Family
Family
Family
FAMILY
COUNSELLING
The Classic Schools
: September 2005
Published by
: Anugraha Publications
Anugraha (Tamil Nadu Capuchin Institute for
Counselling, Psychotherapy and Research)
Nochiodaipatti Post
Dindigul 624 003
Tamil Nadu, India
Tel. 0451 2550100, 2550324, 2550839
Email: [email protected]
ANUGRAHA PUBLICATIONS
Anugraha
(Tamil Nadu Capuchin Institute for Counselling,
Psychotherapy & Research)
Nochiodaipatti, Dindigul 624 003
Tamil Nadu, India
2005
Printed at
: Vaigarai Pathippagam
Beschi College, Dindigul 624 001
Tamil Nadu, India
Tel. 04512430464
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04
Acknowledgements
ACKNOWLEDGEMENTS
TO
MY FAMILY AND
THE FAMILIES OF MY NEIGHBOURHOOD
IN WHICH I GREW UP
TO
UNDERSTAND
Family Counselling
FAMILY
05
COUNSELLING
TABLE OF CONTENTS
11
2
The Conceptual Foundations
1. Background
30
31
31
1
Introduction
Table of Contents
06
13
13
32
32
32
33
33
33
1) Systems Thinking
13
34
14
34
3) Systems Theory
14
34
15
35
2. Salient Concepts
1) Functionalism
15
35
16
36
16
37
(1) Homeostasis
17
37
(2) Constructivism
18
4) Cybernetics of Families
19
8. Emotional Fusion
38
20
9. Emotional Cut-off
39
20
42
21
43
22
44
23
3
Family Systems Counselling of Murray Bowen
5) Twins
38
1) Genogram
44
45
3) Relationships experiments
45
1. Theoretical Formulations
24
4) Coaching
45
2. Differentiation of Self
25
5) The I-Position
45
3. Triangles/Triangulation
27
45
30
7) Displacement Stories
46
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07
4
Experiential Family Counselling of Virginia Satir and Carl Whitaker
Table of Contents
08
6) Focal Hypothesis
61
7) Internalised Objects
61
1. Theoretical Formulations
47
8) Active
62
2. Family Life
48
9) Interpretations
63
10) Aim
63
49
1) Double Bind
50
51
1) Placating
53
2) Blaming
53
3) Super-Reasonable
54
4) Irrelevant Behaviour
54
5. Treatment Techniques
54
1) Family Sculpting
55
2) Family Reconstruction
55
5
Psychoanalytic Family Counselling
1. Sketches of Leading Figures
56
2. Theoretical Formulations
57
57
2) Self Psychology
57
57
58
58
59
6. Treatment Techniques
59
1) Triangles
59
2) Starting Point
59
3) Participant Observer
60
4) Focus
60
5) Assessment
61
6
Structural Family Counselling of Salvador Minuchin
1. Theoretical Formulations
66
1) Family Structure
67
2) Subsystems
68
3) Boundaries
69
70
71
72
73
3. Behavioural Disorders
74
4. Treatment Techniques
75
75
76
3) Diagnosing
77
78
5) Boundary Making
79
6) Unbalancing
79
80
7
Cognitive-Behavioural Family Counselling
1. Sketches of Leading Figures
81
2. Theoretical Formulations
83
1) Responses
85
2) Reinforcements
85
09
Family Counselling
Table of Contents
10
87
4. Treatment Techniques
89
89
1. Erosion of Boundaries
108
91
2. Postmodernism
109
3) A Cognitive-Behavioural
Approach to Family Counselling
93
3. Constructivism
109
95
110
111
6. Social Constructionism
111
7. Narrative Revolution
112
8. Solution-Focused Therapy
113
114
1) Mother Blaming
114
115
(1) Assessment
95
96
96
97
8
Strategic Family Counselling of Jay Haley and Clo Madanes
98
2. Basic Beliefs
98
10
99
4. Healthy Families
100
5. Dysfunctional Families
100
1) Symptoms
100
2) Life Cycle
101
102
6. Treatment Techniques
1) Paradoxical Intervention or
Prescribing the Symptom
104
104
115
1. Therapeutic Spontaneity
117
118
119
4. Individual Interview
119
119
11
Conclusion
120
105
Endnotes
128
105
Bibliography
145
(3) Positioning
106
2) Positive Interpretation
106
106
4) Reframing
107
107
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1
INTRODUCTION
Whenever I use the term family counselling, I mean couple
counselling as well, since the concept of family counselling contains within it the nucleus of couple counselling also. I use the
terms counselling and therapy interchangeably.
In this book I shall be dealing with the classic schools of
family counselling. Among the classic schools, I deal with the
theory and practice of the family systems counselling of Murray
Bowen. In his theory is embedded the systems concept. Some of
the salient concepts are triangulation, multigenerational transmission process, emotional fusion, and emotional cut-off.
Then I take up Virginia Satirs and Carl Whitakers experiential family counselling, which has as its background the thinking of the existential philosophers with its emphasis on freedom
and the necessity to discover the essence of ones individuality in
the immediacy of experience. Both the therapists give importance
to the knowledge of functional and dysfunctional communications in families. The concept of double bind is special to experiential family counselling.
Next comes the famous psychoanalytic family counselling.
Psychoanalysis has played a major role in psychology until very
recently. Still some of the psychological schools have their strong
roots in psychoanalysis. Having the Freudian drive psychology as
the basis, we have its overgrowth as object relations theory and
self-psychology. Self-psychology, for example, has a tremendous
influence on counselling, especially with its colossal emphasis on
empathy. Gone are the days when counsellors used to confront
clients to such an extent that the clients would hesitate to go to the
same counsellor for subsequent counselling. With the arrival of
self-psychology, the client feels understood, upheld, validated and
supported. The counsellor gets into the clients shoes to see the
12
Introduction
clients world from the clients perspective. This is the special merit
of self-psychology. For all these developments, psychoanalysis forms
the basis, though at present the developments seem much different from their source.
Then comes the structural family counselling of Salvador
Minuchin for whom the social context is of paramount importance. Its main belief is that the whole and the parts can be properly explained only in terms of the relations that exist between the
parts. His theory advocates that our psychic life is not merely internal, but interactional with the environment. His valuable concepts for the understanding of family counselling are subsystems,
and boundaries. Then follows cognitive-behavioural family counselling. Its main thrust is that our thinking influences our emotions and behaviours. Therefore instead of changing the behaviour
one would do well to change his/her thinking. Finally I end up
with speaking about strategic family counselling of Jay Haley and
Clo Madanes. They basically believe that clients are not pathological and they can change themselves rapidly. They have developed a set of creative ways to generate change in the clients lives.
At the end I also strongly advocate to develop ones own method
in family counselling, and for that matter counselling itself. We
can never be the duplicate of another individual. Our individuality has to be expressed in every sphere of our activity, especially in
counselling. Though we may follow certain schools of psychology in our counselling approach, it is worth being original in our
approach.
With this brief introduction I invite you to enter into the
different classic schools of family counselling and develop your
own way of doing family counselling.
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2
THE CONCEPTUAL FOUNDATIONS
Like any other social science, family counselling had to grow
from its infancy to a mature stature. It definitely needed concepts
to express its experiences and propose guidelines in conceptual
framework. It was prudent enough to borrow the concepts from
other fields that are akin to its attitudes and value system. A perceptive learner of family counselling can easily sense in his/her
study the conceptual influences from other fields.
1. Background1
1) Systems Thinking
14
whole. Here what we observe is that the components do not function according to their nature, but according to their position in
the network. Now what has become the unit of study is the structure ABCDEF. If one were to study a part outside the system, one
will find that the part in question will function differently outside
the system. Again the part will function differently even inside
the system depending upon where it is placed.
2) Systems Thinking in the Family Process
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physiology from which we have the concept homeostasis; cybernetics from which we have the concept feedback; psychosomatic
medicine from which we have the concept of the social context of
illness; community mental health from which we have the therapeutic community; anthropology from which we have the
concepts of structuralism, functionalism, the participant observer;
and social work from which we have the concept the social
context of problems. Let us consider in this chapter some of the
most salient concepts that have made a deep impact on family
counselling.
2. Salient Concepts
1) Functionalism
16
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18
how the family machine works and how to repair it. In this
approach we may be ignoring the value of the familys functional
state and, the culture in which it exists. It is a value-free mechanistic view of the family.
(1) Homeostasis
(2) Constructivism
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3
FAMILY SYSTEMS COUNSELLING
OF MURRAY BOWEN
The pioneers of family counselling undoubtedly recognized
that we are the products of social context. Yet they limited their
attention to the nuclear family alone. However, Murray Bowen
family systems counselling is a comprehensive view of human
behaviour. Bowen argued that wherever we go, we carry our unresolved emotional reactivity to our parents, in the form of vulnerability to repeat the same old patterns in every new relationship
we enter into. The Unresolved issues with our original families are
the most important unfinished businesses of our lives.
1. Theoretical Formulations
For Bowen, his theory centred around two counterbalancing
life forces. He called one of them togetherness and the other individuality. In an ideal situation, these two forces are supposed to
be in balance. But if there is an unbalance in the direction of
togetherness, it is called differently as fusion, stuck-togetherness,
and undifferentiation. In his theory differentiation is considered the capacity for autonomous functioning, which helps people
avoid getting caught up in reactive polarities. If there is no differentiation, emotional reactivity results in polarized positions like
pursuer-distancer, and overfunctioning-underfunctioning. The tension we experience in our life situation is the condition that evolved
from mother-child symbiosis, to undifferentiated family ego mass,
to fusion/differentiation. Before we could differentiate a mature,
healthy personality, the unresolved emotional attachment to ones
family must be resolved rather than passively accepted or reactively rejected. Now let us see some of the core concepts of his
theory. 1
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potential loss of the self and begin to fight. When this happens the
outside person usually wants to stay distant and avoid the other
two but one of the two close members will try to establish a coalition with the outside person.
Whenever we experience difficult relationship in our families, usually there are two individuals along with one or more third
parties. Any two individuals in a family may experience cycles of
closeness and distance. Triangles are likely to develop when they
are distant. Let us see how triangles develop. In a strained relationship, one of the two connects with someone else as a way of gaining an ally. The third person is sensitised either to one partys
anxiety or to the conflict between them, moves in to offer reassurance or calm things down. Certainly triangulation lessens tension
but it freezes the conflict in place. Triangles usually become chronic
diversions that corrupt and undermine family relationships. Since
most family problems are triangular, working with only one or
two individuals may not solve the problem.
An emotional triangle is formed by any three persons or
issues. Its basic law is that when any two parts of a system become
uncomfortable with one another, they will triangle in or focus
upon a third person, or issue, as a way of stabilizing their own
relationship with one another. Therefore, a person may be said to
be triangled if he/she gets caught in the middle as the focus of
such an unresolved issue. In the same way, when an individual
tries to change the relationship of two others, he/she triangles himself/herself into that relationship and often stabilizes the very
relationship he/she was trying to change. In families we find typical triangles such as mother-father-child; a parent and any two
children; a parent, his/her child, and his/her own parents; a parent, a child, and a symptom in the child (like doing badly in school,
drugs, stealing, sexual acting out, allergies); one spouse, the other,
and the others dysfunction (like drinking, gambling, an affair,
depression).
Emotional triangles are known to have some very specific
rules that they invariably obey. These are applicable to any family
or any group of people.
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own work to take care of her spouse, set his goals for him, run his
household and take care of his children. If she was used to many
brothers at home she would not be content with just one man.
She may like many men around and act as a patroness to them.
The best match for her would be the youngest brother of sisters. A
youngest brother of brothers too may accept her leadership. The
oldest brother of brothers is a poor match for her. Her female
friends will be usually the youngest sisters of sisters or a middle
sister. She may like a only female child too. She is always congenial, and will act as a mediator in conflicts. If in leadership position, she will handle things with care and will be tactful. She will
delegate her work because she thinks that it is not worth her time.
(3) The Oldest Brother of Brothers
He is usually the boss. He has a lot of leadership qualities, is
meticulous, perfectionist and wants to win every game. He is successful, gets along well with other men but is not on intimate terms
with anyone. He likes his wife to mother him. Though he expects a lot from his wife, he gives little. He will find the youngest
sister of brothers a good match. Perhaps the worst match for him
is the oldest sister of sisters. He likes jobs like lawyer, minister,
economist, politician, astronaut, president of a company or of a
country.
(4) The Oldest Brother of sisters
34
The youngest and the only child are never replaced by a newborn. They are always the baby of the family. They are babied
He is daring, headstrong, capricious and rebellious. In history many assassins are youngest sons. His characteristic trait is
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Since they neither have the rights of the oldest nor the privilege of the youngest, they often feel life is unfair to them. There is
a sense of being cheated in life. To get attention from others and to
feel important, they may do crazy things and become self-destructive by eating or drinking too much. They may even become
socially destructive but not like big criminals. They often
exhibit annoying attention-getting habits. They neither have the
authority of the eldest or the spontaneity of the youngest. But
they know how to deal with any type of persons. They are good
negotiators, diplomats, secretaries, barbers, athletes, and waiters.
Because they crave for attention and affection, they may turn to
the field of entertainment.
The position of the middle child can take a huge variety of
combinations with regard to the ages, sexes and numbers of other
siblings and so it is difficult to deal with every variety. When there
is greater variety in the siblings, it is more difficult to find the
appropriate description for the middle child. Nevertheless, one
can safely say that a middle child will tend to have more of the
characteristics of the birth position that he/she is closest to. For
example, if the middle child is at the higher end of the birth order
scale he/she will resemble the oldest child, or if he/she is at the
lower end of the birth order scale, his/her characteristics will be
more like the youngest child. The way the sexes and ages of siblings are distributed is more important to the development of the
personality of the middle child.
If all the children are the same sex, the middle child gets the
least attention and has to compete. He/she will be confused and
will have nearly equal mixture of characteristics of the youngest
and the oldest and will be the most anxious and self-critical. On
the contrary if all the other children are of the opposite sex, then
the middle one gets the most attention and is pampered. Since
such a home situation cannot be duplicated, marriage is rather
difficult for such persons.
4) The Only Child11
The only children have the best and the worst worlds. They
deem themselves as perpetually the oldest and the youngest child
in the family. Even though they have the characteristics of an old-
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parental home and spend their lives elsewhere but will make only
duty visits when it is absolutely essential and unavoidable.
9. Emotional cutoff14
The reason for cutoff is that the person who moves away
feels powerless with the other person who is all powerful. The
person does not see any way of being himself/herself in a close
relationship with that powerful person. Just because they are unsure of themselves, they deny their need of the other by isolating
themselves. Their appearance to be independent is only a faade.
At the cost of emotional distance they maintain independence. If
they happen to be close, they experience a great deal of anxiety.
They are seen to be normal and relate well socially and occupationally. Everything is all right with them if they do not get
involved emotionally with others. The more the degree of unresolved emotional attachment in the family of origin, the greater
will be the depth of the emotional cutoff. Surprisingly even the
person who is cutoff also feels powerless and thinks that the
person withdrawing has all the power. In short they do not see
any way of being themselves in a close relationship.
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10.
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tion, which increase the problem. This cycle keeps repeating, just
as the family goes through similar cycles. The emotional process
in society influencing the emotional process in families is called
societal emotional process. When there is a high level of social
anxiety, it can result in a gradual lowering of the functional level
of differentiation in families. I have noticed that in certain societies, there is a high level of mistrust and correspondingly a high
level of anxiety too. This somehow is reflected in individual families. 15
11. Normal Family Development
For Bowen, there is no discontinuity between normal and
abnormal family development. There are no discrete categories of
families (schizophrenic, neurotic, or normal), but all families vary
along a continuum from emotional fusion to differentiation.
Optimal family development takes place when the family members are relatively differentiated, anxiety is low, and parents are in
good emotional contact with their own families of origin. Emotional attachment between spouses resembles that which each had
in the family of origin. If you were relatively undifferentiated in
your family of origin, you will continue to be undifferentiated
when you form a new family. Fogarty (1976) elaborates the characteristics of well-adjusted families. They are:
1. Families are balanced and can adapt to change.
2. Emotional problems are seen as existing in the whole group, with
components in each person.
3. They are connected across generations to all family members.
4. They use a minimum of fusion and a minimum of distance to
solve problems.
5. Each dyad can deal with problems between them.
6. Differences are tolerated, even encouraged.
7. Each person can deal on thinking and emotional levels with the
others.
8. They are aware of what each person gets from within and from
others.
9. Each person is allowed his or her own emptiness.
44
For Bowen, the hallmark of the well-adjusted person is rational objectivity and individuality. If you are a differentiated person, you will be able to separate thinking from feeling, and remain
independent of, though not out of contact with, the nuclear and
extended family.16
12. Treatment Techniques
In Bowenian family systems therapy there are seven most
prominent known techniques:
1) Genogram
Genogram is a family diagram to collect and organize important data concerning the multigenerational family system. Its main
function is to organize data during the evaluation phase and to
track relationship processes and key triangles over the course of
therapy.
Genograms have been adapted in various ways for clinical
use. Dynamic markings have been developed to point out couples
relationships, repeated patterns, or complementary relationships.
Genograms guide the counsellor to address problem-maintaining
issues in either or both families of origin, and to plan realistically
regarding long-term family change. They may facilitate treatment
for specific types of couple problems, such as sexual dysfunction,
family illness patterns, spiritual and religious issues, or medical
and genetic disorders that could affect planning of children.
Genogram can be used to look mainly at family structure. Patterns of relationship repeat themselves over generations without
varying, and the same symptoms are repeated over generations.
They include spousal abuse, poor health, depression, educational
failure, multiple divorces or desertions, and drug addiction. These
may lead to marriage problems in the here-and-now like distancing, fusion, chronic mistrust, contempt, or triangling in the third
parties. Multigenerational patterns may involve patterns of work,
religion, or political affiliation.17
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4
EXPERIENTIAL FAMILY
COUNSELLING OF VIRGINIA
SATIR AND CARL WHITAKER
It was from the humanistic psychology of the 1960s that an
experiential branch of family counselling emerged. Experiential
counselling emphasized immediate, here-and-now experience. It is
believed that the quality of ongoing experience is both the measure of psychological health and the focus of therapeutic interventions. Feeling-expression is viewed as the medium of shared experience and the means to personal and family fulfilment. When
family counselling was in its infancy, experiential counselling was
most popular. It borrowed its techniques from individual and group
counselling. It drew heavily from Gestalt therapy and encounter
groups. There were other means, which were expressive techniques
such as sculpting, and family drawing, which bore the influence
of the arts and of psychodrama. We should keep in mind that
experiential treatment emphasized sensitivity and feeling-expression. Therefore it was not well suited to family counselling. In
recent times, experiential counselling is not used as much as it was
used earlier. Nonetheless, its emphasis on unblocking honest emotional expression in families is a valuable counterweight to the
reductionistic cognitive emphasis of solution-focused and narrative approaches. Now of course, Susan Johnsons emotionally focused couple therapy is revitalizing the experiential approach of
counselling. 1
1. Theoretical Formulations
For experiential family counsellors, theory is useful only in
the beginning. Later the counsellor should be just himself/herself. What are required are openness and spontaneity not theory
and technique. When one tries to copy the methods of the mentor, one loses spontaneity and creativity. Perhaps we create dis-
48
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Family counsellors usually speak of functional and dysfunctional families, and in the same way, in experiential family counselling they speak of functional and dysfunctional communications. In families we establish a communication pattern. In each
family this can very well be noticed. In a family where there is a
functional communication, the members have their own lives without any invasion from others and also a shared life. It is a kind of
identity and separation. There is a balance between being an individual and being a part of the family. Members of the family
welcome change and view it as an opportunity for growth. There
is thrill and excitement about newness and growth. They keep
themselves flexible and maintain open communication. On the
contrary in dysfunctional communication patterns, there is a lot
of rigidity with no room for flexibility. Stability is valued more
than flexibility and hence any sign of change and growth is looked
down upon. Of course, there is hardly any open communication.
Individuals are not allowed to pursue their own interest and enjoy
their own designs of life but rather they need to conform to the
inflexible rules of the family. Needless to say that they do not
receive any support from the family members, especially the
caregivers. Since there is no genuine autonomy, there is no intimacy either. The family system is purely bound together by rules,
and rules in themselves will not hold for too long any system, and
so the family becomes dysfunctional due to its dysfunctional communication pattern.
Clear communication refers to successful exchange of information between individuals, and in the context of the family among
the members. It allows checking out communication in order to
clarify meaning, and intention. On the contrary, lack of clear communication will mean vague or confusing exchanges of information, and paradoxical communication. Besides there is no room
for checking out meaning.
There are two concepts that describe communications processing theme. They are double bind and paradox. Paradox is
either benevolent or neutral for the person who receives the paradoxical communication. A paradox is a type of interaction between
50
two or more people that makes use of the contrast between contradictory messages at two levels of abstraction in order to alter a
persons behaviour. Double bind is harmful especially in the case
of children. Therefore let us consider in detail what double bind
is. 4
1) Double Bind
A double bind is understood as an outcome from an interaction that is generated through a structured sequence of events and
uses multilevel, conflicting injunctions. It results in a behavioural
change in the recipient, the person to whom the double bind is
directed. It necessarily carries a negative connotation since it disallows alternate responses on the part of the recipient, that are based
on internal perceptions. We effect a double bind through communication process.
At times we receive a double-level message from another person who has not made himself/herself clear to us. When an
individuals words and expressions are disparate, if that person says
one thing and seems to mean another by his/her voice or gestures,
that individual is presenting an incongruent manifestation, and
the person to whom he/she is talking receives a double-level
message. This double-level communication need not lead to symptomatic behaviour. Nevertheless under certain conditions, especially where children are involved, it is known to produce a vicelike situation effect which has been termed the double bind. When
you warmly invite a person for an embrace and keep that person
at a safe distance while embracing, you are giving a double-level
message. On the one hand you ask the person to come closer by
your welcoming and on the other hand by your nonverbal
behaviour you give the message not to come closer.
Now let us see what conditions need to be present for a child
to experience the pressure associated with a double bind. First, the
child must be exposed to double-level messages repeatedly and over
a long period of time. Second, these must come from persons who
have survival significance for the child. Parents are survival figures
for the children since they depend upon them for physical life, for
love and approval. The child learns the techniques for mastering
the environment through the way parents structure their message
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1. I have low self-esteem and believe I am bad because I feel that way,
2. I am fearful about hurting the other persons feelings,
3. I worry about retaliation from the other,
4. I fear rupture of our relationship,
5. I do not want to impose, and
6. I am unconscious of anything but myself and do not attach any
significance to the other person or the interaction itself.
The individual is unaware that he/she is giving double messages in nearly all of these instances. Therefore the listener will be
confronted by two messages and the outcome of the communication will be greatly influenced by his/her response. The possible
responses are that one picks up the words and ignores the rest, or
picks up the nonverbal part and ignores the words, or ignore the
whole message by changing the subject, leaving, or going to sleep,
or comments on the double nature of the message. Unless family
communication leads to realness or a straight, single meaning, it
cannot possibly lead to the truth and love necessary to nourish
family members.
It is good to take a closer look at the four universal patterns
people use to get around the threat of rejection. When we feel and
react to threat, we do not want to reveal our weakness and so we
attempt to conceal it in the following ways: placate, so the other
person does not get mad; blame, so the other person will regard
one as strong (if the person goes away, it will be his/her fault, not
ones own); compute, so that one deals with the threat as though
it were harmless, and ones self-worth hides behind big words and
intellectual concepts; distract, so one ignores the threat, behaving
as though it were not there (maybe if one does this long enough, it
really will go away).
Our bodies portray our feelings of self-worth. When our selfworth is in question, our bodies show it through some form of
physical manifestation. Thus there are four physical stances corresponding to the universal patterns:6
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1) Placating / Placater
The blamer is a fault-finder, a dictator, a boss who acts superior. One does not really feel one is worth anything. So if one can
get someone to obey him/her, then one feels one counts for something. When someone obeys, one feels effective.
54
Whatever the distracter does or says is irrelevant to what anyone else is saying or doing. This particular individual does not
respond to the point. The person is a kind of lopsided top, constantly spinning but never knowing where one is going, and not
realizing it when one gets there. At first this role may appear to be
a relief, but later terrible loneliness and purposelessness will arise.
All of us experience hurt, pain, and stress. Some of us take to
irrelevant behaviour to distract themselves from their hurt, pain
and stress. In some sense, their pain diminishes by their distracting behaviour patterns. In an extreme form, their lives are pulled
in different directions at the same time. They seem to be frightened of stress and so avoid taking a clear position lest they should
offend others.10
5. Treatment Techniques
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The counsellor could ask any one member or all the members of the family to arrange the entire members of the family in a
meaningful tableau. It can be done in various ways such as toys,
drawings, or making use of the real members of the family or
members of a group. This is a graphic means of portraying each
individuals perceptions of the family, in terms of space, posture,
and attitude. It increases awareness in the members of the family
as to how they function and how others view them in the family
system. It is worthwhile that the identified patient does this
family sculpting.12
2) Family Reconstruction
Family reconstruction is a type of psychodrama of reenactment through which clients explore significant events in three
generations of family life. This helps members identify the roots
of their old learning, formulate a more realistic picture of their
parents, and discover their unique personality. Clients could make
use of group members for this purpose. Family maps, family lifefact chronology or wheel of influence (a spatial diagram of all the
significant people in ones life) or some combination of these three
could be used.13
Besides these two, experiential family counsellors could use
drama, reframing, humour, touch, Gestalt therapy and personcentred therapy depending upon the situation.
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5
PSYCHOANALYTIC FAMILY
COUNSELLING
Psychoanalysis had a tremendous influence on every field of
psychotherapy for a long time. Many of the pioneers of family
counselling were trained in psychoanalysis, including Nathan
Ackerman, Ian Alger, Murray Bowen, Lyman Wynne, Theodore
Lidz, Israel Zwerling, Ivan Boszormenyi-Nagy, Carl Whitaker, Don
Jackson, and Salvador Minuchin. But all of them turned towards
systems dynamics. While Jackson and Minuchin moved far away
from psychoanalysis, Bowen, Lidz, and Wynne retained a distinctly
analytic influence in their work.
In the 1980s, family counsellors took a renewed interest in
the psychology of the individual. Gradually there was a revival of
interest in psychoanalytic thinking. It definitely reflected changes
in psychoanalysis moving from the individualism of Freudian
theory to the more relationship-oriented object relations theories
and self psychology.1
1. Sketches of Leading Figures
Freud was interested in the family but he thought that the
family is the context where people learned neurotic fears, rather
than the contemporary context where such fears are maintained.
Later, major advances were achieved in the psychoanalytic understanding of family dynamics by child psychiatrists. They began to
analyse mothers and children concurrently. The result of the concurrent analysis of married couples revealed the family as a group
of interlocking, intrapsychic systems. Erik Erikson explained the
sociological dimensions of ego psychology. In the 1950s and 1960s
one notices that the American Psychoanalysis was dominated by
ego psychology, which focuses on intrapsychic structures. At the
same time, object relations theory, which lends itself to interper-
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For Freud, at the heart of our nature are the drives, which
are sexual and aggressive. When children think that these basic
impulses will lead to punishment, mental conflict arises. Conflict
is usually signalled by unpleasant affect: anxiety or depression.
Anxiety is unpleasure associated with the idea, which is often
unconscious that one will be punished for acting on a particular
wish. Depression is unpleasure plus the idea, which is often
unconscious, that the feared calamity has already occurred. The
balance of conflict can be shifted in any one of the two ways. It
could be by strengthening defences against a conflicted wish or by
relaxing defences sufficiently to permit some gratification.3
2) Self Psychology
58
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There are four psychodynamic techniques, which are, listening, empathy, interpretation, and maintaining analytic neutrality.
Listening is a strenuous but silent activity. In order to establish an
analytic atmosphere it is important to aim at listening and understanding without worrying about making changes or solving problems. Change may come about as a byproduct of understanding.
That is the presupposition of psychodynamic family counselling.
The counsellor suspends all anxious involvement with the outcome. This frame of mind is of great importance in establishing a
climate of analytic exploration. The counsellor resists the temptation to be drawn in to reassure, advise, or confront families in
favour of a sustained but silent immersion in their experience.
Whenever an intervention is made by the counsellor, it is to
express empathic understanding to help family members open up.
The counsellor interprets to clarify the hidden and confusing aspects of the experience.
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Psychoanalytic counsellors function less as detached observers and more as participants in the interpersonal patterns of treatment. Their function is described as participant observation. Thus
psychoanalytic family counsellors organize their explorations along
four channels, namely 1. internal experience, 2. the history of that
experience, 3. how the partner triggers that experience, and 4. how
the context of the session and the counsellors input might contribute to what is going on between the family members.
2) Starting Point
4) Focus
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ality defects. For them family dynamics is more than the additive
sum of individual dynamics. They believe that individuals may
bring impaired object relations to family life, but it is the unconscious fit between family members that determines adjustment.
5) Assessment
Dicks (1967) applied object relations theory to family evaluation and proposed three levels on which to assess the marital relationships: 1. cultural values and norms race, religion, education,
and values, 2. central egos personal norms, conscious judgements
and expectations, habits, and tastes, and 3. unconscious forces that
are repressed or split off, including drives and object-relations needs.
Dicks says that if a couple is in harmony on any two of these three
levels, then they will stay together, but if they are incompatible on
two or more levels, they will probably end in divorce.
6) Focal Hypothesis
Arnon Bentovim and Warren Kinston offer a five-step strategy for formulating a focal hypothesis:
1. How does the family interact around the symptom, and how does
the family interaction affect the symptom?
2. What is the function of the current symptom?
3. What disaster is feared in the family that keeps them from facing
their conflicts more squarely?
4. How is the current situation linked to past trauma?
5. How would the counsellor summarize the focal conflict in a short
memorable statement?
Object relations theory understands marriage as a transaction between hidden, internalised objects. Their marital and
parenting relationships are reflected by these internal objects. Now
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When we consider the nature of psychoanalytic family counselling, it is more active than classical psychoanalysis. All the same,
it remains a nondirective, uncovering technique. The counsellor
interferes minimally and scrutinizes ones responses to eliminate
unessential or leading interventions. This is done with individuals
and with families. For them interpretations are not meant to reassure nor to direct the clients. Interpretations should facilitate the
emergence of new material, forgotten or repressed, and mobilize
the feelings previously avoided. The counsellors even limit the
number of interpretations per session.
Usually sessions are started with the invitation of the counsellor to discuss current experiences, thoughts, and feelings. In the
sessions that follow, the counsellor might begin either by saying
nothing or perhaps saying, Where would you like to begin
today? The counsellor after asking such a question sits back and
lets the family talk, with minimal direction or interference with
the spontaneous flow of their communication. If at all questions
are asked by the counsellor, they are limited to requests for amplification and clarification like Could you tell me more about that?
Have the two of you discussed how you feel about this? This
process will naturally dry up. At that time the counsellor probes
gently, eliciting history, peoples thoughts and feelings, and their
ideas about family members perspectives like What does your
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mother think about your problems? How would she explain them?
This is done to understand assumptions and projections.
It is true that psychoanalytic family counselling is nondirective in nature, but it need not be taken to mean being passive.
When family members speak about what is on their minds, the
counsellor is actively analysing what is being said for deriving their
drives, defences, ego states, and manifestations of transference. The
bare facts from the clients are always ambiguous, but the counsellor organizes them and makes them meaningful. Besides this, the
counsellor pursues the past. The childhood memories and associations to the interactions with parents are probed.
9) Interpretations
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There is a difference in interpreting resistance between individual psychoanalytic counselling and psychoanalytic family counselling. In the former the counsellor will wait until three or four
occurrences take place in order to make an interpretation. For example, a client is late for the session a few times. At the first
instance the counsellor will not attempt to interpret it. But in family counselling it is done at the earliest.
Finally counselling not only fosters insight and understanding but also stimulates the family members to consider what they
are going to do about the problems they discuss. Family members
must first of all be aware of their motivations, and also hold themselves accountable for their behaviour. Counsellors must help clients face the intrinsically destructive expectations involved in
invisible loyalties, and then help them develop a balance of fairness among various family members.
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6
STRUCTURAL FAMILY
COUNSELLING OF SALVADOR
MINUCHIN
Structural family counselling became the most influential
model in the 1970s. Families are collections of individuals who
affect each other in powerful but unpredictable ways. Structural
family counselling attempts to offer a clear framework that brings
order and meaning to the transactions of the members. Since there
are consistent, repetitive, organized, and predictable patterns of
family behaviour, we are inclined to think of a structure, though it
is only in a functional sense. There are concepts like boundaries
and coalitions, which are in themselves abstractions, but they are
helpful for counsellors to intervene in a systematic and organized
way in family counselling.
Structural family counselling approaches the human person
in his/her social context. It is one of the many responses to the
concept of human person as part of his/her environment. The
mind is viewed as extracerebral as well as intracerebral. Therefore
pathology may be inside the client, in his/her social context, or in
the feedbacks between them. Counselling designed from this perspective rests on three axioms:
1. An individuals psychic life is not entirely an internal process.
One influences his/her context and is influenced by it in constantly recurring sequences of interaction. The individual living
within a family is a member of a social system to which he/she
must adapt.
2. Changes in a family structure contribute to changes in the
behaviour and the inner psychic processes of the members of
that system.
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1. Theoretical formulations
The theoretical foundation of structural family counselling
rests on the belief that the whole and the parts can be properly
explained only in terms of the relations that exist between the
parts. It focuses on the link that connects one part to another.
Human social phenomena are considered expressions of these linkages. Therefore all human products, whether they are behavioural,
linguistic, institutional or material, essentially communicate a
social relation.
Structuralism attempts to identify the codes that regulate the
human relationship. It also presupposes that there is in man an
innate, genetically transmitted and determined mechanism that
acts as a structuring force. Structures are inseparable from performance. The structures we see in society emanate from human reason and reflect the structure of the human mind.
There are dominant structures and subordinate structures.
The dominant structures are those upon which most of our family operations are based. The subordinate structures are those which
are less frequently called upon. The structural dimensions of transactions often identified in structural family counselling are boundary, alignment, and power (or force). Each and every unit of transaction contains all three of these structural dimensions.
Boundaries of a subsystem are the rules defining who participates, and how. These rules dictate who is in and who is out of an
operation, and define the roles those who are in will have vis--vis
each other and the world outside in carrying out that activity.
Alignment is the joining or opposition of one member of a system to another in carrying out an operation. This dimension includes the concepts of coalition and alliance. Coalition is a process
of joint action against a third person in contrast to an alliance
where two people might share a common interest not shared by
the third person. Power is the relative influence of each family
member on the outcome of an activity. In a unit of operation,
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Family structure is a set of covert rules that govern transactions in the family. It is shaped partly by universal and partly by
idiosyncratic constraints. It is the organized pattern in which family members interact. It is a deterministic concept, but it prescribes
or legislates behaviour. It describes predictable sequences. When
family transactions are repeated, they foster expectations that
establish enduring patterns. It is seen that once the patterns are
established, members use only a small fraction of the full range of
behaviour that is available to them. It is like something as follows,
regarding who has to do what: It starts questioning who is going
to do. Then it is followed by the answer so and so will probably
do. Later so and so will always do becomes a structure.
Family structure is known as the invisible set of functional
demands that organizes the ways in which family members interact. A family is viewed as a system that operates through transactional patterns. So repeated transactions establish the patterns of
how, when, and to whom to relate, and these patterns underpin
the system. It is the transactional patterns that regulate the
behaviour of the family members. They are maintained by two
systems of constraint: 1. generic, and 2. idiosyncratic. The generic
system of constraint involves the universal rules governing family
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70
3) Boundaries
Associated with
Representation
Rigid Boundary
Disengagement
_____________________
Clear Boundary
Normal Range
- - - - - - - - - - ---- - - - - - - - -
Diffuse Boundary
Enmeshment
.....................
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4. Treatment Techniques
Structural family counselling is a counselling of action. It
aims to modify the present, not to explore and interpret the past.
Here the assumption is that since the past was instrumental in the
creation of the familys present organization and functioning, it is
manifest in the present too and will be available to change by
interventions that change the present. Therefore the target of
intervention in the present is the family system. The counsellor
joins that system and uses himself/herself to transform it. The
counsellor changes the position of the members of the system and
thus change is brought about in the subjective experiences of the
members. To do this, the counsellor relies on some of the properties of the family system. They are:
1. A transformation in its structure will produce at least one possibility for further change.
2. The family system is organized around the support, regulation,
nurturance, and socialization of its members. Therefore, the counsellor joins the family not to educate or socialize it, but to repair
or modify the familys own functioning so that it can better perform these tasks.
3. The family system has self-perpetuating properties. So, the processes that the counsellor initiates within the family system will
be maintained in his/her absence by the familys self-regulating
mechanisms. 11
Structural family counsellors make use of the seven following steps to deal with couples and families:
1) Joining and Accommodating
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Every family that comes for counselling has its own established homeostatic patterns. Nobody likes to be disturbed in the
established homeostasis. A counsellor is an outsider who introduces himself/herself into the family system and disturbs the homeostasis. Because family members may consider the entry of the
counsellor as an intrusion, they might resist the presence and
intervention of the counsellor. The family members outnumber
the counsellor. In such a situation, the counsellor needs to disarm
their defences and ease their anxiety by conveying understanding
and acceptance to every single member. Greeting each person by
name and making some friendly contact is good initially. It is good
to accept the hierarchical structure and organization of the family.
This will mean allowing the parents to present the problem and
then of course not ignoring the children; ask them to tell their
version of the problem. The counsellor need not force a silent
member to speak up. He/she could wait until the silent member
feels comfortable to speak up. However, acknowledging and inviting the silent member to become involved and speak up when
opportune should be extended. As a practical step, the counsellor
could greet the family in a friendly way and ask for each persons
view of the problem. This should be followed by careful listening
and reflecting the content and feeling (what the counsellor hears
and experiences).
For the sake of transforming the family system, the counsellor has to intervene so as to unbalance the system. Whenever it is
done, it should indicate that you the counsellor have no preference and act in a way that is consonant with truth and justice.
When unbalancing occurs by the coalition of the counsellor with
any one member of the family, the other members experience stress
and so they may insist on system maintenance. But the counsellor
should make the members move towards the therapeutic goal while
enduring the uncertainties of the transitional period. The counsellor can facilitate this process by his/her understanding, support,
and confirmation of the family members experiences and felt
needs.12
2) Working with Interaction
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It would not be surprising to note that family members conceive of problems as located in the identified patient and as determined by events from the past. This is done so that the counsellor
may not disturb the family homeostasis. But family counsellors
need to regard the identified patients symptoms as an expression
of dysfunctional transactional patterns affecting the whole family.
First of all, a structural diagnosis broadens the problem beyond
the individual(s) to family system. Secondly, it moves the focus
from discrete events in the past to ongoing transactions in the
present. The goal is to transform the family in a way that it benefits all of its members. Humans can get used to any situation.
What we initially saw as pathological may become a normal course
of action in our own eyes as the days pass by. This happens because in family counselling the counsellor is slowly inducted into
the family dynamics. Therefore he/she is not able to perceive the
problem areas as clearly as he/she saw them at the beginning.
Therefore it is good to take note of the first impressions and assessments made by the counsellor, which can later be edited. Otherwise the counsellor may become blind to the obvious facts of the
dynamics of the family. It is good to take into account both the
problem the family presents and the structural dynamics they display.
What is meant by diagnosing is the working hypothesis that
the counsellor evolves from his/her experiences and observations
upon joining the family. It involves the counsellors accommodation to the family to form a therapeutic system, followed by his/
her assessment of his/her experiences of the familys interaction
in the present.
The counsellor focuses on six major areas in assessing the
familys interactions.
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1. The counsellor considers the family structure, its preferred transactional patterns and the alternatives available.
2. The counsellor evaluates the systems flexibility and its capacity
for elaboration and restructuring, as revealed by the reshuffling
of the systems alliances, coalitions, and subsystems in response
to the changing circumstances.
3. The counsellor examines the family systems resonance, its sensitivity to the individual members actions.
4. The counsellor reviews the family life-context, analysing the
sources of support and stress in the familys ecology.
5. The counsellor examines the familys developmental stage and
its performance of the tasks appropriate to that stage.
6. The counsellor explores ways in which the identified patients
symptoms are used for the maintenance of the familys preferred
transactional patterns.14
4) Highlighting and Modifying Interactions
Naturally when families begin to interact, problematic transactions emerge. It is good to focus on process, not on content.
Therefore let the counsellor look for who says what to whom and
in what way. For example, when one of the members complains
about another member, the counsellor could ask the other member to respond to the statement. Families do respond to intense
messages. Intensity comes from being clear about the goal. Intensity can be achieved by selective regulation of affect, repetition,
and duration. To raise the affective intensity of statements, tone,
volume, pacing, and choice of words can be used. Intensity can
also be achieved by extending the duration of a sequence beyond
the point where the dysfunctional homeostasis is reinstated. For
example, a teenager wanting to go out at night after 10 p.m. may
create a scene so that his/her parents may allow him/her. If only
the parents were to maintain their position without yielding, the
teenager may not in future resort to the tactics he/she customarily
uses. At times, intensity may require repetition of one theme in a
variety of contexts. For example, infantilising parents (who do
things for their children the things which they themselves can do)
could be told not to do so.
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By shaping competence, the counsellor can modify interactions. Intensity is used to block the stream of interactions, but
shaping competence is like altering the direction of the flow by
highlighting and shaping the positive. Instead of dwelling on the
mistakes, the counsellor could concentrate on the right things that
the members do. The counsellor needs to keep in mind that he/
she need not do things that the clients can do for themselves.15
5) Boundary Making/Marking Boundaries
The aim of unbalancing is to change the relationship of members within a subsystem. It happens when families are stuck in a
stalemate in conflicts. The members check and balance each other
and as a result remain frozen in inaction. Evidently in unbalanc-
80
ing, the counsellor joins and supports any one individual or subsystem at the expense of others. Unbalancing is not done in a bid
to prove who is right or wrong, but to unfreeze and realign the
system. Ultimately balance and fairness are achieved since the counsellor takes sides in turn with various members of the family.
Escalating stress is one of the most radical strategies in the
restructuring repertoire. Stress need not be taken as dysfunctional
in the family system. On the contrary it can be used to demonstrate differences or to challenge a family system that is not functioning properly. To do this, the counsellor allies himself/herself
with one member of the family to precipitate a crisis during the
family session.17
7) Challenging the Familys Assumptions
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7
COGNITIVE-BEHAVIOURAL
FAMILY COUNSELLING
Behavioural family counsellors started out using the learning theory techniques. These techniques were used to treat individuals and applied to the problems encountered by families. This
has grown to such a state that it has developed a variety of powerful, pragmatic techniques that it administers to a variety of family
problems. Its main emphasis is on parent training, behavioural
couples therapy, and treatment of sexual dysfunctions.
The origin of behaviour family counselling is from the classical and operant conditioning. At the outset, the target behaviour
is precisely specified in operational terms. Then operant conditioning, classical conditioning, social learning theory, and cognitive strategies are used to produce change in the target behaviour.
Gradually behavioural counsellors began to address such traditionally nonbehavioural concerns as the therapeutic alliance, the need
for empathy, the problem of resistance, communication, and problem-solving skills. At all times they are distinguished by their
directive approach. They are known for their assessment and evaluation. In behavioural counselling, analysis of behavioural sequences
prior to treatment, assessment of counselling in progress, and evaluation of final results are made. Since behavioural counselling believes that behaviour is determined more by its consequences than
its antecedents, counsellors are explicit and direct.1
1. Sketches of Leading Figures
Behaviour counselling originates from the laboratory investigations of Ivan Pavlov, the Russian physiologist whose work on
conditioned reflexes led to the development of classical conditioning. When we analyse classical conditioning, we find that an
unconditioned stimulus (UCS), such as food, which leads to a re-
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Patterson developed methods for sampling periods of family interaction in the home. Liberman used the operant learning framework to family problems. Stuart transferred the operant principles
used to modify childrens behaviour to the couples in distress. He
applied a reciprocal reinforcement paradigm in which couples
learned to
1. List the behaviour they desired from each other,
2. Record the frequency with which the spouse displayed the
desired behaviour, and
3. Specify exchanges for the desired behaviour.
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1) Responses
Responses are understood as respondent or operant. Respondents are those that are under the control of eliciting stimuli, and
their consequences do not usually affect their frequency of occurrence. Operants are those behaviours that are not automatically
elicited by some stimulus, but whose occurrence is affected by
their consequences. From what we have said, it is clear that operants are causes while respondents are effects. It is a linear viewpoint but when we think in terms of circular causal chains of systems, the distinction between these two responses is not useful.
There are some responses, which may not be recognized as operants (something done to get something) just because we are not
aware of the reinforcing payoffs. For example, temper tantrum is
usually reinforced by attention. Even though the attention may be
unpleasant (like yelling), it may be the most social interaction that
the child receives. Therefore, responses are often maintained under conditions that are counterintuitive.4
Responses
2) Reinforcements
86
to sit in the corner or being asked not to go out for a week. Negative reinforcement and punishment are often confused but they
have distinctly different meanings. Reinforcement and punishment
can be either primary or secondary. Primary reinforcers are natural or biological outcomes, including sex and food. Primary punishments are physical pain or loud noises. Secondary reinforcers
are those that have acquired a positive meaning through social learning, like praise or eye contact. Secondary punishments are criticism or withdrawal of attention. Attention as such has a very powerful influence on behaviour. Therefore focusing attention on
undesirable behaviour often provides unintended social reinforcement.
1. Positive (Positive or rewarding
consequences)
2. Negative (aversive consequences
terminated by a response)
1. Reinforcers
(Consequences
1. Primary (Natural biological
accelerate
outcomes, including sex and food)
behaviour)
2. Secondary (The ones that have
acquired a positive meaning
Reinforcements
through social learning, like praise
(Consequences
or eye contact)
that affect the
1. Aversive Control (e.g., yelling or
rate of
spanking)
behaviour)
2. Withdrawal of Positive Conse2. Punishers
quences (Having to sit in the corner or being grounded for a week)
(Consequences
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causes them so much pain. The reason does not reside in a motive
for suffering, but in the simple fact that people often inadvertently reinforce precisely those responses that cause them the most
distress.
It is likely that punishment will produce the opposite effect
from what is intended. For misbehaviour if you use punishment
even by shouting, that is an attention, which reinforces the
behaviour. To get that attention one may misbehave. Attention is
an extremely powerful social reinforcer. Parents, who respond to
problem behaviour in their children by scolding and lecturing,
though looking like punishment, may in fact be reinforcing
because of the attention the child gets. Ignoring is one of the best
ways in such situations. When we ignore some misbehaviour, we
need to do it consistently; otherwise things will become worse
since intermittent reinforcement is the most resistant to extinction. Punishment should be effective. If you make threats, you
should follow through. Punishment should neither be that mild
that it is not effective, and nor so severe to cause fear and anxiety,
instead of discriminative learning.
Behavioural family counsellors have identified a number of
defective patterns of reinforcement in cases of marital discord. Azin,
Naster, and Jones give us eight causes of marital discord:
1. Receiving too little reinforcement from the marriage.
2. Too few needs given marital reinforcement.
3. Marital reinforcement no longer provides satisfaction.
4. New behaviours are not reinforced.
5. One spouse gives more reinforcement than he or she receives.
6. Marriage interferes with the extramarital sources of satisfaction.
7. The communication about potential source of satisfaction is not
adequate.
8. Aversive control predominates over positive reinforcement.
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nagging, crying, withdrawing, or threatening. These things usually alienate each other. But on the contrary, if they learn to shape
positive alternatives, it will enhance their marriage. One notices
in distressed marriages, there are less of rewarding exchanges and
more of punishing exchanges verbal and instrumental. What
happens in such situations is that spouses typically reciprocate their
partners use of punishment, and this creates a vicious circle. Whenever there is a failure to exchange benefits, the reward system shifts
from positive to aversive control. Couples in distressed families
may have poor problem-solving skills like changing the subject
while discussing important issues, phrasing wishes and compliments in vague and critical ways, and responding to complaints
with countercomplaints. 6
4. Treatment Techniques
Behavioural family counselling is used mainly for parent training, couples counselling, family counselling, and treatment of sexual
dysfunction. We shall deal with these three separately.
1) Behavioural Parent Training
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their own behaviour before they are put into time-out. Parents
could also use verbal reprimand, ignoring, and isolation. But simply repeating commands to the child is the most ineffective way to
change its behaviour.
Counsellors could observe parent and child interaction
behind a one-way glass screen in the clinic. In this method, parents can be taught how to play and discipline their children. This
is useful in dealing with small children and preadolescents. But
with teenagers it is better to use contingency contracting. In this
technique, everybody in the family gets something by making compromises. Both parents and teenager are asked to specify what
behaviour they would like the other to change. In this there should
be a clear communication of content and feelings and clear presentation of demands leading to negotiation with each person
receiving something in exchange for some concession. It is always
good to start with easy issues.7
2) Behavioural Couples Counselling
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behavioural descriptions, rather than in vague and critical complaints. 2. They are taught new behaviour exchange procedures
emphasizing positive, in place of aversive, control. 3. They are
helped to improve their communication. 4. They are encouraged
to establish clear and effective means of sharing power and making decisions, and 5. They are taught strategies for solving future
problems, as a means of maintaining and extending gains initiated
in therapy.
Stuart used the operant method of exchanging token as
rewards for targeted desired behaviours. Later refinements of this
approach dispensed with tokens, but mutual exchanges were based
on written contracts. His contingency contracting and principles
of enhancing the mutual positive reinforcement potential of family members have been used widely by behavioural family counsellors. Couples were asked to express their wishes and annoyances
specifically and behaviourally. One way of doing this is to ask
each spouse to list three things that he/she would like the other to
do often. A variant of this method is that each partner thinks of
things the other might want and do to see the results. Yet another
method is to celebrate love days during which each one doubles
his/her pleasing behaviours towards the other. This could be also
called caring days. It will become evident to notice that these
procedures are meant to help couples establish reinforcement reciprocity, based on rewarding behaviour, in place of coercion. Of
course we may agree that positive control is more pleasant and
effective than aversive control. Partners need to say what they want
than expect the other to intuit it. Research has proved that
disagreement and angry exchanges may not be harmful in the long
run. May be it means dissatisfaction at the present but later they
may get on well with each other. On the contrary defensiveness,
stubbornness, and withdrawal from conflict leads to long-term
deterioration in marriages.
Group format is the ideal setting for training in communications skills. It may involve instruction, modelling, role-playing,
structured exercises, behavioural rehearsal, and feedback. Couples
can be specific, express requests in positive terms, respond directly
to criticism instead of cross-complain, talk about the present and
future rather than the past, listen without interruption, minimize
punitive statements, and eliminate questions that sound like declarations.8
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mental feedback are in constant reciprocal interaction among themselves and sometimes serve to maintain the dysfunction of the family unit. The fact that members of a family simultaneously influence and are influenced by each other is shared by the cognitivebehavioural approach and the systems theory. Thus, the behaviour,
cognitions, and emotions in the other members elicit reactive cognitions, behaviour, and emotions in the original member. In this
process, the family dynamics escalates, rendering the family vulnerable to negative spirals of conflict. There are four means identified by which family members cognitions, behaviour, and emotions may interact and build to a volatile climax. They are: 1. The
individuals own cognitions, behaviour, and emotion regarding the
family interaction, 2. The actions of individual family members
toward him or her, 3. The combined (and not always consistent)
reactions several family members have toward him or her, and 4.
The characteristics of the relationships among other family members. These serve as stimuli during the family interactions and often become ingrained in family patterns and permanent styles of
interaction.
Aaron Becks method is called cognitive therapy (CT), which
places a heavy emphasis on schema or core beliefs. Just like individuals have their own schemata, family members too have their
own joint beliefs about their family, which is called family schemata. These family schemata are the jointly held beliefs about
the family formed as a result of years of integrated interaction
among the members of the family unit. We are supposed to have
two separate sets of schemata about families: one is related to our
parents family of origin, and the other is related to families in
general. In any case both types have a major impact on how we
think, feel and behave within the family setting. The family of
origin of each partner in a relationship plays a crucial role in the
shaping of the immediate family schema. It is hoped that the beliefs, whether conscious or unconscious, passed down from the
family of origin contribute to a joint or blended schema that leads
to the development of the current family schema.9
Cognitive-behaviour family counselling is in its infancy and
needs a lot more research. All the same it is recognized as a major
theoretical approach.
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10
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and helping clients identify and stop the negative thoughts that
interfere with sexual desire. In arousal disorders, there are decreased
emotional arousal and difficulty achieving and maintaining an erection, or dilating and lubricating. Clients with such problems are
helped with a combination of relaxation techniques, and teaching
couples to focus on physical sensations involved in touching and
caressing, instead of worrying about what comes next. In orgasm
disorders, what is involved is the timing of orgasm (e.g., premature
or delayed), the quality of the orgasm, or the requirements for
orgasm (e.g., some people only have orgasm during masturbation).
Premature ejaculation and lack of orgasm may respond to sex
therapy. In the latter case, the woman can be taught to practice on
her own and learn to fantasize.
(2) Insight and Attitude Change
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later let the partner know which touch is most pleasing and which
is less so. At the beginning they are to avoid touching the sensitive
parts like breasts or genital areas in order to avoid undue anxiety.
After this, the couple is asked to become more intimate gradually
but should slow down if any one of them becomes anxious. When
anxiety drops, desire may mount and this is the time when the
couple needs to engage in progressively more intimate exchanges.
During this time the couple is asked to communicate what they
like and what not. Besides, it is good to say what type of stroke or
touch each one likes. Instead of enduring an unpleasant touch until
one explodes with anger, it is good to communicate to the partner
at the very beginning in a very gentle manner. The couple is taught
not only to communicate when they want sex but also when they
do not want sex.
(4) Tailored Techniques
After the sensate focus exercise, the couple is introduced to
specific techniques tailored to their problems. For women, the most
common problem is orgasm. This problem seems to be rooted in
lack of information. One may expect the woman to have orgasm
during intercourse without additional clitoral stimulation. For men,
the most common problem seems to be premature ejaculation for
which the squeeze technique is used. In the squeeze technique, the
woman stimulates the penis of the man until he feels the urge to
ejaculate. At that time, the woman squeezes the fraenulum (at the
base of the head) firmly between her thumb and first two fingers
until the urge to ejaculate subsides. After a while stimulation can
be resumed and then followed by another squeeze. For erectile
failure, the counsellor counsels the man how to reduce the performance anxiety and increase sexual arousal. Usually desensitisation
of the mans anxiety is undertaken. There could be discussions in
which the partners describe their expectations. They could increase
the variety and duration of foreplay. There is also the teasing technique, in which the woman alternately starts and stops stimulating the man. The couple could also start intercourse with the
woman guiding the mans flaccid penis into her vagina.
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8
STRATEGIC FAMILY
COUNSELLING OF JAY HALEY
AND CLO MADANES
1. Sketches of Leading Figures
The prominent proponents in the strategic family counselling model are Jay Haley and Clo Madanes. Theirs is called communication therapies. In strategic counselling, the counsellor initiates what happens during treatment and designs a particular
approach for each problem. In this model the counsellor takes the
initiative and responsibility for directly influencing family members. The counsellors intention is to have some influence, however temporary it could be, in order to bring about beneficial
change. The main concern of the counsellor is about the theory
and means for inducing change. The prominent figures besides Jay
Haley and Clo Madanes are Milton Erickson, the Mental Research Institute (MRI) group (including John Weakland, Paul
Watzlawick, Richard Fisch, Arthur Bodin, and Carlos Sluzki),
Gerald Zuk, Lynn Hoffman, Mara Palazzoli-Selvini and associates
in Milan, Italy, and Richard Rabkin. Let us now consider the commonalities among the major strategic approaches represented by
the above groups. We specially give attention to the general principles that apply to most of them.1
2. The Basic Beliefs
Strategic family counselling operates with the beliefs that 1.
counselling should be brief, 2. people are not pathological, and 3.
clients can change rapidly. The strategic school applied Gregory
Batesons ideas directly to family treatment, resulting in a set of
creative ways to generate change, and outwit the resistance, in families seen as cybernetic systems. In the 1970s and early 1980s, strategic methods were amply used but later in the 1990s the strategic
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family counselling method seen as therapist-as-expert-manipulator was rejected in favour of therapist-as-collaborator. All the
same this approach contains the elements of sophisticated understanding of family complexities and powerful techniques. They
are useful in family counselling.2
3. The Interest in Changing Behaviour
The strategic counsellors were more interested in changing
behaviour than in understanding them. Therefore one will find
more literature on techniques than on theories. They are ever
active in designing novel strategies for solving problems. In a way
they are pragmatic. The one who influenced the thinking of strategic counsellors is Milton Erickson. Milton Erickson was not in
agreement with what was the psychiatric tradition of his time.
Psychoanalysts were not concerned about the symptoms since they
believed that symptoms only represented the tip of the intrapsychic iceberg. But Erickson was symptom- or problem-focused.
Unlike psychoanalysis, Erickson found the unconscious mind a
source of wisdom and creativity. Therefore, if unfettered by conscious inhibition, it could solve problems and heal symptoms. So
he did not advocate the traditional attempts to foster insight through
interpretation. He was of the opinion that deep down the clients
knew what to do. Perhaps, he thought, the clients did not have
access to that wisdom. Therefore he proposed that one way to get
access was to break out of habitual patterns of behaviour and thinking. For that he developed a number of clever ways of getting people
to simply do something different in the context of the old
behaviour, or to do the old behaviour in a new context.
Erickson, because of his association with hypnosis, was convinced that clients could change quickly and so he made therapies
as brief as possible. If there were any failure, he would not attribute it to resistance but would find ways to bypass or use resistance. By using hypnotic techniques, he applied paradoxical techniques. For example, to induce trance, he would ask the client to
keep the eyes open until they become unbearably heavy instead of
telling them straight away to close the eyes. Thus rapid change and
utilization of resistance became the cornerstones of strategic family counselling. Added to that, the cybernetic concepts of Bateson
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things they have been doing, they are just obeying the counsellor,
which means that the members give undue power to the counsellor. Thus the counsellor can make the symptom occur at his/her
bidding. If the members resist the paradoxical instructions, they
are moving towards improvement, which in the long run amounts
to doing the bidding of the counsellor. Certainly there is going to
be confusion as to how to resist ? which leads to new patterns and
perceptions, and thus to change. This leads to a certain amount of
detachment from the disturbing behaviour. Thus, a directive, which
appears on the surface to be in opposition to the goals being sought,
serves to move toward them. Here one can see the principle clearly
that if you can turn the symptom on when you try, you will be
able to control it, instead of it controlling you.
actively said that they may not need frequent counselling, that
impelled the couple seek counselling quite frequently.
Strategic family counsellors divide the strategies of paradoxical intervention into three types: prescribing, restraining and positioning.
(3) Positioning
In this strategy, the counsellor attempts to shift a problematic position by accepting and exaggerating that position. This
intervention is used when the patients position is (assessed to be)
maintained by a complementary or opposite response by others.
For example, when a clients helplessness is reinforced or maintained by an encouraging response from the significant others, the
counsellor may outdo the clients helplessness by defining the situation as even more dismal than the client had originally held it to
be.
2) Positive Interpretation
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Interpreting the problem and reframing are one and the same.
When the counsellor gives a new meaning to a behaviour pattern,
the client may evolve a new behaviour pattern in order to fit the
counsellors new interpretation. Thus, reframing has helped the
client to change his/her behaviour. For example, when the
overinvolvement of the mother is interpreted by the counsellor as
concern for the child, the mother might change her behaviour
into one of concern rather than maintain it as overinvolvement.12
5) The Ordeal Therapy
The ordeal therapy is meant to facilitate bonding among family members by rituals of penance and absolution. Any
misbehaviour on the part of any individual in the family that has
seriously affected other members of the family needs to be dealt
with. The concerned person is asked to apologize to, or ask pardon of, the other members of the family. This helps restore dignity and love among the members.13
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9
CURRENT STATUS OF
FAMILY COUNSELLING
Unlike other branches of psychology, family counselling had
a wide variety of leaders and theorists and drew followers from
many backgrounds. The systems-oriented family therapy models
had differentiated from each other. Boundaries around each model
tended to be rigid. But the family that each of these models was
trying to understand was not well differentiated. Most of them
were addressing two-parent nuclear family systems. No consideration was given to ethnicity, class, race, or sexual orientation, or to
family variation such as single-parent families, foster families, or
stepfamilies. Family counsellors were experts who would overcome
families homeostatic tendencies and reorganize their structure or
convert them to a better way to view their problems. Since they
were focusing their attention on systemic issues, they lost sight of
the personal experience of individual family members and viewed
their expression of feelings as distraction from the main issue, which
is systemic. This period could be placed between1960 and 1970.1
1. Erosion of Boundaries
Rigidity to hold on to a model or approach, gradually, gave
in and the boundaries between the discrete schools within the field
have largely melted. Now counsellors borrow liberally from a
variety of approaches, even models which cannot be classified as
family counselling. Gone are the days when counsellors thought
themselves to be experts, confident of fixing families. Now they
are inclined to consider themselves more as facilitators or partners
hoping to awaken the inherent resources in the members of the
family. The resources are found both within the family structures
and social forces in which they are embedded.2
2. Postmodernism
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It was in the 1980s that an era of scepticism and reexamination had started. Established truths were challenged. It was a reaction to modernism, which began around the turn of the century
as an optimistic, pragmatic replacement for romanticism, which
held that there were unseen, unknowable forces at work in the
world. According to modernism the truth of things could be uncovered through objective scientific observation and measurement.
Besides, it considered that the universe was conceived of as a machine whose laws of operation were waiting to be discovered. Thus
modernism was interested in large-scale theories (grand narratives)
that could explain human behaviour. If universal laws were discovered, we could control its environment, and the problems could
be solved. This thinking influenced family counselling too. Family counsellors were considered technical experts who could diagram and diagnose the functional from the dysfunctional family
systems. But postmodernism was a reaction to this modernist thinking. One quickly realized that there is no absolute truth and ones
truth may be as good as someone elses truth. Authority was questioned; faith was lost in the absolute validity of the scientific, political, and religious truths. One began to doubt whether absolute
truth could be known at all. Scepticism has been gradually building up. Einsteins theory of relativity challenged the solid certainties of Newtonian physics. Marx challenged the right of any one
class over another. The feminists challenged patriarchal dominance.3
3. Constructivism
According to postmodernism there are no realities, only
points of view. From this view emerged an interest in how the
narratives that organize peoples lives are generated. Postmodernism
concerns itself with how people make meaning in their lives and
how they construct reality. Thus we have constructivism, which
took hold of family counselling in the early 1980s. For
constructivism, reality does not exist as a world out there but instead is a mental construction of the observer. When this view is
applied to family counselling, it will mean that counsellors should
not consider what they are seeing in families as existing in the
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families. What they see is the product of their own particular set
of assumptions about people, families, and problems, and their
interactions with the family. The implications of constructivism
are a note of humility on the part of the counsellor. The theory
with which the counsellor approaches is not the most accurate
reflection of reality, but only one of the many potentially useful
stories about people. Counsellors bring their stories in the form of
theories, and clients bring their own stories, which may be more
or less useful than the counsellors but no more or no less true.4
4. Collaborative, Conversational Approaches
Constructivist philosophy was translated into a collaborative
approach in the 1980s and 1990s. It was a process of democratisation
of the traditional counsellor-client hierarchy by persons like
Harlene Anderson, Harry Goolishian, Lynn Hoffman, and Tom
Andersen. They were united in their opposition to the cybernetic
model and its mechanistic implications. They are the
postmodernists who focused more on caring than curing. They
advocated that instead of trying to manipulate language, one should
hold empathic conversations from which emerge new meanings.
In this model, the counsellor moves out of the expert-in-charge
position to form a more egalitarian partnership with the clients.
Theirs is more of an attitude or philosophy than a particular
method. They have the conviction that too often the clients are
not heard because the counsellors are doing counselling to them
rather than with them. For the collaborative family counsellors,
questions are important. Conversational questions come from a
position of not knowing and are the counsellors primary tool. In
counselling, conversational questions are not generated by technique, method or a preset template of question. We can say that
each question comes from an honest, continuous therapeutic posture of not understanding too quickly, of not knowing. Since there
is no formula about the language-based, collaborative approach, it
is difficult to describe it. The counsellor reflects, empathizes, and
offers a positive reframe here and there. In other words, the counsellor gives clients the feeling that their story has been heard and
helps them hear each others stories.
The collaborative approaches did not constitute a new school
of family counselling, since they were a manifestation of a new
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way of thinking about how to understand people. This new collaborative perspective was heavily influenced by an approach to
knowledge that emerged from the Biblical studies called hermeneutics, which comes from the Greek word for interpretation.5
5. The Hermeneutic Tradition
According to hermeneutics, understanding experience, including ones own, is never simply a process of seeing it, grasping it, or
decoding it. Our experience is fundamentally ambiguous. Fragments of experience without determinate meaning are understood
only through a process that organizes them, selects what is salient,
and assigns meaning and significance. Though there is nothing
democratic about hermeneutic exegesis, it challenged the therapeutic authoritarianism. The hermeneutic tradition seemed a perfect partner to efforts to make counselling a more collaborative
enterprise. When two people converse on their own beliefs, they
may both walk away feeling understood and with some new perspectives on ones own and the others beliefs. When this is translated into clinical practice, the collaborative counsellor is forever
setting aside presumptions and assessments in order to sincerely
understand the clients world. 6
6. Social Constructionism
We have already seen how constructivism focuses on how
individuals create their own realities. We also know that family
counselling has always emphasized the power of interaction. Combining these aspects, another postmodern psychology called social constructionism arose. Its main proponent is a social psychologist Kenneth Gergen who emphasized the power of social interaction in generating meaning for people. From the point of view of
social constructionism, not only are we unable to perceive an objective reality, but the realities we do construct are anchored in the
language systems in which we exist. Gergen did not accept the
notion that we are autonomous individuals, holding independent
beliefs, and implies instead that our beliefs are highly plastic, changing radically with changes in our social context. He argues that
the sense of what is real and what is good emerges from relationships. For him, people do not have innate resources that the counsellors can draw out. He says that people are like sponges,
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internalising the conversations around them. People are not affected by early childhood experiences. Their personalities can be
reconstituted rapidly once situated in a new conversational environment. Since we have a sponge-like self, we can become easily
overwhelmed by the many messages with which we are bombarded
on a daily basis. We lack a sense of coherence and feel torn in
many directions, a condition that produces incoherent and disconnected relationships.
Its clinical implication is in line with postmodern scepticism.
It suggests that since everyones thinking is governed by his or her
social environment, no one has the monopoly of the truth. All
truths are merely social constructions. First of all, this idea invites
counsellors to help clients understand the cultural roots of their
beliefs. Secondly, it suggests that if counsellors can lead clients to
new constructions about their problem, the problems open up.
One is viewed as a participant in multiple relationships. A problem is a problem because of the way it is constructed in certain of
these relations. Thirdly, it suggests that counselling has to be collaborative. Neither the counsellor not the client brings the truth
to the table. New realities emerge through conversations where
both sides share opinions and respect the other persons perspective. Fourthly, since clients are so thoroughly influenced by their
current relationships that, once the counsellor succeeds in becoming significant to the client and in co-creating new, more useful
constructions about the problem, the counselling is basically complete. Therefore the counselling can be quite brief.7
7. Narrative Revolution
There were some family counsellors who were trying to shift
the fields focus from changing the action to changing the meaning. They warmly welcomed social constructionism. They believed
that the counsellors job was to co-create new realities with families, and not to direct or advise them. Thus came into existence
narrative counselling. Narrative counsellors follow Gergen in
considering the self a socially constructed phenomenon. Our sense
of self is thought to emerge when interpersonal conversations are
internalised as inner conversations. These conversations are then
organized into stories by which one understands ones experience.
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All of us have points of view and their effects. It is not the question of truth but of which points of view are useful and which
lead to preferred effects for clients. For narrative counsellors, the
problems are not in persons as psychoanalysis holds it, or in relationships as family systems theory holds it, but rather the problems are embedded in the points of view about individuals and
their situations. Therefore narrative counselling is a process of
helping the clients reexamine the stories they live by. The selfhate, pessimisms, and passivity that disempower many clients would
be related to having internalised toxic cultural narratives regarding
their worth. Narrative counselling highlights the impact of patriarchy, heterosexism, racism, social class, and materialism on the
family members self-concepts. Therefore the goal of narrative
counselling is to expose these internalised narratives so they can
be replaced with more empowering life stories.8
8. Solution-Focused Therapy
Steve de Shazer and his colleagues took up the concepts of
constructivism and social constructionism to more pragmatic
direction. Thus we have the emergence of solution-focused counselling. They argued that if a clients reality is merely a social construct that is a product of language, then the goal of counselling is
simply to change the way the client languages the problem. They
believed that once the problem is described differently, it disappears, since it only existed in the way the client talked about it.
Here it is easy to note that language is reality. Solution-focused
counsellors are not interested in identifying and debunking the
internalised cultural narratives. What they aim at is to get the clients to shift from dwelling on their problems to identifying solutions. Perhaps they already have solutions but they are not using
them. Whatever solution the families come up with are fine as
long as the solutions are satisfying to the family members.
Solution-focused counsellors were assisting clients to shift
from problem talk (trying to understand or analyse their problems) to solution talk (focusing on what is working or could work
in the future) as quickly as possible. The fact that one focuses
ones attention on solution, it eliminates problems. In this direction, solution-focused counsellors have designed a number of clear-
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cut techniques for getting clients into this future-oriented, productive mindset. As solution-focused counsellors lead clients toward
solution-talk, they remain collaborative in the sense of not imposing particular kinds of solutions but trusting the clients to find
their own way. Their attitude seems to be one of strengths-oriented, concentrating on client resources and successes. They believe that exploring the problems encourages the paralysing problem-talk. Solution-focused model became popular in the 1980s
when mental health agency budgets were slashed, and managed
care began to erode the number of sessions for which private practitioners could be reimbursed. This demanded a brief, formulaic,
commonsensical approach. We can say that solution-focused counselling is one of those.9
9. Feminists Family Counselling
Feminism brought to light the pernicious effects of cultural
attitudes on families. It accuses of the gender bias inherent in the
existing models. The Batesonian version of cybernetics was strongly
opposed to the use of power metaphors. He said that unilateral
control in systems was impossible because all elements are continually and circularly influencing one another in repetitious feedback loops. Therefore, if all parts of a system are equally involved
in its problems, no one is to blame. This idea somehow was appealing to family counsellors since family members often enter
therapy pointing fingers at each other and failing to see their own
steps in their circular dances. But feminists had difficulty with the
idea of equal responsibility for problems. In this case, we blame
the victim and rationalize the status quo. Take for example the
cases of battering, incest, and rape, for which psychological theories have long been used to imply that the women either provoked
or consented to the crime. In our patriarchal society, marriage and
family life inherently subjugate women, and to suggest that husbands and wives have contributed equally to and have equal responsibility for changing their problems is to collude with the
rules of these patriarchal microcosms of society.10
1) Mother Blaming
Family counsellors spoke a lot about the dysfunctional family constellation in which contributing to the problems is the pe-
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The feminists complain that issues of gender or, more specifically, patriarchy, permeate the counsellors work, even though
they have been conditioned not to notice them. Counsellors need
to avoid and counter the unconscious biases toward seeing women
as primarily responsible for childrearing or housekeeping; as needing to support their husbands careers by neglecting their own; as
needing to be married or at least to have a man in their lives. They
need to stop relying on traditional male traits such as rationality,
independence, competitiveness, as their standards of health and
stop denigrating or ignoring traits traditionally encouraged in
women like emotionality, nurturance, and relationship focus.
10. New Emergence
There are issues like family violence, multiculturalism, and
gay and lesbian families. These have emerged so strongly these
years. Family counsellors need to take into account these new realities.
It was in the early 1990s that the family counsellors first
started to look at family violence. According to the traditional
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view of the family counsellors, family violence involves the interacting influences of all the members of the family. Family violence was viewed as the outcome of cycles of mutual provocation,
and escalation.
When in a country there are culturally different ethnic groups,
the stereotyped family therapies will not be adequate to address
the cultural differences of the people. What in one culture one
considers as evidence of enmeshment or overprotectiveness is considered as virtue in another culture. Therefore family counsellors
need to be wary of transferring concepts, which are culturally
bound to some other cultures that have a different meaning altogether. Family counsellors have to look again at many of the things
they previously considered pathological.
There are issues like gay and lesbian families. Many straight
family counsellors may not understand what such clients face in a
homophobic world. One should keep in mind that harmonious
relationships are more difficult to achieve for gay and lesbian
couples, not because they are inherently more pathological than
straight couples, but because our society presents them with far
more obstacles.12
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10
ONES OWN WAY
Here let me introduce my own way of doing couple/family
counselling. After all where we are most competent is when we
are able to counsel people in the way we feel strong and competent. By approach I am eclectic and so I have no interest in delineating differences between approaches. Approaches are points of
view and they are all valuable. All of them speak of truth in their
own way and each has its own contribution to make. To limit
oneself to one approach is a danger, we lose the viewpoints of
others. I have no great concern to have an elaborate narrative or
grand theories of personality and healing. They may be elegant
but may not have practical utility. Whenever I underwent training
for counselling, I did not like the limitation each model had in
insisting on holding on to a certain pattern of the model only.
Though I have always been trying to make use of the model they
present for the most part, I accessed other methods as well, that
were appealing to me in dealing with clients. In fact I do encourage counsellor trainees to go ahead and find their own method of
doing counselling. What is taught as a method or skills are only
guidelines, and they are not absolutes. This has been proved through
the centuries by the shifts we have been having starting from
psychoanalysis to the latest models in postmodernism.
Here I intend to narrate the way I approach couple/family
counselling that works out for me, and may not be for you. Take
it for what it is worth. The basic aim of writing this chapter and
sharing my method is that you will do your own type of counselling and enrich the life of the clients. Counsellors who were themselves and had their own stamp of counselling without condemning other methods have always attracted me.
1. Therapeutic spontaneity
Being spontaneous is of paramount importance in counselling. Genuineness is one of the most important attitudes a counsellor can adopt. Genuine people are spontaneous without put-
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ting on an air of wisdom and power. One can bring out ones best
as a counsellor only when one is spontaneous. When we are
inhibited or try to hide and put on a front, the clients can very
easily notice the discrepancies. Besides, the inhibition a counsellor feels may hinder his/her effectiveness. Therefore, being spontaneously genuine is a welcome attitude on the part of the counsellor.
2. Let them unpack in your presence
There are counsellors who are afraid of clients unpacking
their stories in front of them. May be the dynamics is too overwhelming for the counsellor to handle and so they make the ground
rule not to exhibit the family working dynamics in the consulting
room. I would seriously question this attitude. We learn a lot when
naturally the family unfolds itself in the way they do at home. It is
safer to go by what we see than what we hear. Perhaps what we see
is the truest aspect of the family dynamics. Therefore I just observe and listen as the family comes for the first time, may be
asking a few questions to clarify the issues or what they are trying
to tell. This I found very useful in understanding couples and families. I notice who says what to whom and in what manner. This
indeed gives a clue to where the problem lies, especially the power
struggle the family is trying to adjust and the roles of persecutors,
victims and rescuers.
3. The First Conjoint Interview
The first interview is with all the members who happen to
come to meet me or when I approach the family all those who
happen to be there interested in presenting the problem. As I said
this interview gives me basic information about the problem areas
though at times I may have to revise my opinion after interviewing individuals. But in most cases the conjoint interview has been
highly beneficial. It is good to notice who talks, who does not
talk; who sits where and close to whom and distant from whom;
who dominates the session and who feels cowed down. When I
visited a family the father was almost silent nodding his head to
what his wife was telling. There were seven children in the family.
The only person who spoke most was the wife. That gave me the
understanding that most of the responsibility of the problem was
with the wife who was dominating. She would just silence any of
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her children talking. Even when I was giving a chance to the children to talk, she would intervene and answer for them. Later it
helped me to focus my attention on the wife who happened to be
the primary problem maker.
4. Individual interview
Just operating on what one gets impressed by the conjoint
interview may land up with difficulties. Because, in the conjoint
session some significant persons would not have spoken at all.
Without knowing what everyone has to say and without everyones
cooperation counselling will not be effective. Almost always I have
experienced the benefits of interviewing family members in counselling. Once I was counselling a couple. The man had invited me
to conduct some counselling sessions to his department where he
was working. In the evening he invited me to his house, telling
that his wife wanted counselling. When I went home, he asked his
wife to talk to me. But he maintained his presence with us. I told
him that his wife might like to talk to me privately. He flatly said
that she would not want it and so he continued to be with us. Of
course she touched upon some peripheral issues and the real issue
seemed to be that the man had developed some relationship with
the widow sister of his wife. The wife was trying to hint at this
issue, but for fear of her husband she could not fully open up. Had
I the chance to interview her I would have got the real problem
between the couple and facilitated them to solve it. There are times
when wives would tell things to me in individual interview rather
than in the conjoint interview. Therefore valuable information can
be got in individual interviews.
5. Periodical Individual and Conjoint Interviews
Once a pattern of interviewing the whole unit and the individuals is established, the counsellor can switch from one to another according to necessity. Now at this level first I may give a
chance to each one to speak individually and then get them together to sort out things for discussion, or I might have already got
an agenda to propose to the conjoint meeting, mostly drawn from
individual interviews. Thus initially I interview the whole unit to
get the first impression and then go in for individual interviews
followed by conjoint interviews. Later whenever they come, I may
start with individual interviews and land up with conjoint interviews. It is good to find out what method works for one and do
the needful.
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Conclusion
11
CONCLUSION
With humans we find that after differentiation comes integration. In the same way, in the field of family counselling we find
the first stage was marked by the proliferation of schools of
thoughts. Now it is time for an integration to take place.
Humans are quite complicated as they are thinking, feeling,
and acting creatures, who exist in a complex system of biological,
psychological, and social influences. On the one hand, any counselling should address all these dimensions. On the other hand
eclecticism may rob counselling of the intensity made possible by
strategic concentration on certain elements of experience. Effective integration should involve more than mere borrowing from
different types of counselling. Therefore integration worth the
name should draw on existing models in such a way that they can
be synthesized with a clear and consistent direction. There may
be many ways of producing integration. For example, one may
apply principles or techniques from one field to the phenomena
of another, as in the case of using psychodynamic concepts to understand family processes. One might also blend concepts and
methods from separate schools, like creating a synthesis of cognitive therapy and behavioural therapy. One may create something
new by selecting valuable ideas and techniques from a variety of
sources and connecting them with common presuppositions as in
the case of selecting samples from various schools of family counselling. One may also juxtapose different models sequentially using one for one stage and second for another stage, as in the case of
starting with one kind of counselling and ending with another.
One may try methods one after another checking which really
fits in for the particular client. Thus there could be various
approaches to integration.1
Here I would like to present the essentials of the five love
languages of Gary Chapman. 2 According to him there are five
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where touching is forbidden, people tend to make use of pet animals to satisfy that need. In societies where normal touch is a
taboo, child abuses abound. This is precisely what happens when
the normal is denied by cultural biases and so humans satisfy
their need to touch through deviant ways. Humans find ingenious ways of satisfying the need for human touch through disguised means. Physical touch can make or break a relationship. It
can communicate hate or love. I have observed something interesting among monkeys. The phenomenon I describe was observed
in solitary monkeys that roam about. When two of them happen
to meet, the need for touch is very strong which goes by violent
touch of pulling the hair in a mock anger. This process of touching by pulling the hair violently goes on for quite sometime after
which the two monkeys settle down fondling each other and sitting quietly enjoying the presence of each other with physical
touch. In moments of crisis we need someone to hold our hand
and touch. There are some people who are more prone to wanting touch than others. It is good to know the dominant love language of our partner and give a physical touch.
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you cherish your partner. Thinking positively about ones partner is a good way.
3. The third principle is turning toward each other instead of away.
It will mean that the couple keep themselves connected with exchanges even trivial. When one is calling for attention to something, the other should at least show interest even if one does not
like it very much. Do small things together like folding laundry,
or watching TV. We often ignore others emotional needs out of
mindlessness, not malice. It is all about saying how we stay connected with our spouse emotionally in little ways. Couples could
ask each other at the end of the day when each comes back from
work (or when one of them stayed back home), how the day had
been. This step will initiate an animated conversation or atleast
one will unburden ones worries. Or it could just let the other
one unwind after a days work. Such conversation in fact reduces
stress. During such moments of conversation, one must not give
unsolicited advice. When couples share, it is not for advice, but
for the relief of sharing something burdensome. As we listen it is
good to show genuine interest, communicate our understanding,
being supportive even if we believe that the perspective of our
spouse is unreasonable. Couples may feel lonely and alone in
certain stand they take; at that moment it is good to express a we
against other attitude. One could also include expression of
affection and validation of emotion. For example: saying yes;
that is really annoying. In this context one needs to avoid criticizing the spouse and siding with the enemy when the spouse
shares some hurt feelings that he/she experienced at the hands of
others. Sentences like I am sorry your boss made you feel very
hurt, That is really unfair to treat you that way, and I understand how you should be feeling now will go a long way in making the spouse feel understood by you. In this way, you turn towards your spouse and not away from him/her.
4. The fourth principle is let your partner influence you. Couples
should treat each other with respect and honour, each will allow
the other to influence. Any decision making should be equally
shared not imposed. There could be power imbalance in couple
relationships. Therefore the one who is understood as strong
should be sensitive enough to listen to the opinion and contribution of the weaker one in decision making. In patriarchal societ-
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Endnotes
ENDNOTES
1
Introduction
2
Conceptual Foundations
01. Michael P. Nichols and Richard C. Schwartz. Family
Therapy: Concepts and Methods. New Jersey: Allyn and
Bacon, 1995, pp. 109-110; Edwin H. Friedman. Generation
to Generation. New York: Guilford Press, 1985, pp.
14-15, 17.
02. Michael P. Nichols and Richard C. Schwartz. Family
Therapy: Concepts and Methods. Op.cit., pp. 110-111;
Imelda W. Clements & Diane M. Buchanan. Family Therapy.
A Nursing Perspective. New York: John Wiley & Sons,
1982, p. 5.
03. Ibid., pp. 111-112.
04. Michael P. Nichols and Richard C. Schwartz. Family
Therapy: Concepts and Methods. Op.cit., pp. 112-116;
Michael P. Nichols and Richard C. Schwartz. The
Essentials of Family Therapy. 2nd ed. Op.cit., pp. 6366; Edwin H. Friedman. Generation to Generation. New
York: Guilford Press, 1985, p. 23; Gwen Marram van
Servellen. Group and Family Therapy. Toronto: The
C.V. Mosby Company, 1984, pp. 19-20, 26; Scott Simon
Fehr. Introduction to Group Therapy. 2nd ed. New York:
The Haworth Press, 2003, pp. 48-49; Imelda W. Clements
& Diane M. Buchanan. Family Therapy. A Nursing
Perspective. Op.cit., p. 103; Michael P. Nichols and
Richard C. Schwartz. The Essentials of Family Therapy.
2nd ed. New York: Pearson, 2005, pp. 62-63.
05. Michael P. Nichols and Richard C. Schwartz. Family
Therapy: Concepts and Methods. Op.cit., pp. 116, 118;
Gwen Marram van Servellen. Group and Family Therapy.
Toronto: The C.V. Mosby Company, 1984, p. 25; Michael
P. Nichols and Richard C. Schwartz. The Essentials of
Family Therapy. 2nd ed. Op.cit., pp.70-71; Michael P.
Nichols and Richard C. Schwartz. The Essentials of
Family Therapy. 2nd ed. Op.cit., pp. 59-61.
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BIBLIOGRAPHY
Beavers, W. Robert.
Bowen, Murray.
Brill, Naomi I.
Chapman, Gary.
Clements, Imelda W. &
Diane M. Buchanan.
Dobson, James C.
Fehr, Scott Simon.
Friedman, Edwin H.
Gottman, John M.
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Satir, Virginia.
Bibliography