Origins and Growth of Family Therapy

Historical Roots of Family Therapy

  • Schizophrenia Research

    • Researchers aimed to investigate the influence of a pathogenic family environment on the development of schizophrenia.

Origins and Growth of Family Therapy

  • **Schizophrenogenic Mother **

    • Concept introduced by Fromm-Reichmann (1948).

    • Characteristics of the mother:

    • Cold

    • Dominating

    • Possessive

    • Rejecting

    • Effects on the child:

    • Believed to be a determining factor in the child’s schizophrenic behavior.

  • The Double Bind (Bateson)

    • Definition: A communication scenario within emotionally significant relationships characterized by conflicting messages from different logical levels, leading to confusion.

    • Hypothesis: A breakdown in an individual's ability to distinguish between Logical Types occurs in double bind situations.

General Characteristics of Double Bind Situations

  1. Intense Relationship:

    • The individual feels a critical need to accurately discern the communicated message to respond appropriately.

  2. Contradictory Messages:

    • One party expresses two contradictory orders of messages, where one message denies the other.

  3. Inability for Meta-communication:

    • The individual cannot comment on the expressed messages to rectify the miscommunication or clarify which message to respond to.

  • Classic Example of Double Bind:

    • A mother expresses love verbally while displaying disgust through body language (e.g., turning her head away).

    • The child struggles to determine whether to react to her words or her nonverbal cues, creating a confusion rooted in dependent relationships.

Theoretical Implications

  • Redefining Schizophrenia:

    • By examining communication sequences within families, researchers like Bateson, Jackson, and Haley began to redefine schizophrenia as an interpersonal phenomenon.

Pathological Family Dynamics (Lidz, 1957)

  • Pathological Fathering

    • Verbal descriptors:

    • Rigid and domineering

    • Hostile

    • Paranoid

    • A spouse of little or no significance at home

    • Passive and submissive

  • Marital Schism:

    • Defined as a disrupted marital situation marked by:

    • Family disharmony

    • Self-preoccupation

    • Undermining of one spouse by the other

    • Frequent threats of divorce from either partner.

  • Marital Skew:

    • Defined as a compromised marital relationship where:

    • One partner excessively dominates the family.

    • The marriage is sustained at the cost of reality distortion.

Family Communication and Mental Health Research

  • Bowen, Wynne and NIMH Studies (1950s):

    • Key findings from NIMH mothers who lived in cottages indicated significant emotional distance within familial structures.

    • Notion of Emotional Divorce emerged as families disengaged emotionally.

  • Pseudohostility:

    • Defined as:

    • Families engage in bickering to sustain the relationship, avoiding deeper emotions and feelings of true hostility.

  • Pseudomutuality:

    • Characterized by a façade of open and satisfying relationships among family members that conceal underlying issues.

  • Rubber Fence (Wynne):

    • Proposed boundary around a family:

    • Allows specific acceptable information to penetrate while protecting against external influences.

The Child Guidance Movement

  • Premise:

    • Established clinics operating on the belief that psychological disturbances often start in childhood, advocating for early intervention.

    • Pioneer: Adler in early 1900s Vienna.

The Evolution of Family Therapy

  • Urgent Practice Transition:

    • Indicators of rapid development in practice:

    • Innovative techniques

    • Self-examination among practitioners

    • Professionalization of the field.

  • Medical Family Therapy:

    • Involves collaboration among healthcare professionals in addressing family health issues through psychoeducational methods.

  • Multiple Family Therapy:

    • Engages several families collectively to address both individual and shared familial problems.

  • Multiple Impact Therapy:

    • A crisis-oriented intervention where family members are seen together or in various combinations for intense professional engagement typically over two days.

  • Network Therapy:

    • Usually conducted in the patient's home setting, involving family members and other significant individuals in the therapeutic process, particularly beneficial for post-hospitalization recovery (e.g., schizophrenia).

Current Context of Family Therapy

  • Integration and Eclecticism

    • Emphasizing the necessity of diverse methodologies.

  • Social Constructionism

    • Consideration of social dynamics in therapy.

  • Ecological Context

    • Focus on the context influencing family dynamics.

  • Multisystemic Interventions

    • Addressing problems across various systems interacting with the family.

  • Evidence-Based Practice

    • Utilizing empirically supported strategies in therapy.