The Family Cycle: Breaking the Intergenerational Transmission of Trauma through Mentalizing

ABSTRACT

In recent years, attachment and mentalization theory have been used to guide and inform clinical work with complex, vulnerable adults and children, who struggle to make sense of their own experience or to understand and reflect upon the thoughts and feelings of others. Traumatized parents often have difficulty reflecting upon their children’s thoughts and feelings, at great cost to the child’s sense of trust and safety in the world. In this paper we describe the use of the Family Cycle a clinical activity designed to promote mentalizing in high-risk parents and children with histories of significant and often chronic developmental trauma – with parents whose children are enrolled in an intensive home visiting program aimed at avoiding psychiatric hospitalization. Our aim is to both help them make meaning of their own histories, and understand how these have, in turn, impacted their children. We first present the Family Cycle activity generally, and then use case material to describe its use with a parent in our program.     

Impact of a Genetic Diagnosis of a Mitochondrial Disorder 5–17 Years After the Death of an Affected Child

This study used in-depth interviews to explore the experiences of parents who were re-contacted with new genetic results many years after the death of a child with a mitochondrial disorder. At the time of their child’s illness, parents had consented to a tissue sample being taken to help with diagnosis of a suspected mitochondrial disorder, and subsequently further DNA testing identified the genetic cause. Parents did not express negative feelings about being re-contacted with new information, and hoped that continuing research might help other families. Positive aspects included relief from feelings of guilt over the cause of the child’s disorder, and having accurate genetic information available for surviving children. Difficult emotional and psychosocial implications included contradictions to previous beliefs about inheritance, deciding how and when to communicate information to surviving children, and coping with new fears for the mother’s health if a gene located in the mitochondrial DNA was identified. In half of the families the new results significantly altered the parents’ understanding of the inheritance pattern. This study highlights the impact of new genetic information offered after a delay of several years, which has the potential to re-open feelings of grief and uncertainty and can present a new inheritance scenario for which research participants or their families are unprepared. Health professionals involved in conveying genetic research results can help to support families through this process.     

Working with the institutionalized aged and their families: Considerations for clergy

The institutionalization of an aged parent presents unique challenges and strains to the family system. It also provides opportunities for limited intervention and support by empathic clergy. It is often difficult for middle-aged children to understand some of the strong and often sudden emotions they experience regarding their institutionalized parents, particularly as these feelings become confused with their own sense of having reached middle age. Again, opportunities present themselves for clergy to be sensitive to these confusing feelings.     

Helping Families with Defiant Adolescents

This paper presents a model for working with defiant adolescents that aims to support parental authority and repair ruptured family relationships. After an initial family meeting in which the therapist presents a treatment contract focused on restoring mutual trust, a series of separate meetings with the parents and adolescent is held during which the therapist works concurrently with the parents to restore order in the household and with the adolescent to uncover feelings of hurt and betrayal. The final phase brings the parents and adolescent back together for a series of discussions focused on repairing the ruptures in their relationship.     

The abused child as parent: Perception of self and other

Although not all abused children grow up to be abusive parents, it is well known that people who were severely mistreated by their parents as compared to those who were not are at higher risk for mistreating their children. It has also been shown that abusive parents often have unrealistic expectations for their children—expectations based on distorted perceptions of their children's needs, feelings, and abilities. In this paper, we examine the utility of new methods developed in social psychology to study: (1) the impact of abuse on the structure and content of interpersonal and self-perception and (2) the interrelationships among an abused mother's social and self-perception, the quality of her interactions with her child, and the child's development. Case studies will be presented to illustrate how these new methods reflect risk for abuse as predicted independently by clinicians treating the cases.     

Development and Preliminary Evaluation of Family Minds: A Mentalization-based Psychoeducation Program for Foster Parents

Mentalization-based interventions show promise in improving mental health outcomes for children and parents through increasing a family's reflective functioning, or ability to mentalize. Mentalizing involves the ability to understand behavior in relation to mental states, such as thoughts and feelings, and typically develops within the context of secure attachment relationships. One area not given much consideration when training foster parents is their capacity to mentalize. This study evaluated Family Minds, a newly developed psychoeducational intervention for foster parents, designed to increase their ability to mentalize. The current paper reports on the development and preliminary empirical evaluation of Family Minds in a quasi-experimental study where 102 foster parents received either Family Minds or a typical foster parenting class, which served as a control group. Results indicate that parents who received Family Minds significantly increased their levels of reflective functioning as assessed with the Parental Reflective Functioning Questionnaire and a new Five-Minute Speech Sample procedure coded using the Reflective Functioning Scale, and revealed a tendency to show decreased levels of parenting stress on the Parenting Stress Index, while the control group showed no such improvements. These findings support the hypothesis that a short-term psychoeducational intervention may improve foster parents' ability to mentalize themselves and their children. These skills are very beneficial for foster parents, as they frequently deal with children who come into their home with challenging behaviors, attachment issues, and negative internal working models of relationships. This type of intervention has the potential to lower placement breakdowns and improve the mental health of foster children.     

Parental representations and attachment style as predictors of support‐seeking behaviors and perceptions of support in an academic counseling relationship

The role of parental representations and attachment style as predictors of support‐seeking behaviors and perceptions of support in the context of an academic counseling relationship was investigated. Prior to participation in a 10‐hour academic counseling program in college, 91 students completed scales assessing perceptions of their current relationship with their parents and their attachment style. Students' support‐seeking behaviors and counselors' sensitivity, as reported by both participants (students and counselors), were evaluated twice during the counseling process, and general feelings of support were evaluated at the end of the program. Parental representations and attachment style both predicted students' support‐seeking behaviors and perceptions of support in counseling. The strength of the prediction differed as a function of time of measurement and source of evaluation. In addition, student‐perceived counselor sensitivity was found to mediate the relation between parental representations and support‐seeking behaviors in counseling     

Family Gender Role and Guilt in Spanish Dual-Earner Families

In dual-earner families the balance between work and family demands facilitates the development of guilt feelings when parents perceive a non-fulfillment of their responsibilities in childcare. Specifically, women who aspire to personal and professional development on the basis of more egalitarian gender role models must deal with the traditional stereotypes that maintain an intensive maternity mandate that prioritizes the family. On the other hand, for men the role change is primarily in the family setting with the development of a new father role more involved in the care of their children, which is not easily compatible with the more traditional breadwinner role. This study explored the feelings of guilt about parenting in 251 employed Spanish parents with children between 3 and 6 years of age, through the Scale of Guilt Feelings about Parenting, and its relationship with traditional stereotypes of maternal and family role. The scale addresses diverse situations pertaining to child rearing in which work requirements do not allow parents full availability for the care of their children. This availability is present in the model of intensive maternity and in the new father role model. Results indicate the presence of similar and high levels of guilt in fathers and mothers, although in men guilt is related to a non-traditional family role ideology, whereas in women guilt is related to a more traditional maternal role stereotype.     

Language Use and Post-Traumatic Stress Symptomatology in Parents of Pediatric Cancer Survivors1

The words parents use when disclosing their current thoughts and feelings about their children's cancer were hypothesized to be associated with post-traumatic stress symptomatology among parents of children who had successfully completed treatment. A word-based, computerized text-analysis program was used to analyze writing samples from 82 parents. Parents completed a questionnaire and a structured interview assessing post-traumatic stress symptomatology. Results indicate partial support for the association between language use and post-traumatic stress symptoms. Use of past-tense verbs was associated with fewer traumatic stress symptoms, and use of future-tense verbs was associated with more traumatic stress symptoms. Time since completion of the child's treatment moderated the relationship between use of past- and future tense verbs and post-traumatic stress symptoms. Implications for using computer-based text analyses in the study of psychological processes associated with post-traumatic responses are discussed.     

Parental Awareness and Monitoring of Adolescent Internet Use

This study focused on four aspects of parental monitoring of Internet use by their children: parental supervision, communication and tracking, and adolescent disclosure. Data were obtained from a SAFT (Safety Awareness for Teens Project) national survey of Singapore youths and parents regarding Internet safety at home. Study 1 examined 1,124 adolescents and 1,002 parents; Study 2 examined a subsample of 169 dyads of adolescents and their parents. Frequency of use and engagement in risky Internet behaviors such as visiting inappropriate websites were analysed. The results indicated that parents tend to underestimate adolescents’ engagement in risky Internet behaviors and overestimate the amount of parental monitoring regarding Internet safety that occurs at home. The study suggested that mothers have a better awareness of their adolescents’ Internet use than fathers. The findings were explained in the context of parental monitoring. The results suggest that parental monitoring needs to be reconceptualized and that parents need to improve the communication with their adolescents regarding Internet use.     

Professional support for adolescent mothers: Who gives it,how adolescent mothers evaluate it,what they would prefer

Forty-two adolescent mothers with 2-year-old children were questioned about their sources of social support, their satisfaction with that support, and their views about including members of their informal support network in the receipt of professional services. The results indicated that 74% of the mothers received parenting advice from some professional source, as well as from their informal support network, and that most were satisfied with their professional contacts. Nonetheless, 75% of the mothers indicated that they would like additional parenting advice from parenting classes, organized neighborhood groups, or from visiting public health nurses or other child development specialists. Ninety percent of the mothers thought it would be helpful to have members of their informal support network participate with them in the receipt of professional services, and 81% thought these individuals would be willing to do so. The implications of these findings for both future research and the design and implementation of programs directed toward adolescent parents and their children are discussed.     

The Ecology of Teachers’ Experiences with Violence and Lack of Administrative Support

Teacher‐directed violence is a common, yet understudied, phenomenon. Perpetrators of violence against teachers include not just students, but also administrators, parents, and colleagues. Administrators are key stakeholders when it comes to shaping school climate and safety that can reduce or increase the negative impact of violence against teachers. In this study, 237 teachers’ qualitative responses from a larger sample of 2,431 anonymous, online survey responses were examined to better understand their experiences with incidents of violence and how administrators played a role in these experiences. Results reveal that lack of administrator support negatively impacts teachers at multiple levels, including teachers’ feelings (individual); challenges associated with addressing issues related to students, parents, and other perpetrators (interpersonal); and school systems and policies (organizational). This study highlights the importance of administrative support and illustrates how administrators’ actions and inactions can have ripple effects at each level of the school microcosm. Implications for research, practice, and policy are discussed.     

The effects of baby bath and massage by fathers on the family system: The sunraysia australia intervention project

Instruction in baby massage and the Burleigh Relaxation Bath technique was given to one-half of our sample of 32 couples who had just had their first child. This brief intervention, given at 4 weeks post-partum, led to beneficial behavioural and psychological effects for the family system when assessed at 12 weeks postpartum. Depression and marital satisfaction were assessed with mothers and fathers at 4 weeks and 12 weeks after the birth of their child, and self-esteem was measured at 12 weeks only. The mothers and fathers who were shown baby bathing and massage techniques showed higher degrees of marital satisfaction and self-esteem, as well as lower levels of depression at 12 weeks post-partum, than parents who did not receive instruction. It seems likely that brief interventions which educate new parents concerning functional techniques of baby care may favourably affect their feelings of competence and be of benefit to the entire family system.     

SOCIAL VULNERABILITY AND ADJUSTMENT OF CEREBRAL PALSIED CHILDREN

Social adjustment of forty cerebral palsied children was studied by means of the Düss Fable Test, and interviews with parents and teachers. More cerebral palsied than normal children apperceived the fables as containing rejective and frustrating elements and responded with feelings of hostility, jealousy and defiance. The cerebral palsied children revealed a more dependent and conflict-laden relationship with their parents. One third of the cerebral palsied children showed a poor social adjustment in school but those with harmonious family background obtained a satisfactory social adjustment in school. The data gave no support for the existence of a typical psychological syndrome of cerebral palsy.     

Parents of the Handicapped Child: Facilitating Acceptance Through Group Counseling

All parents have an image of the way they would like their children to be. Often this expectation is contradicted by reality for the parents of a handicapped child. Whether at the time of birth when obvious differences are apparent or later when performance differences are recognized, the discrepancy between expectation and reality causes parents to experience a loss and accompanying feelings of grief. This article suggests that the method of group counseling using a relevant framework on which to base discussion is without equal as a means of assisting parents to deal with their situations. Presented to those who lead parent groups for these persons is an applicable model and guidelines for its implementation.     

Gender-related Needs, Challenges, and Dangers in the Immigration Experience in Israel of Emerging Adults from the Former Soviet Union

In-depth interviews were conducted to examine gender-related patterns of adaptation and maladaptation, and the relationship between adaptation and relationships (parents, friends, and romantic partners) for 34 emerging adult immigrants from the Former Soviet Union in Israel. Qualitative analysis highlighted gender-related needs, difficulties, and challenges following the immigration experience. Women’s adaptation was connected to mutually supportive and empathic relationships with parents, friends, and romantic partners. Maladaption for women was connected to overly close, nonmutual, and enmeshed relationships with parents, which led to feelings of guilt or to distant relationships that lacked support and intimacy. Adaptation for men was connected to inner strengths that enabled achievement and success in acculturative tasks, which led to feelings of mastery, competence, and self-definition combined with respect and valuing the relationship they have with their family. In contrast, maladaption among men was not connected to relationships but to a lack of inner strengths needed to succeed in developmental and immigration-related tasks. Despite the gender-related distinction found among less adaptive individuals, adaptive young immigrants, women and men alike, were more characterized by an ability to balance between needs of self and needs of others in their family relationships. As such, narratives of adaptive emerging adult immigrants emphasized gender similarities, whereas those of less adaptive immigrants emphasized gender differences.     

Emotional Support from Parents and In-Laws: the Roles of Gender and Contact

After the birth of a child, new mothers and fathers commonly have a substantial amount of contact with their parents and in-laws. However, this contact may not always result in emotional support. We tested if contact, rather than geographical distance, influenced emotional support received from parents and in-laws and whether there were gender differences in these associations. Online questionnaire data were collected in 2008 from a community sample of U.S. first-time mothers (n?=?93) and fathers (n?=?93) who were in a heterosexual relationship and living together. Results indicated that for new mothers, greater contact with own parents and in-laws was related to receiving more emotional support. However, for mothers, greater contact with parents also was related to less emotional support from in-laws. For new fathers, contact was not related to emotional support from either parents or in-laws. These findings suggest that receiving support as a result of contact with family members may be gendered, particularly for new mothers’ and fathers’ relationships with their in-laws. The current study highlights the importance of reducing stigmas about men and their emotional needs and of encouraging new fathers to seek and receive support from family during the transition to parenthood.     

TRANSITION TO PARENTHOOD AND MENTAL HEALTH IN FIRST‐TIME PARENTS

This study aimed to examine the transition to parenthood and mental health in first‐time parents in detail and explore any differences in this transition in the context of parental gender and postpartum mental health. Semistructured clinical interviews (Birmingham Interview for Maternal Mental Health) were carried out with 46 women and 40 men, 5 months after birth. Parents were assessed on pre‐ and postpartum anxiety, depression, and postpartum posttraumatic stress disorder (PTSD), and a range of adjustment and relationship variables. One fourth of the men and women reported anxiety in pregnancy, reducing to 21% of women and 8% of men after birth. Pregnancy and postpartum depression rates were roughly equal, with 11% of women and 8% of men reporting depression. Postpartum PTSD was experienced by 5% of parents. Postpartum mental health problems were significantly associated with postpartum sleep deprivation (odds ratio [OR] = 7.5), complications in labor (OR = 5.1), lack of postpartum partner support (OR = 8.0), feelings of parental unworthiness (OR = 8.3), and anger toward the infant (OR = 4.4). Few gender differences were found for these variables. This study thus highlights the importance of focusing interventions on strengthening the couple's relationship and avoiding postnatal sleep deprivation, and to address parents’ feelings of parental unworthiness and feelings of anger toward their baby.     

Survey of School Psychologists' Attitudes,Feelings, and Exposure to Gay and Lesbian Parents and Their Children

Abstract

School psychologists' attitudes and feelings toward gay and lesbian parents were surveyed in relation to their training and exposure, and professional services offered to gay and lesbian parents and their children. The relationship between attitudes, feelings, training, exposure, and demographic characteristics was explored as well. A stratified random sample of 500 school psychologists who were members of NASP was surveyed using a 30-item questionnaire. Out of the 500 surveys sent, 267 school psychologists (53.4%) returned them. Overall, school psychologists have positive attitudes and feelings toward gay and/or lesbian parents. More specifically, school psychologists who were female, homosexual/bisexual, or living in the Western region of the United States had significantly more positive attitudes and feelings toward gay and/or lesbian parents. Although few school psychologists (30%) received any formalized training, those who had some training indicated more positive attitudes. The majority of school psychologists (89.4%) reported having personal associations with homosexual individuals. More exposure to homosexual individuals by a school psychologist indicated more positive attitudes as well as feelings. Implications of the findings and future research directions are discussed.