Psycho Pathology Week 13 11-15

Psychopathology

11/15/2006

Family Systems - Family is seen as a system o Has a wholeness, boundaries, hierarchies, controls (homeostasis) o Always trying to get back to homeostasis  Doesn’t mean healthy, could have a problematic homeostasis - Structural Model by S. Minuchin o Views family as interrelated system o Focuses on  clarity & firmness of boundaries  subsystems o Boundaries  Serve to protect subsystems & differentiation • Subsystems – parental & sibling subsystems • Subsystem demands its own unique function, greatest development of interpersonal skills develops when there is not a lot of interference from other subsystems o Children work out differences without parental involvement o Healthy families have hierarchy with strong parental system on top, boundaries are clear & firm but not ultra rigid o Too strong boundaries – disengagement in members of family o Clear boundaries – clear relationships o Imeshed boundaries – no boundaries o Boundaries around the family (instead of w/in)  Abuse  secrets, not a lot of contact with outside people  Can lead to fear of outside world, live in isolation o Need enough flexibility to allow autonomy & interdependence o Pathological development in families develop from structural issues  Often in divorced families, children become referees  Boundaries btw child and family are not clear o Chronic boundary problems  rigid triads  Triangulation • Child caught in middle of parent conflict o Each parent demands child side with her or him o Child is viewed as attacking other parent if side with one  Can never win & becomes paralyzed & torn  Detouring • Parents express distress through one child and becomes the identified patient (symptom bearer)

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Child is acting out symptoms for whole family, often takes on the role given to them • False sense of harmony created btw the parents o Developed bc they are united in blaming child or helping child  Stable Coalitions • One parent unites with a child against the other parent o Goal is to balance and reorganize structure  Clear & firm boundaries with parents & children  Good for anorexia, asthma, adults w/ drug addictions -

Communication Model by the MRI Group (Satir, Waltzlawick, Bateson, Jackson & Haley) o Focus is on communication and its impact on the family’s functioning o No such thing as a non-communication o Most communication and symptoms occur at the non-verbal level o Mssg of communications have impact on family as a whole  A fight btw two members has impact on all o Double bind – maladaptive communication that has at least 3 elements:  Injunction that telling the person if they do or do not do something they will be punished  Secondary injunction, usually non-verbal, conflicts with 1st injunction but at a more abstract level, enforced by punishment  Third injunction, prohibits the victim from escaping the field (can’t point out the inconsistency)  Ex: a son sees mother, hugs her, feels shoulders stiffen, son quickly withdraws, she asks “don’t you love me anymore?”, she scolds him for blushing when she says that • Wrong either way he reacts o Paying attention to the syntax of communication  What are the channels of communication? A lot or a little variability?  Notice the family’s capacity for information • Same conversations regardless of what has happened in the lives of the family o How’s school? How’s the weather? Or stuck somewhere else in time  Look at the clarity of language being expressed  Look at ability of receiver to process what is being said o Pragmatics  Look at what are the behavioral affects of the communication • Acknowledge or disavow? • Supportive or conflictive?

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Look at if communication is contradictory Are verbal & behavioral mssgs contradictory Pathology develops if communication is poor or mssg isn’t understood