Theories that consider the clients’ perspective as the foundation for therapy

 

 

In the last three weeks, you’ve learned about theories that consider the clients’ perspective as the foundation for therapy. Rather than the therapist bringing the client to a theory, the theory is designed to work around the clients’ understanding of the “problem.” In your previous work, you were asked to analyze family interactions. Next, as we learn to think systemically, let’s look for patterns in those interactions.

Looking for Patterns in Family Interactions Template [DOCX] to help you structure your reflections.

Consider one of the systemic conflicts the family in your chosen TV show or movie is experiencing. How would each family member describe the problem from their perspective?
For each theory, using the vocabulary in your readings, provide the theory of problem formation and problem resolution.
What patterns emerge from your fictional family’s interactions? Does someone consistently use humor to diffuse? Does someone get angry? Does someone pacify? How do the other family members respond? Is there consistency in these interactions that show you any systemic pattern

 

Sample Solution

Conceptual Example: “The Simpsons” – Systemic Conflict: Homer’s Irresponsibility and Financial Strain

1. How Each Family Member Would Describe the Problem:

  • Homer: “There’s no problem! I’m just living my life, trying to have a good time. Why is everyone always nagging me about money or jobs? It’s everyone else’s fault for being so uptight.” (He externalizes blame, minimizes consequences).
  • Marge: “The problem is Homer’s constant irresponsibility. He makes impulsive decisions, wastes money, and never seems to learn. It puts so much stress on me, and I worry constantly about our financial stability and the kids’ future. I just wish he would take things more seriously.” (She identifies Homer as the problem, feels burdened and anxious).
  • Bart: “Dad’s just being Dad. It’s kinda funny sometimes, but then he messes things up, and Mom gets mad. It’s not my problem, usually. I just try to get out of the way or egg him on.” (He sees it as characteristic behavior, often detaches or even reinforces it).
  • Lisa: “The problem is systemic. Dad’s lack of foresight and impulsive behavior create a constant state of financial precarity and emotional instability in the household. It hinders our personal growth and long-term security. Mom enables him, and Bart capitalizes on the chaos. We need a rational, long-term solution to break this cycle.” (She analyzes it intellectually, sees patterns, and identifies enabling behavior).
  • Maggie: (Through actions/expressions) “Stress. Chaos. Insecurity. Comfort from Mom, sometimes fear.”

2. Theories of Problem Formation and Resolution (using vocabulary):

  • Structural Family Therapy (Minuchin):

    • Problem Formation: The problem is maintained by rigid, dysfunctional boundaries within the family system. Homer and Marge have enmeshed boundaries regarding Marge’s over-responsibility and Homer’s under-responsibility, making it difficult for Marge to set firm limits and for Homer to grow. There’s a detouring pattern where the children might become symptoms (e.g., Bart’s rebelliousness) to distract from the parental dysfunction, or a cross-generational coalition (Marge and kids against Homer) that paradoxically reinforces Homer’s position as the “problem” by not allowing individual growth or healthy confrontation within the marital dyad.
    • Problem Resolution: The therapist would aim to realign boundaries. This involves strengthening the parental subsystem, perhaps by empowering Marge to set clearer boundaries with Homer and encouraging Homer to take on more adult responsibility. Techniques like enactment (having them interact as they typically would in session) and boundary making (physically separating them or giving specific directives to change interactional patterns) would be used to create structural shifts. The goal is to create a more effective hierarchy where parents are responsible for leadership, reducing the need for children to assume problematic roles.
  • Strategic Family Therapy (Haley/Madanes):

    • Problem Formation: The problem is maintained by maladaptive communication patterns and power struggles within the family. Homer’s irresponsibility might be seen as a way to maintain control or gain attention, and the family’s attempts to “fix” him paradoxically maintain the problem through repetitive, unhelpful sequences. There might be a symptom as communication where Homer’s behavior serves to distract from marital issues or to fulfill an unstated need. The family is stuck in a vicious cycle where each member’s predictable response reinforces the other’s behavior.
    • Problem Resolution: The therapist would use directives and paradoxical interventions to break the dysfunctional cycle. This might involve prescribing the symptom (e.g., telling Homer to be more irresponsible in a specific way, making it less appealing) or reframing the problem in a way that shifts perspective (e.g., viewing Homer’s irresponsibility as a desperate plea for connection). The therapist might also use ordeals (making the symptom more difficult than the solution) or therapist-designed tasks to disrupt the established communication patterns and shift power dynamics. The goal is to change behavior directly, leading to new interaction patterns.
  • Milan Systemic Family Therapy (Palazzoli et al.):

    • Problem Formation: The problem is maintained by a set of covert “family games” or unspoken rules that govern interactions, often around issues of power and control. There’s a circular causality where each family member’s behavior is both a cause and effect of the others’. Homer’s irresponsibility might be part of a dirty game where family members maintain an unspoken pact to keep the system stable, even if dysfunctional. Information is often selectively withheld or distorted, creating punctuation where blame is assigned linearly rather than viewed systemically.
    • Problem Resolution: The therapist would use techniques like circular questioning to reveal hidden patterns and different perspectives, making the implicit explicit. Positive connotation would be used to reframe problematic behaviors in a positive light, reducing blame and increasing family cooperation (e.g., Homer’s “irresponsibility” is his way of ensuring the family pulls together). Hypothesizing about the family’s “game” helps the therapist and family understand the systemic function of the problem. Neutrality is maintained by the therapist to avoid siding with any subsystem. The goal is to introduce new information that perturbs the system, breaking the “game” and allowing for new rules and interactions to emerge.

3. Patterns That Emerge from Fictional Family’s Interactions:

  • Homer: Consistently uses denial and externalization (“It’s not my fault!”) when confronted. When pressed, he might retreat into childlike sulking or engage in a distraction (e.g., watching TV, going to Moe’s). His primary coping mechanism is avoidance.
  • Marge: Consistently uses nagging and enabling. She expresses frustration and worry, attempts to control Homer’s behavior through verbal directives, but often steps in to clean up his messes, inadvertently reinforcing his irresponsibility. Her response is often an escalation of anxiety.
  • Bart: Consistently uses humor/mischief to diffuse or deflect. He often finds Homer’s antics entertaining, or even participates, which can sometimes divert Marge’s anger from Homer to himself. His response is often comedic disruption or avoidance of responsibility.
  • Lisa: Consistently uses intellectualization and critical analysis. She points out the logical flaws in Homer’s behavior and Marge’s enabling, often proposing rational solutions that are then ignored. Her response is often frustration and feeling unheard.
  • Maggie: Consistently observes the chaos quietly, often seeking comfort from Marge. Her reactions (e.g., pacifier sucking, eye-rolling) are often the most grounded, unspoken commentary on the family’s dysfunction. Her response is often passive observation and subtle coping.

Consistency in Interactions Showing Systemic Patterns:

There is a clear “pursuer-distancer” pattern between Marge (pursuer of responsibility/control) and Homer (distancer/avoider). Marge’s attempts to control Homer often lead to his increased avoidance, which in turn fuels her anxiety and further pursuit. Bart’s mischief can be a detouring mechanism, drawing attention away from the core marital issue. Lisa’s intellectualization, while insightful, often leaves her feeling isolated from the emotional dynamics, serving as a form of emotional cutoff from the direct conflict. The family is caught in a negative feedback loop where their individual coping mechanisms, while understandable, collectively reinforce the very problem they complain about, making it difficult for the system to self-correct.

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