Posted: March 15th, 2022
Psychology of Marriage and Family Systems
The literal meaning of the word “psychopathology” is a mind disorder or disease. Psychological diagnosticians, while assuming that the illness is located inside a person, always use the medical model in treating or studying patients with ‘mental illnesses’. In comparison with the approach they take, I present two converging and related psychopathology perspectives. The two perspectives give an analysis based on context from the family’s viewpoint. The first approach, the “family systems” approach, is a conception that came up in the 1950s as a substitute to the traditional focus of psychopathology on individuals (Goldenberg & Goldenberg, 1996).
The second approach, “family risk factors” has been in existence in psychopathology but not in the foreground. It tries to identify a couple family aspects of the functioning of the family that are significant in the treatment as well as etiology of patients that have tested positive for various disorder diagnosis or that are undergoing high psychological stress levels. Present and past relationships between the child and parent are often cited as the risk factors in the family considered to have an effect on normal development as well as psychopathology. Several perspectives give suggestions that negative or positive relationship patterns between the parent and child are always repeated for generations and foster adaptive psychopathology and functioning in the family’s individual members (Haley, 1977).
Current patterns of family systems: parent – child relationship
Increasing evidence from the last 2 decades show that relationship quality between parents of the children is connected with internalizing and externalizing problems of behavior the child displays. Even though the investigators utilizing the perspective of family risk factors sometimes examine the impact made by two or more family protective or risk factors, the analysis they make is often unidirectional – to mean that focus is put on family effect on the adaptation of individuals or the psychopathology present in a member of the family (Haley, 1977).
The psychology of marriage
It is critical that it is established that marriage is a global risk factor in the internalization of symptoms, nonetheless, it makes no clarifications on the nature of marriage effects on psychopathology. The problem could be because people always narrow matrimony down to universal satisfaction in the studies earlier carried out. Exclusive focus on satisfaction in marriage gives a limited view of the way marriage makes a contribution to the psychopathology of an individual, and this has prompted agitation for the need to investigate the roles of certain processes in relationships (e.g., conflictual and supportive interactions) in the course of development of psychopathology (e.g., Beach, 2002).
Clinicians and researchers understand that the current interventions in the treatment of psychopathology will be enhanced greatly by the identification of fresh clinical targets; having increased understanding of the relationship between depression and marriage processes is very important in the enhancing of effectiveness and efficacy of the interventions (emphasis added; Beach, 2002). The use of family therapy as a means of practice of psychotherapy began in the 1960s. Nevertheless, the concepts and clinical factors that influenced its development is traceable to an earlier time.
Purpose of the paper
The aim of this paper is identifying a number of the main social factors and the research, clinical as well as conceptual efforts that gave the soil nourishment for family therapy growth as a modality for treatment.
Theory of family systems and therapy
While the contemporary family therapy seeds were planted in 1950s by individuals practicing research that is centered on family in areas of schizophrenia etiology, those who tilled the soil came from a period earlier than then. It began with professional social work development in the 19th century and 20th century, together with other group work, child guidance and marriage counseling movements that took place in the beginning of the 20th century. It is in this period that the soil that supported family therapy was cultivated (Becvar & Becvar, 2000; Nichols & Scwartz, 2008; Sayger, Homrich & Horne, 2000).
Assessment of theory with rages to marriage
Having the focus shifted to relationship processes will give enhancements to the theoretical model’s specificity in a number of ways. First, the focus would afford the researchers an opportunity to capture various marriage relationship aspects not yet accounted for by any of the global measures of satisfaction (Beach, 2002). Secondly, relationship processes adapt well into marriage theories as well as individual psychopathology. For instance, the marital discord model of depression (Beach, Sandeen, & O’Leary, 1990) gives a suggestion that matrimonially discordant couples undergo changes in relationships which drive depression. Indicatively, the spouses undergo through more interactions that are negative (like conflict) which cause stress as well as decrease positive functioning (like support) that therefore causes reduction in relationship challenge coping ability. An important aspect of this model is that relationship between marital depression and discord is accounted for by relationship processes. Thirdly, if the symptoms variance in the control of global satisfaction is accounted for by relationship processes, then programs of prevention can be refined to specifically target these processes. This kind of refinements would enhance program efficacy since relationship processes would be targeted directly in the interventions, while global satisfaction will be indirectly targeted through the alteration of marriage functioning (e.g., through the teaching of skills for it). The available research indicating the relationship between psychopathology and marital processes, identification of 4 relationship processes specifically relevant to the current study was made (Rebecca and Erika, 2011):
Problem/conflict-solving interactions: length and frequency of arguments; the behaviors they engage in case of conflict; aggression severity levels; presence; strategies of recovery following arguments
Support transactions: the support quality given when a partner has a problem or is down; parity between received and desired support levels; whether the support is negative or positively given; if support is received and given mutually between the partners
Emotionally intimate transactions: a mutual sense of closeness; affection and interdependence; warmth; emotional vulnerability comfort; comfort to be oneself around partner; quality of self-disclosures made; demonstration of affection and love; friendship (physical and verbal expressions)
Balance of control and power: the ability of the couple to negotiate control in various areas (e.g., finances, scheduling the day) and treating one another as competent and independent persons; a/symmetry when it comes to making of decisions as well as power (Rebecca and Erika, 2011).
Psychopathology Definition and Its Significance in Theory of Family Systems
Therapists and theorists in family systems do not devote as much attention to issues in psychopathology definition. Different kinds of criteria are made use of in differentiating normal development and psychopathology. They all involve descriptions of people extremely deviating from social values and norms – from the population mean (a continuous psychopathology view), or from a psychological functioning ideal that is clinically defined. The resource takes quite a broad view, giving family systems as well as risk factor approaches descriptions to a range of phenomena ranging from stress levels that are statistically significant to other disorders diagnosed clinically (Cowan & Cowan, 2006).
Etiology: Causal Models vs. Risk Models
One common saying in psychopathology study is that an understanding of each disorder’s etiology is essential. This has been viewed as the identification of causal events, variables or conditions (A) which are linked to a disorder (B), or are a precedent to the disorder (A before B) and give some action that give rise to the disorder. Further, for an establishment of causal connections to be made, it must be proven that B. cannot be traced to any other factors but A; that a unique link exists between the cause as well as effect (Cowan and Cowan, 2006).
Provision of causality evidence in family study involving children’s development is not an easy task (Measelle, Ablow, Cowan and Cowan, 1998). People are aware that indeed correlations only is not evidence of any causality, but a lack of any correlations is harmful to a claim that there is cause. For instance, where no association exists between schizophrenia presence in a family and communication that is double binding in that family, it may not be possible to support the theory that the schizophrenia has a link to communication.
Formulations of etiology try to give causal explanations to disorders using the metaphors of the pre-20th century in the world of medicine that actually had a basis on 17th century physics. These models always have a direct link between effect and cause. Contrastingly, developmental psychopathologists adopt models on risk-outcome used in public health epidemiology (Rebecca and Erika, 2011). In this model:
A risk factor is an antecedent condition or variable linked to an increased possibility of a given specific result in the population;
A protective factor is a condition or variable that leads to a reduction in negative outcomes probabilities linked to a certain risk; and
A vulnerable factor is a condition or variable which raises the possibility of negative outcomes linked with a certain risk (Cowan and Cowan, 2006).
It is difficult to define resilience. Sometimes, where risk is high, adults and children perform quite well, and are viewed as resilient. While resilience can be taken as an evasive quality of an individual, its interpretation should allude to cases where challenges come with risks but positive outcomes are realized (Cowan and Cowan, 2006).
In several cases, the link between outcome and risk may just represent association between these two factors, and there is no necessity in claiming a causal linkage; establishing predictors that are accurate is essential in the identification of individuals who are at risk of having problems with high possibility of future emergence. In a number of these cases, the linkage can be identified as causal risk, when demonstration can be made that a specific condition or variable sets in motion processes resulting in a specific outcome. How then can determination of the differences between causal risk and statistical risk indicators be made? The most effective way of establishing causality is by using intervention studies which make use of random procedures of assignment to put comparable individuals in control groups and intervention. Comparative data as well as statistical controls can be made use of in trying to do away with other possibilities, so that it is plausible to do causal interpretations of the given data (Cowan and Cowan, 2006).
In developmental psychopathology, an ideal study is that which follows families and individuals forward, finding the links from the risks to the outcomes, instead of just doing a follow back design that starts with diagnosis then followed by looking for antecedents. The major issue with retrospective designs in causality establishment is that even their showing a presumed antecedent is linked to several disorders (multifinality) or when multiple risk factors are present and each predict a particular disorder (eqeifinality) (Cowan and Cowan, 2006).
Early Works on Family Systems and Psychopathology Approaches: significance in psychology
The identification of perspectives of family systems on certain diagnostic disorders is challenging, since a majority of the leaders in the area have avoided usage of diagnostic terms in the discussions they present, save for some generalities when referring to diagnoses that are given to a patient. We must then infer psychopathology conceptualizations from how family therapists have characterized the main problems of families treated by them (Cowan and Cowan, 2006).
The initial practitioners of Family Systems Approaches in mid 20th century, clinician groups in various parts of the U.S., Starting from varied premises of theory, challenged every notion that focusing on individual psychopathology was enough to give guidelines of treatment for patients who are seriously ill mentally. In various ways, every group has alluded to one or a couple of family functioning facets which they perceived to have the responsibility of resulting in schizophrenia or the maintenance of the symptoms following the patients’ return from a medical facility. The concept that family systems approaches origins started in consideration of this population influenced the direction taken by the initial generation of practitioners in family systems theory (Cowan and Cowan, 2006).
A psychoanalyst, Nathan Ackerman, who later headed Ackerman Institute in New York, advocated for the significance of consideration to family risk factors when treating children (Ackerman & Sobel, 1950). Fearing that his colleagues will reject him, he started hinting, instead of directly advocating his perspective that members of the family ought to be conjointly seen – all in a single room. Finally, he was able to clearly argue (Ackerman, 1962) that all household members ought to be conjointly treated when a child is in to undergo therapy. The therapy proposed by Ackerman was not similar to the others used by subsequent practitioners since Ackerman’s focus was on family member dynamics that ensured that interaction was hard. A therapist would therefore do individual therapies but in the whole family context (Cowan and Cowan, 2006).
Treatment of family systems in the past
Family systems theory has seen tremendous growth since its inception. Looking back, a captivating cycle can be observed in how the early theories of family systems in the 1950s and 60s impacted research in family risk factors in the 1970s and 80s, which also began influencing a shift towards integrating varied family systems approaches in the diagnosis as well as treatment by the end of the 1990s (Cowan and Cowan, 2006).
In explaining psychopathology emergence in an adult or child, patterns of relationship from various domains of the family ought to be considered as probable protective or risk factors which affect a child’s adaptation or his maladaptation: parent-child relationship qualities (Steinbers, 2001), relationships of the couple (Cummings & Davies, 1994) as well as relationships over and between the generations (Caspi & Elder, 1988) are top. While genetic risk factors do get considered as opposed to family factors and environmental risk factors, like in contrasting nurture family (Rutter, 2002) and nature (i.e. Genetics) we hold the view that genetic transmission to the child from the parents is inherently a process that is family-based, even when that transmission is achieved by way of sperm donation or some other means that is artificial. These gene patterns that are combined after transmission to the offspring is basically an extension of patterns in the family linked with the child’s biological mother and father. It should be noted that as opposed to the emphasis on family units by the family systems, the family risk factor approach makes the assumption that at least one risk factor is involved in producing psychopathology in the individual members of a family (Cowan and Cowan, 2006).
The family risk factor approach possesses both a short and long history. A person can see family factors approach at play in plays of the Greeks as well as their myths that Freud used to give an illustration of psycho-dynamic arguments. While the Greeks laid emphasis on gods, fates as well as literal deux ex machina forces affecting the behavior of men and women, the Electra, Medesa and Oedipus stories give vivid illustrations of the way struggles in the family can cause destruction or even madness in a family (Cowan and Cowan, 2006).
Significance of family systems in psychology
Fresh charismatic family therapists became members of the ‘club’ that had been created by the field’s founders, every one of them making use of the early theories of family systems as reference point for marital decisions but giving a slightly varying major idea of what they considered to be wrong and needed to be fixed when affected families came for treatment (Cowan and Cowan, 2006).
While the new field leaders had a focus on theories of social interactions of change or stability in a family environment in the explanation of roles played by internal psychological factor aspects in both family and individual maladaptation. This time period that saw the establishment of competing thought schools on family therapy services and training, but also in which small systematic evaluation took place, has been defined aptly, albeit in a harsh way, as the “battle of the brand names (Hoffman, 1981).
Carl Whitaker, a member of the 2 ndgeneration of family therapy practitioners does maintain a direct link with the treatment of patients who are ill mentally with the members of their family. He emerged as an authority, initially at Emory, Atlanta and then later at the Department of Psychiatry at the University of Wisconsin Medical School. His strengths were not in constructing elaborate theories or proposing special formulations of the main issues the families were facing. His genius came in the demonstration of his approach to groups in large and small workshops, meetings that had people of influence in family therapy. While his focus was on family systemic properties, Whitaker gave attention to his feelings and inner thoughts while in a session, and then told them to the members of the family. This is to say, he made use of transference as well as counter transference psycho-dynamic therapy notions, basically as a means of being one with his patients during a treatment session and he had them put on point by using cryptic but focused remarks (Janice and Mikal 2010).
An example of a family theory that was more psychodynamic like the theories of Ackerman (1962) can be found at The Family Institute of Philadelphia being proposed by Ivan Boszormenyi-Nagy and James Framo (Boszormenyi-Nagy & Framo, 1973; Framo, 1962). They put forward what can be referred to as contextual family therapy, which emphasized adults coming to terms in a psychological manner as well as in interactions directly with parents as a means of doing away with distress at couple, individual as well as parent-child level (Janice and Mikal 2010).
On departing from the Palo Alto group, Jay Haley practiced in Minuchin, Philadelphia to help develop structural family therapy, focusing on therapist’s role in organizational and family subsystems change. He launched a fresh strategic therapy ‘school’ that had a focus in behavioral family efforts in solving problems at the instance (Haley, 1976; Madanes, 1984). Haley found delight in an approach that was paradoxical, saying to families while they gave descriptions of the problems they had, that they were insoluble. The main task a therapist had was helping families overcome their state and so begin the change process, and give a prescription of strategies which would assist in overcoming homeostasis and launch the change process, including prescription of a symptom where he asked family members to repeat a pattern that was maladaptive so as to bring it to light and make them consciously aware of it (Janice and Mikal 2010).
A major development in international family therapy took place in Italy, where Luigi Boscolo, SelviniPalazzoli, Gianfranco Cecchin and GuilianaPrata became the associates in Milan (as cited in Boscolo et al., 1987). Having a close orientation theoretically to Palo Alto Group (Bateson and Colleagues), their focus was on short-term intensive interventions which focused on disrupting deviant ‘games’ of communication through which families that were severely disturbed (schizophrenia, severe eating disorders) ensured maladaptive state maintenance. The focus of the Haley and Milan associates was behavior, though they weren’t behaviorists. Focus was on the rules of communication teaching, reinforcing behavior exchange or consequences of behavior (Janice and Mikal 2010).
A different deviation from the Palo Alto Group made by the ideas of Bateson was narrative therapy (White & Epston, 1985), which had a focus on the concept that family stories or narratives impoverished in families that were disturbed, and the job of the therapist by talking was to give new narrations and reframe these stories in a fashion that showed fresh possibilities. As in several postmodern theories, the narrative therapies emphasize on word meanings, and the derivations that members of the family put on their specific realities, every one of which possesses some grain of truth or validity (Janice and Mikal 2010).
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