is sitting at some distance from this group. When the child began to whine, dad would tell his wife in a stern voice: “Look what’s wrong with him.” The wife made some movement towards the child, the grandmother said calmly and measuredly into space: “It’s okay, everything is fine with us.” It is clear that the hypothesis about possible disturbances in the functioning of this family system is born very quickly: the grandmother is the functional mother of the baby. His biological mother is a functional sister; there has been no separation between mother and daughter; there is a struggle for power and influence in the family between the husband and grandmother. Structurally, the family is divided as follows: coalition grandmother–mother–child and sometimes a coalition mother, father. Mom is between two fires, she is put in a situation of choice between her husband and her mother.
It is very important to give the family the opportunity to choose the layout of the space. Therefore, in the office of a family therapist there should always be more chairs and armchairs than there are family members. Mutual arrangement is a quick and reliable way to diagnose family structure (Minukhin, Fishman, 1998).
Preliminary arrangements for the family to come must be made by the psychotherapist himself or a member of his team. The content of the preliminary conversation allows us to formulate a systemic hypothesis even before starting direct work with the family.
Questions that need to be asked during a telephone conversation: 1) what is the caller complaining about (in short, only the main thing - a marital problem or a child-parent problem)? 2) who is the initiator of the appeal? 3) what is the composition of the family? 4) how old are the children and other family members?
Analysis of the answers to these questions allows us to draw up a preliminary system hypothesis. During a face-to-face meeting with the family, the psychotherapist checks the correctness of this preliminary hypothesis.
The methodological principles of systemic family psychotherapy deny simple, direct communication between the psychotherapist and the family. One of the goals of psychotherapeutic communication is to test a systemic hypothesis. It must be said that all the methodological principles of this approach are designed to protect the psychotherapist from the influence of the clients’ family system on him. Each open family system strives to absorb, “suck into itself” every element that finds itself in its “orbit”. It is clear that only open family systems are accepted. Consequently, the clients' family system tends to absorb the therapist. Eventally, this manifests itself in the fact that the family seeks to extend its rules to communication with the therapist, form coalitions with him, gain recognition of his myth, etc. That is, a process occurs that is called family transfer. If the therapist falls under this influence, and it is almost impossible for a novice family therapist not to consciously fall under it, since usually people are not aware of systemic influences, then he begins to freely project his problems, his experience of family life onto the family and immediately loses effectiveness. The methodological principles of the systems approach protect the therapist from the influence of the family system.
One psychotherapist can work with a family, but a psychotherapeutic team can also work, that is, a person who directly talks with the family and two or three supervisors who observe the process from behind Gesell's mirror. In the classic Milanese model, a team works with the family; supervisors can intervene at any time in the conversation with the family, give instructions to the interviewer what to ask, from whom, how to position himself in the space, depending on the characteristics of the emerging contact with different family members. Problems of teamwork are the most popular topic at all recent international conferences on family psychotherapy.
Techniques for working with families
Circular interview. This is a basic and widely used technique (see Tomm, 1981; Hennig, 1990).
The psychotherapist asks family members in turn questions formulated in a special way or the same question. In order for this technique to “work” not only for the therapist, that is, to be not only a diagnostic tool, but also an instrument of psychological, psychotherapeutic influence, you need to master it masterfully. Typically, learning to do this requires at least one hundred hours of practice under the supervision of a supervisor.
A mother came in with a complaint that her eleven-year-old son did not go home after school, but spent his time somewhere, mainly on Arbat, and sometimes did not even come to spend the night. The family consists of three people - mother, father and son.
I omit the beginning of the conversation and give an example of the actual circular questions.
Psychologist (question to son): Who usually meets you at home when you finally return?
Son: Usually mom.
Psychologist: How does your mother greet you, what does she do?
Son: She gets angry, yells at me, sometimes cries.
Psychologist (question to mom): Your son returned late, you are angry and crying. What is your husband doing at this time?
Mom: He calms me down and scolds my son.
Psychologist (question to dad): What does your son do when you scold him?
Dad: He slams the door of his room, leaves, gets offended.
Psychologist (question to son): When you sit in your room, what do your parents do?
Son: They are sitting in the kitchen, talking, drinking tea. Dad consoles mom.
Psychologist (to his son): Before, before you started disappearing from home, in what cases did your parents sit in the kitchen together, drink tea, talk?
Son: I don’t know something... Dad isn’t home much. I do not remember.
The last question is asked to both mom and dad. From the answers it becomes clear that such conversations in the kitchen were extremely rare. The couple often quarreled.
This simple example shows how, with the help of circular questions, the function of a child's behavior disorder becomes clear. The departure of their son unites the parents and stabilizes the system. Children often sacrifice themselves for family stability. Please note that the above circular questions did not go beyond behavioral responses. The psychologist did not ask about thoughts or feelings. If this layer of psychic reality is also involved in circular questions, they become even more complex.
Young spouses came in complaining of frequent quarrels. Quarrels arose for various reasons, but most often due to the fact that the wife stayed at work for a long time and came home late.
Psychologist (to husband): How do you explain to yourself why your wife is late at work?
Husband: She just doesn’t want to go home, she doesn’t want to see me.
Psychologist (to husband): When this thought comes to your mind, how do you feel?
Husband: Well, it’s unpleasant...
Psychologist: Are you lonely, hurt, angry?
Husband: Here, here.
Psychologist: When you are angry and offended, how do you usually behave?
Husband: I don’t do anything, I don’t make a scandal, I just remain silent and that’s all.
Wife: For weeks now.
Psychologist (to wife): When your husband doesn’t talk to you, how do you explain this to yourself?
Wife: That he doesn’t want to communicate with me.
Psychologist: How do you feel then?
Wife: Offense. Undeserved, unfair. Then I don’t like making excuses, I don’t do anything wrong. Yes, resentment and some kind of hopelessness.
Psychologist: When you feel all this, what do you do?
Wife: I’m sitting at work. What should I do at home?
As you can see, the circle has closed. Each spouse, through his or her behavior, positively reinforces the behavior of his partner that he does not like. Questions about thoughts and feelings help spouses understand the mechanism by which this “snowball” forms.
It will be useful for a novice systemic family psychotherapist to memorize a list of topics that need to be addressed in a conversation with the family using circular questions:
· What expectations did the family come with? Questions are asked about who referred them for consultation and who they contacted before.
· How does the family see its current problem? (For example, a child cannot cope with school requirements.)
· What is the current situation in the family?
· How did the family cope with difficulties and problems in the past? What were the solutions?
· How does the family interact about the current problem? It is necessary to clarify the circles of interaction at the level of behavior, at the level of thoughts and feelings.
· What system does the family have for understanding the problem and the causes of its occurrence?
· What are the key trigger situations? (For example, there will definitely be a scandal between everyone and everyone if a child gets a bad grade.)
· What is the worst way for the situation to develop? How can the problem be made worse?
· What are the positive aspects of the problem? (See the example of the boy who left home.)
· Questions about everyone’s psychological resources.
· Questions about how each person imagines the future with and without the problem.
· What would family life be like without a problem, without a symptom?
Of course, this entire range of topics cannot be covered in one session. Usually it can be completed in two or three meetings. After this, the system hypothesis becomes reliable. The specific formulation of questions in a circular form is determined by the individual skill and creativity of the psychotherapist, his ability to build contact with the family.
Positive connotation technique (positive reformulation). This is a technique for providing feedback to the family after the therapist has established his circular hypothesis for the current moment of working with the family problem. The therapist (or team) talks to the family about how he/she perceived and understood the content of the family dysfunction. A story follows certain rules (Palazzoli et al., 1978; Madanes, 1984; Haley, 1998).
1. It is recommended to relieve the family’s anxiety about what is happening. The technique of normalization is suitable for this: the content of family dysfunction is considered in a broader sociocultural, age, and statistical aspect. In the case of dysfunction associated with a particular stage of the family life cycle, it is useful to inform clients about the pattern of occurrence and pervasiveness. This message relieves family members of the feeling of guilt and the “charm” of uniqueness. If the dysfunction is related to migrations, it is good to refer to the phenomena of culture shock. Normalization in a systems approach serves the same function as communicating a diagnosis in medicine; it gives people the certainty and hope that professionals have already dealt with similar problems and know how to approach them.
2. Focus on the positive side of dysfunction. Any dysfunction that exists in a family has a positive side. The mechanisms for stabilizing the family system through child behavior disorders were described above. In this sense, any family dysfunction “works” as a stabilizer. You can positively reformulate not only the current symptom, but also any past events. The teenager is being raised by his aunt's family because his drug-addicted mother gave him to her sister at an early age. He is offended by his mother and believes that she abandoned him. Positive reformulation of this episode: “Your mother understood that she herself could not raise you well, keep you healthy, provide you with housing, because she suffers from drug addiction. She herself put you in good hands and did not tear you away from your family. She did the best she could for you. She loved you and loves you now.”
3. Inclusion of a contradiction or paradox in the feedback text. This is necessary so that the psychotherapist's paradox can neutralize the paradox of the real family situation. Previously, typical paradoxes were cited that are easily revealed by circular logic: the mother wants the child to study well, and does everything to deprive him of the skills of independent work. Spouses want to improve their marriage and do everything to avoid falling into marital roles, to remain only parents, and not to get closer. The counter-paradox in the latter case would be: “You value your marriage and relationships with each other so much that you try not to communicate so as not to inadvertently spoil what you have.”
Let us turn to the case where the child is a poor student, the mother spends all her free time preparing homework with him, and the father is rarely at home. The feedback pattern is: “You are all behaving normally for your abnormal circumstances. Mom and dad often quarrel. In order not to quarrel again, they try not to communicate; dad practically deprived himself of the opportunity to have his own home. A devoted son does not allow himself to study well, despite the fact that he has all the data for normal studies, so that his mother is constantly busy with his problems and does not have free time to think about her relationship with his father. Mom has no personal time, spends all her energy on her son, has almost turned into a home teacher, has forgotten how to be just a mother and wife in order to maintain peace in the house. Your love and care for each other is very impressive.”
Any symptom in the family system can be positively reformulated because it ensures the homeostasis of the system and in this sense has a positive meaning for the family.
Prescription. The last technique described here is prescribing certain behaviors to family members. The therapist asks family members to perform certain tasks, mostly specific actions. Prescriptions can be direct or paradoxical (Madanes, 1981, 1984; Palazzoli et al., 1978).
Often paradoxical instructions are almost impossible to fulfill. In these cases, the purpose of the order is to allow the family to reflect and discuss with the therapist at the appointment why the order is not feasible for the family.
A family in which family roles are confused and the boundaries of subsystems are violated is recommended to live for a week like this: no one has their own sleeping place; Every evening the children go to bed where they want, and the parents go where they find a place for themselves. This injunction brings the chaotic, unstructured habits of this family to the point of absurdity and causes protest among family members. At the next meeting, people’s feelings are discussed and more constructive options for organizing life, distributing responsibilities, etc. are proposed.
Direct instructions, as a rule, do not cause protest; at first glance, they are simple to implement. For example, in a family in which there has been no distribution of roles and functions, in which the main theme is the struggle for power and control, it is effective to offer a prescription of actions in time: on Monday, Wednesday and Friday the husband decides everything, the wife and children obey, on Tuesday, Thursday and on Saturday everything is decided by the wife, on Sunday it is suggested to argue and swear as usual. Experience with a new ritual and discussion of this experience provide a therapeutic effect.
Scheme of the initial appointment
1. Telephone conversation and construction of a primary circular hypothesis.
2. Conducting a circular interview in person. Testing the primary hypothesis. Proposing the next hypothesis if the primary hypothesis is not confirmed.
3a. If a therapeutic team is working with the family, the results of the interview with the team are discussed and strategies and tactics of influence are developed. If the therapist works alone, he immediately moves on to the next stage. The psychotherapist develops the strategy and tactics of influence himself and immediately.
3b. The therapist provides feedback to the family regarding his or her understanding of the family problem. (Positive connotation technique.)
4. Offering a course of family psychotherapy. Discuss with the family the frequency and duration of their future visits. Discussion of payment for therapy. In fact, this is the conclusion of a psychotherapeutic contract, as a result of which both clients and the psychotherapist (psychotherapeutic team) have a clear understanding of the purpose of psychotherapy, how responsibility is distributed, and what the result of therapy may be.
An example of a psychotherapeutic contract.
A father came in with a complaint that his twelve-year-old daughter behaves like a boy, wants to be a boy, and asks to be called by her male name at home and at school. Request: “Help make sure a girl remains a girl.” During the initial consultation, it became clear that the girl’s desire to become a boy was just one of many violations of her behavior. The girl's neatness skills were impaired; she had difficulty finding contact with parents, teachers, and children. In early childhood, no hugging was noted; it was always uncomfortable to hold her in your arms - she did not cuddle, she seemed distant. The whole family had signs of impaired intra-family communication: there was practically no family time, everyone existed on their own, not together, but side by side. Family communications are riddled with double traps. This was a classic so-called “schizophrenogenic family”, described by many authors (see Palazzoli et al., 1980). During the conclusion of a psychotherapeutic contract, the psychologist drew the family’s attention to the above circumstances: “I do not undertake to make Katya stop wanting to be Kolya. It seems to me that this is one small fragment of the overall picture of the characteristics of your family communication. I could work with you on your family interaction style. If all the warm feelings you have for each other, all the tensions and grievances were easily and safely expressed, it would be easier for you all to understand each other. As your contact improves, Katya may see the benefits of being a woman. It will be easier for her to find a common language at school. Against this background, it will be more effective to work with Katya’s specific difficulties if they remain. I believe that to solve this problem we will need at least four months of work to begin with.”
Thus, the request “Help our child” was reformulated as help for the whole family. When the parents and Katya agreed to follow the proposed path, they discussed the frequency of visits, the time and day of arrival, and the amount of payment.
5. Prescription. This is the last stage of the initial intake, when the family is offered a direct or paradoxical prescription of a behavioral ritual that they must perform during the time until the next psychotherapy session. Often the order is given to the family in writing to eliminate the effect of a “damaged phone”.
At subsequent meetings, using the above-described techniques for working with families, events that took place between meetings, features of the implementation of instructions, past circumstances, childhood memories of adult family members, rules, myths, family history, communication stereotypes and much more are discussed.
When and how to end work with family
This is one of the most difficult issues of any psychotherapeutic approach, not only systemic family psychotherapy. In general terms, the answer is this: the family system must become functional. This means that the family becomes able to solve life's problems. For example, a family consisting of three generations of single female alcoholics became functional when the women stopped drinking, began to regularly attend Alcoholics Anonymous classes, the youngest, a student, returned to university, and the older women began to work. The disappearance of a symptom, the emergence of an internal feeling of satisfaction, the joy of life are not necessary signs of a therapeutic effect in this approach. A necessary and sufficient sign is external behavioral changes.
The family, which complained about the father’s depression, became functional after the father, despite his condition, returned to work, the wife, who had recently been caring only for her husband, began to devote time to her daughter. Complaints of depression remained, but depression was no longer used by the system. Depression became a personal matter of the father, and not a sign of general trouble; the dynamics of his condition were no longer directly determined by family circumstances, the behavior of his wife and daughter. Against this background, drug treatment had a quick effect, and for two years the depression did not return, although previously, despite massive treatment, the family learned that autumn or spring had arrived based on the father’s condition.
Literature:
- Minukhin S., Fishman Ch. (1998) Family therapy techniques. - M.: Independent company “Class”.
- Papp P (1998) Family therapy and its paradoxes. - M.: Independent company “Class”.
- Haley J (1998) Challenge Therapy. - M.: Independent company “Class”.
- Chernikov A.V. (1997) Integrative model of systemic family psychotherapeutic diagnostics. Thematic supplement to the journal “Family Psychology and Family Therapy”. - M.
- Sherman R. Fredman N. (1997) Structured techniques for family and couples therapy. - M.: Independent company “Class”.
- Bateson G. et al. (1969) Toward the communicative theory of Schizophrenia // A. H. Buss, E. H. Buss (Eds.). Theories of Schizophrenia. - N.Y.
- Carter E., McGoldrick M. (1980) The Family Life Cycle. - N.Y.: Gardner Press.
- Erickson G. D., Hogan, T. P. (Eds.) (1972) Family Therapy. An introduction to Theory and Technique. - California: Brooks/Cole Publishing Company.
- Haley J. (1980) Leaving Home. - N.Y.: McGraw Hill.
- Hennig K. (1990) Das Systemische Interview mit Einzelnen und Familien als Diagnostisches Instrument. - Oberschulamt, Tübingen.
- Horne A., Ohlsen M. M. (Eds.) (1982) Family counseling and therapy. Handbook. - Illinois: F. C. Peacock Publishers.
- Madanes C. (1981) Strategic Family Therapy. - San Francisco: Jossey-Bass.
- Madanes C. (1984) Behind the one way mirror. - San Francisco: Jossey-Bass.
- McGoldrick M., Gerson, R. (1985) Genograms in Family Assessment. - N. Y.: W. W. Norton & Company.
- Palazzoli S. et al. (1980) Hypothesising - Circularity - Neutrality: three guidelines for the conductor of the session // Family Process. 19(1), 3–12.
- Palazzoli S. M., Boscolo L., Cecchin G., Pratta G. (1978) Paradox and counterparadox. - N.Y.: Jason Aranson.
- Spiegel J. P., Bell N. W. (1959) The family of the psychiatric patient // S. Apieti (ed.) American Handbook of Psychiatry. - N.Y.: Basic Books.
- Tomm K. (1981) Circularity: A Preferred Orientations for Family Assessment. // A. Gurman (ed.). Questions and Answers in the practice of Family Therapy. - N.Y.
My “I”, my character, my name - everything was in the hands of adults; I learned to see myself through their eyes, I was a child, and a child is an idol that they create out of their disappointments.
Jean Paul Sartre
Systemic family therapy is based on the premise that the individual human personality can only be understood in the context of its social environment. In other words, given the ontologically inherent way of existence of a person, he is “sentenced to communication.”
System-communicative family model
In the 1950s-1960s. this type of psychotherapy was just in its infancy, as stated in a review study by K. Broderick and S. Schroeder, published in 1991. According to the authors’ point of view, these two decades witnessed the establishment in science of the general theory of systems in biology and cybernetics, in computer technology. Instead of, according to the scientific tradition, analytically dividing the phenomena under study into the smallest elements, for example, electrons, neutrons, etc., the general theory of systems (L. Von Bertalanffy) defended the priority of 1) the principle of integrity, the irreducibility of the whole to the sum of elements, 2 ) the principle of development through the establishment and complication of intra-system and extra-system connections. The problem of improving “feedback” mechanisms, i.e., came to the fore. methods of communication, management and control common to both biological and cybernetic systems (N. Wiener).
In its most general form, a system is understood as a set of elements that are in constant interconnection. For example, the family as a system does not simply include x individuals. It also covers their cross-relationships, as well as the overall context in which the family lives and the existing set of rules of that family. Even permanent role titles assigned to various family members, such as “parent” and “child,” make it clear that there is a stable connection between the two designated individuals.
A system is a set of elements organized in accordance with certain rules. The principles of organization suggest that as soon as a stable combination of interconnected elements is made up of disparate elements, a unity is created, an integrity that is not reducible to a simple sum of its constituent units. The marital system, for example, can only be divided into two components (two separate individuals), which are two individual subsystems. But between individual individuals there is a stable relationship that creates a marital subsystem: thus, in the marital system it turns out that 1 + 1 = 3.
The system is organized in such a way that connections between elements determineborders both around the system as a whole and around each subsystem included in it. In biology, these boundaries are clearly distinguishable: every cell has a membrane, every animal has skin. In systems whose elements are people, boundaries are often more abstract; they are set by the rules of relationships. For example, the rules of monogamy help define the boundaries of traditional marriage. A spouse who has had sexual intercourse on the side “crosses the line” or begins to act beyond the boundaries of the relationship between the spouses. Bordersmay be veryunclearAndvague; they are defined by vague rules about who is allowed to interact with whom and how to interact. In families where incest is practiced, the boundaries between the subsystems of parents and children are so poorly defined that the relationship between the subsystems borders on pathology. Rules against incest are very important, if only because they help define the boundaries of healthy family relationships. However bordersmay be excessiverigid, without allowing adequate interaction between the individuals that make up the system or between different systems. Thus, families who abuse children are often severely isolated from larger social systems and therefore unable to receive public support that could help stop the abuse. Another example: if the life of a family passes under the motto “We are a close-knit and friendly family!”, then any abuse of family members will be regarded by them as “pathological fantasies,” and their real victim will thus be isolated and ostracized “from within.” "
Systems are connected to each other through several hierarchical levels. Each system consists of lower order subsystems and in turn is part of a larger system.
The family system consists of individual subsystems - marital, child and parental. In addition, the family system is part of the larger system of the local community. That, in turn, is hierarchically linked to the larger system of the territorial community, which ultimately is an integral part of the nation.
For systems to function effectively, they needcontrol methods behind their organizational structure. Living systems can be likened to stable, dynamically developing states. They reflect the state of a system that does not change structurally over the years. Systems theory emphasizes the balance or stability of relationships between elements of a system. Very often these two qualities are mistaken for lack of flexibility, i.e. as a forced and inert formation of behavior patterns. In fact, the theory under discussion emphasizes the controllability of change, which makes it possible to develop an impressive number of very complex types of relationships. Control mechanisms allow system elements to maintain dynamic relationships with each other. The elements of the system have the ability to enter into meaningful relationships with each other, and therefore there is a whole set of very sophisticated control mechanisms. Control, on the one hand, it allows you to keep the elements of the system within certain limits, and on the other hand, adapt to changing conditions of existence.
Control over adaptation is a key point in conscious system change. Controlled growth leads to an increase in the physical mass of cells, differentiation of biological tissue, organs, and also to the development of human personality. Uncontrolled growth, such as the increase in the number of cancer cells, entails disorganization and even death of a living system. The concept of homeostasis, or equilibrium, of the elements of a system helps explain how living systems control and maintain the stability of their state. Physiologist Walter Cannon in 1939 first described a set of mechanisms of internal regulation of the neuroendocrine system, the function of which is to maintain constant parameters of the internal environment of the body - constant blood pressure, temperature and water content. If changes within the body begin to exceed safety limits, the regulatory mechanisms of the hormonal and autonomic nervous systems are activated to return the condition to normal.
Family systems also have their own mechanism for controlling the activities of their elements. Their goal is to maintain an acceptable balance in the behavior of family members. The researchers note that there is a surprisingly stable balance of verbal communication. In family systems with a high degree of verbal communication between family members, there is a stable rate of verbal communication when family members come together, while the degree of verbal activity of individual members can vary greatly.
Mechanisms that significantly influence the processes of self-regulation of marital or family systems are similar to servomechanisms in cybernetics (N. Wiener, 1962) Feedback cycles are the most important
nal control mechanisms. Two events can be connected not only by linear cause-and-effect relationships, but also by cyclical relationships, the distinctive feature of which is positive or negatively expressed feedback.
With positive feedback, quantitative and qualitative changes in one of the elements of the system have a reciprocal effect on the quantitative and qualitative state of another element. This type of sequence assumes an increase in the return effect in case of deviations from the norm. Thus, positive feedback increases deviations and serves as a mechanism of self-destruction; it can be likened to the situation of running away boiling water, when the framework of the normal existence of relationships between elements is broken, and the system is no longer able to function. Thus, violent quarrels in the family can get out of control, since the anger of one spouse fuels the anger of the other and returns back in a significantly intensified form. The release of anger into the atmosphere can temporarily disable the system, or even completely destroy it.
Negative feedback, on the contrary, balances various deviations between the elements of this particular system. It helps maintain stability in relationships in marriage and family as a whole. If one of the family members expresses irritation, then another family member will painfully experience this outburst. And if both deviations from the norm balance each other, then hostility is created in the family, which is maintained at a constant level.
Living systems are characterized by openness. This means that they can both throw energy beyond their limits and receive it from the outside. Information is an extremely important form of energy for living systems because it serves to reduce uncertainty. An increase in the volume of information can significantly increase the level of structural organization of the system. If the information is properly programmed or grouped, the functionality of the system becomes more perfect. Information transfer (communication) includes the transformation of information from one state to another or its movement from one point in space to another.
The fundamental concepts of general systems theory and cybernetics provided a powerful charge of intellectual inspiration to the developers of innovative methods of systemic therapy. Since there is no generally accepted point of view on this type of psychotherapy, this work will consider three approaches - communication-strategic, structural and M. Bowen's theory. Systemic therapy is focused on patterns and patterns of relationships between members of the system, and not on the fate of an individual, therefore, in our presentation we omit those aspects of the corresponding methods (approaches) where personality theory is considered. However, in all three approaches, significant attention is paid to the disruption of intrafamily communication as a
the general mechanism of development, maintenance and stabilization of psychopathology and, accordingly, family psychotherapy - as a way to get rid of it.
- Servo mechanisms are automatic devices whose purpose is to provide feedback and notify that errors have been detected.
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Among other types of psychotherapeutic effects, family psychotherapy has a significant place. It is a special type of interaction between one or more psychotherapists with family members, or with one of the members. Family psychotherapy is aimed at eliminating behavioral and emotional disorders and provides correction of interpersonal relationships. In this case, for the psychotherapist, the patient is not the person who caused him to see the doctor, but the entire family, that is, its members.
Family psychotherapy is a special area necessary for the effective provision of psychological assistance. In the process of such psychotherapy, attention is paid to the development of the individual located in the family environment, and interaction with all members of the family system is also taken into account. These features distinguish family psychotherapy from ordinary individual intervention, in which the specialist sets as his goal only unilateral interventions, and his task is to study the patient’s personality and help him adapt to society.
The basis of family therapy is changes occurring in the entire family system, while individual therapy is aimed at working with the specific problems of a particular person. When providing assistance to him, the psychotherapist does not have the right to change the conditions in which he finds himself, and can only partially influence them. It often happens that the reasons that force a person to turn to a psychologist have their origins in the family. Therefore, after finding psychological help again in the same social environment, the patient finds himself under the influence of close people, whose behavior does not change, it remains the same as it was before visiting the psychotherapist.
A person who has attended a psychotherapeutic session changes; he begins to resist the thoughts and actions that his loved ones and family members show towards him. If the family itself is “unhealthy,” then the existing environment can inhibit the positive changes occurring with the patient. In some cases, the influence of the family negates the results achieved by the therapy, and can also increase the suffering of the patient who turned to a psychotherapist for help.
Systemic family therapy is focused on work that should be carried out with all members of a given family, even if not all of its members are present. Thanks to this approach, maximum productivity and economic efficiency are achieved. In the process of family therapy, the family reveals the existing mechanisms of organization and formation of the family system, and the interactions that exist between all members of this family become clear. Based on this, the family psychotherapist identifies the destructive aspects of interactions and helps family members realize them. Thus, the whole family receives a kind of impetus, which contributes to its self-organization and self-healing.
Creative forces awaken in the family, the so-called internal resource is activated, which allows the entire family system to begin a harmonious and constructive existence. It should be noted that the self-organization of the family, its self-change is a fairly stable formation. In the future, this is a guarantee that the family, each of its members, will not return to the same problems. The professional activity of a family psychotherapist is intended to help reduce the intensity of various pathogenic mechanisms and factors that interfere with the normal functioning of the family.
It is impossible to name the exact duration of family psychotherapy, since this process is absolutely individual and depends on many factors. In some cases, a few weeks are enough for people, and sometimes it takes several years to restore a harmonious atmosphere in the family. The severity of the mental disorders present in the main troublemaker is of great importance. The severity of interpersonal family relationships should also be taken into account. In addition, each family member must be motivated to create change. To identify the problem itself and build the correct psychotherapeutic hypothesis, a specialist will need from three sessions, sometimes up to six. Each one lasts two hours.
How will events develop further? The interaction between the psychotherapist and family members always depends on the sufficiency of the information received by the doctor. In particular, it is necessary to create effective recommendations that will help restore the functional state of the family system. Only in this case is the family able to undertake further work on adaptation and self-restoration. In some cases, the family is not ready to cope without outside help, and then family members decide to continue working with a psychotherapist. The first classes begin with two sessions per week. Further, when maladaptive mechanisms are revealed and destructive elements are identified, meetings with a psychotherapist may be less frequent.
Since the goal of counseling is to change the entire system of family interaction, the focus of the problem should shift from I and You to the couple together (Kratochvil S., 1991, Menovshchikov V.Yu., 2000). Only after such reformulation is it possible to change and solve the problem. This is the essence of a systematic approach to individual family consultations.
The system theory is based on the assumption that psychological and socio-psychological phenomena of family interaction cannot be understood and explained only on the basis of linear cause-and-effect relationships. According to M.G. Burnyashchev, most of them are rather included in connections similar to automatic control circuits, and are influenced by complex feedback processes. This means that the cause becomes the effect, and the effect becomes the cause.
As part of a systematic approach to resolving family problems, a significant number of different concepts were presented, the most famous of which are structural (S. Minukhin) and strategic (J. Haley, S. Payaschdoli) theories of family psychotherapy and counseling. Within their framework, ideas were developed about how the family “functions” in the most optimal way, and the therapeutic interventions developed were aimed at bringing the family from a “dysfunctional” to a “functional” state.
The systems approach avoids the concept of "pathological families" and looks at families or groups that are not functioning well. At the same time, there may be normally functioning systems that create a “problem” case out of the blue. Therefore, when such families come for consultation, all family members are taken into account. The consultant tries to understand every element of the family system in which the person in difficulty lives. Systems therapists not only try to find defects in the system. They also try to find out which parts of it are functioning well because this makes it possible to improve or overcome the difficulties they are experiencing. It is in this way that it is often discovered that the family has already tried to find its own solution and has even gone a long way in a certain direction. If this fails, it is only because the proposed solution creates its own problems. The solution is to try to give a new direction to the search for a solution, but this can only be done if the original approach is changed, i.e. if the problem begins to be viewed by family members differently, in a new light.
Within the framework of S. Minukhin's structural family therapy, a fairly directive approach to resolving family problems is implemented. The main provisions of S. Minukhin’s theory, which are the basis of the approach he developed, are that:
1. Spiritual-soul life is not an exclusively internal process. Each person and his environment are in a relationship of interaction.
2. Changes in the family structure contribute to changes in the behavior (relationships) and intrapsychic processes of family members,
3. The behavior of the therapist working with the family becomes part of the context; the therapist and the family form a new system. Thus, the therapist recognizes himself as part of the system that he is trying to change (Silyaeva E.G., 2002)
According to the point of view of S. Minukhin, the main function of the family is to protect its members from each other and from outside interference. That is why, in his opinion, the balance between a sense of security and the experience of a state of separation is of great importance. In connection with this, the author introduces the concept of family “boundaries”, which occupies a central position in his concept. For optimal family functioning, it is important that the subsystem of parents and the subsystem of children (siblings) are “well” differentiated from each other, and it is important that this differentiation is combined with emotional closeness, trust, etc. If the boundaries within the family are too rigid, the so-called “isolated) type of family is formed; if they are blurred or unclear, the family type is “confused.” Between these poles there are families with transparent boundaries through which family members can interact “well” without erasing or violating them (Kratochvil S., 1991).
When carrying out advisory and therapeutic work S. Minuchin attaches great importance to the creation of a therapeutic system. This process involves:
- “acceptance” of the therapist into the family;
- recognition of his professional authority (role of navigator);
- a systemic definition of the problem (which often turns out to be different than the one with which the family addressed);
- systematic definition of the goal (and it may differ from the one with which the family came);
- drawing up a therapeutic agreement (contract), which stipulates the scope of the consultation process, installation, payment, etc.
Structural consulting involves, first of all, changing the structure of the stated problem. To do this, the consultant initially listens to its definition by each family member, thus finding out the ways of its subjective construction. As a rule, according to S. Minukhin, the family member who is most affected by this problem is blamed for the problem. At the same time, Minukhin himself avoids using the term “guilt.” In accordance with the basic principles of the systems approach, he notes that the difficulties of family interaction are the result of a dysfunctional system of relationships that needs to be changed. Transformation of the structure of the problem in the minds of family members, through the introduction of a construct about its common belonging, makes it possible to change the ways of building relationships in the family. Taking responsibility for a problem helps resolve it. The individual is included in the system of relations associated with this problem, thus, there is a transformation of relations in the family, the unification of the efforts of its members in terms of resolving existing difficulties according to the scheme outlined in the counseling process. This construction of the therapeutic process allows, according to S. Minukhin, to successfully resolve a wide variety of problems that arise in the family system.
The founder of strategic family therapy, the concept of which was also developed within the framework of a systems approach, was J. Haley. Strategic family therapy involves the development of specific strategies to solve existing problems in the family. The peculiarity of this approach is that the consultant refuses relatively much data (anamnesis, family history, etc.) and focuses exclusively on the identified problem and a detailed description of the mechanisms that support it. Consultants note that often the attempts that people (couples, families) make to solve an existing problem lead to the exact opposite result, i.e. to its stabilization or exacerbation. A vicious circle arises that can lead to a serious crisis in the family. In this regard, the object of influence for consultants working within the framework of the strategic concept is not the family itself, but the symptom or problem stated by its members. When targeting a symptom, it is assumed that a change at this point will entail other changes. Indeed, the situation in a marriage often changes for the better when, for example, the child's symptomatic behavior weakens or stops if the parents stop arguing about how to properly treat him. At the same time, in the strategic concept it is considered not so important whether such behavior of the child was the cause or consequence of the existing problem, i.e. in this case we are talking about the correction of a specific violation, through which the general situation in the family changes.
P. Vaclavik, Wilkend and Fish (Eidemiller E.G., 1999) describe a four-step strategy for producing changes in the family:
1. Definition of a family problem (it is assumed, as in the previous approach, to emphasize that this problem belongs to and concerns all family members, and not just one of them).
2. Determining what the family did to resolve the problem, highlighting and emphasizing what did not work in the process did not allow for success.
3. Setting a family goal. The goal and direction of the change must be determined by the family itself, since what is good for one system may not be suitable for another.
4. Developing a therapeutic intervention that disrupts the habitual interaction patterns that create the problem.
Consultants working within this concept pay considerable attention to forms of family organization. As with structural techniques, it emphasizes the important role of clear hierarchies in families. For example, the parents of a psychotic teenager who has gone astray for the first time are encouraged to set clear boundaries for their son, which will provide a basis for peace of mind, help him get oriented, and ultimately make psychotic behavior redundant. Almost the same applies to antisocial teenagers, whose behavior can almost always be understood when viewed against the backdrop of a shaky family structure. The behavior of antisocial youth, according to J. Haley, may be a reaction to the structure of the family system, in which boundaries are blurred and blurred, where coalitions of several generations often occur.
In addition to the described advisory concepts within the framework of systemic family therapy, other, no less interesting theories of psychological impact have been developed: development-oriented family therapy by V. Satir, the concept of B. Hellenger, the multi-generational model of H. Stirlin, the reflective team of T. Andersen, etc. .