What it is & What it isn’t and What Perhaps it Could Be

What it is & What it isn’t and What Perhaps it Could Be

 The Issue of the Feasibility of Family Interventions

“Would you tell me, please, which way I ought to go from here?”

“That depends a good deal on where you want to get to,” said the Cat.
“I don’t much care where–” said Alice.
“Then it doesn’t matter which way you go,” said the Cat.
“–so long as I get SOMEWHERE,” Alice added as an explanation.
“Oh, you’re sure to do that,” said the Cat, “if you only walk long enough.”

I have been accused of being the eternal optimist and taken to task numerous times for encouraging therapists and other clinicians to look beyond the individual identified patient. Many have avowed the near impossibility of engaging family on a regular basis. Others have applauded the “important aspects of this holistic way to view treatment in Psychiatry” and even offered an unlimited flow of referrals if I was to relocate closer to them.

Regardless, family relationships are not optional. As Carter & McGoldrick wrote in their seminal work on The Family Life Cycle, “Whom we are related to in the complex web of family ties over all generations is unalterable by us.” The negative side of the triangle is merely a symptomatic expression of a total family problem. Regaining and maintaining health and well-being is a cooperative effort.

The past is prelude and without it we have no present and certainly no future. While the deeds and events of the past are unalterable, the meaning we ascribe to those experiences is malleable and the damage repairable. The Systemic Family Therapy perspective is holistic and integrative (Please see Systemic Thinking for “Individual Diagnoses).

Family Systems Theory has a positive view of both the individual and the family. A senior founding clinician famously stated, “When families come to me for help, I assume they have problems not because there is something inherently wrong with them, but because they’ve gotten stuck — stuck with a structure whose time has passed, and stuck with a story that doesn’t work.”

Froma Walsh identified three goals for family systems therapy that focus on process and health.

  1. Develop the ability to “struggle well”, reduce vulnerability and respond successfully to stressful crises and persistent challenges
  2. Focus on growth and resources to emerge strengthened and more resourceful to heal from painful experiences
  3. Empower families to overcome persistent adversity and continue to live and love fully by actualizing the potential for personal and relational transformation and growth that can be forged out of adversity

Ronald B. Cohen of www.familyfocusedsolutions.com explains why family systems therapy is a more successful approach to mental health problems than individual therapy.As to the subtitle of this post, the feasibility of family interventions, Robert F. Kennedy sought to inspire civil rights activists by saying, “Some people see things as they are and say why? I dream things that never were and say, why not?” This is a paraphrase of lines from a little known play by George Bernard Shaw “Back to Methuselah” which in the original read, “You see things; and you say ‘Why?’ But I dream things that never were; and I say ‘Why not?’”

Family and marital therapy is challenging. If it were easy then everybody would do it. But individual therapy can be hazardous to a couple or family’s emotional health. Life after all, is lived in relationship and that’s where we want people to succeed, not in the safety of the one-to-one transference of the consulting room. There can be no differentiation without connection, no autonomy without healthy interdependence.

For further insights & understanding please see previous posts on The Magic of Family Therapy, Thinking About Thanksgiving, and Alcoholism and the Family “A Systemic Approach”.

Please feel free to ask any questions or to comment in the “Leave a Reply” box below. To request more information and/or schedule an initial consultation, click here . If you found this post useful, don’t keep it a secret. Go ahead and share this article with your own networks. You are encouraged to click on the buttons in the second to the right hand column at the bottom of the page.

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Ronald B Cohen, MD, PC www.familyfocusedsolutions.com Ronald B. Cohen, MD
Bowen Family Systems Coach
1 Barstow Road, Suite P-10
Great Neck, NY 11021
(516) 466-7530
RBCohenMD@FamilyFocusedSolutions.com

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2 comments

  1. shery french on March 6, 2013 at 10:31 pm said:

    Yes….individual therapy is a piece of cake compared to couples’ and family work.
    Along with others, I think that some, perhaps unwittingly, sabotage marriage because they know more about individual therapy, and are certainly more comfortable with it. I sometimes see individuals as part of couple therapy, but the marriage is my client.

    • Ronald B Cohen, MD on March 7, 2013 at 6:08 pm said:

      Hi Shery,

      We are reading from the same page or same paper as it were, specifically William J. Doherty’s HOW THERAPISTS HARM MARRIAGES AND WHAT WE CAN DO ABOUT IT, an expanded version of his 1999 conference presentation How Therapy Can Be Hazardous To Your Marital Health. His opening paragraph reads “Two dangers face now married people who seek therapy as individuals or as couples. The first danger is individually trained therapists who are incompetent in working with couples. The second is therapists, whether competent or not, whose individualistic value orientation leads them to undermine marital commitment when the marriage causes distress for an individual.” The LinkedIn header for this post comes from an article in the Psychotherapy Networker Journal “Why we avoid doing couples therapy” By Ellyn Bader and Peter Pearson http://www.psychotherapynetworker.org/magazine/recentissues/2011-novdec/item/1435-facing-our-fears I expand on these ideas in The Magic of Family Therapy http://www.familyfocusedsolutions.com/blog/page/2/ and About Family Therapy http://www.familyfocusedsolutions.com/family-therapy/.

      Regards,

      –Ron

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