Mentalizing Family Violence Part 2: Techniques and Interventions

This is the second of two companion papers that provide an overview of mentalization‐based concepts and techniques when working with the seeming “mindlessness” of intra‐family violence. The focus of this paper is on general mentalization‐oriented approaches and specific interventions that aim to (1) disrupt the non‐mentalizing cycles that can generate intra‐family violence and (2) encourage the emergence of patterns of family interactions that provide the foundation for non‐violent alternatives. Various playful exercises and activities are described, including the taking of “mental state snapshots” and “selfies” in sessions and staging inverted role‐plays, as well as using theatrical masks and creating body–mind maps and scans. These can make “chronic” relationship issues come alive in session and permit “here and now” experiences that generate a safe context for mentalizing to take place. At the core of the work is the continuous focus on integrating experience and reflection. Without acute awareness of the thoughts and feelings occurring in the sessions, mere reflection is not likely to enable change. By increasing mentalizing in the family system, family members’ trusting attitudes grow, both within and outside the family.     

A model for the treatment of eating disorders of adolescents in a specialized centre in The Netherlands

Treatment of adolescent patients with eating disorders has to take into account that these patients differ in age, their stage of development, and the constellation and functioning of their family life. Our treatment model takes these factors into account and is family and cognitive behaviourally orientated. The work has developed and changed in recent years, based on our experiences over the past ten years, as well as in combination with ideas we picked up from the experiences of colleagues elsewhere, be they via oral reports or written papers. Our approach is flexible; yet it also offers a structured containment for the patient, both by the treatment team and the parents. We aim, as much as possible, to let the family members carry out the treatment, providing them with the environment and the tools they need. Including the family members actively in the treatment of their ill daughter and teaching the parents how to help their child at home is the core of our philosophy, and we believe that this prevents prolonged inpatient stays or readmissions. This paper describes the different ways and settings in which we try to carry out our work.     

Freud and the Hammerschlag family: a formative relationship

From his obituary of Samuel Hammerschlag, we know of Freud's great veneration for his teacher of Jewish religion. However, not only Hammerschlag himself but his whole family had a formative influence on young Freud, who was deeply impressed by their humanity. This paper describes Freud's relationships with all the family members. In particular, it shows how warmly he felt towards the only daughter, Anna Hammerschlag, who was his patient for a while and whom he chose as a godmother for his youngest daughter Anna. By virtue of the crucial role she played in Freud's 'specimen dream' of July 1895 ('Irma's injection'), she also became as it were the godmother of Freud's magnum opus, The Interpretation of Dreams. All the known extant letters from Freud to members of the Hammerschlag family are published here for the first time in English translation.     

Breathing life into family processes: introduction to the special issue on families and asthma

This introduction to the special issue dedicated to families and asthma proposes that the study of asthma highlights general systems topics such as integration of individual needs into the group, developmental trajectories of risk and resilience, supportive and destructive patterns of interaction, and the cultural adaptation of family therapy. It briefly introduces papers in the special issue and concludes that asthma can serve as an exemplar in the study of family health due to its comorbidity with mental health problems, potential to affect multiple members of the family, disproportionate influence on low-income and minority families, and multiple avenues for intervention.     

Impact of On-Site Personal Experience of Violent Death on Posttraumatic Stress Disorder of Bereaved Japanese Family Members in Forensic Autopsy Cases

The present study investigated the influence of direct on-site experience of violent death on the symptoms involved in posttraumatic stress disorder (PTSD) of bereaved Japanese family members (n = 367) in forensic autopsy cases, using a questionnaire survey. Factor analyses of three core symptoms of PTSD confirmed the factor structure. In general linear modeling, the major effect of direct on-site experience of violent death on PTSD score was significant, while manner of death alone did not have such an effect. These findings suggest that direct on-site experience of violent death is essential in the clinical assessment of PTSD-related symptoms of bereaved family members.     

Enlisting family support in drug treatment

Drug abuse programs often experience difficulties involving clients' families in treatment. This article describes general principles and specific techniques for recruiting family members in drug abuse programs and in other treatment settings. Stanton and Todd's principles of recruiting for family therapy in drug programs generally apply, adapted to a project that involves only one family member in multifamily groups and provides psychoeducational training rather than therapy. Additional principles include: focusing on family members who live with the client, tailoring recruitment to the needs of individual families, emphasizing how the family member will benefit, addressing resistance directly, helping families to build a support network, and informing family members of what is expected of them. The psychoeducational approach shows promise as a beneficial adjunct to client-focused treatment and as a gateway to more extensive family treatment.     

Empathic Family Stress as a Sign of Family Connectedness in Haitian Immigrants

Research on familial experiences has documented the important role of receiving family support, but has not examined the effects of providing such support. Empathic family stress refers to the stress that individuals experience in response to difficult life circumstances of family members. The current study took a first step in examining the empathic family stress of 134 Haitian immigrants. Results from hierarchical regressions indicate that empathic family stress is a significant predictor of depressive symptoms, but not acculturative stress, for Haitian immigrants. Findings from the study are examined from a strengths-based perspective, where empathic family stress is viewed as a sign of strong family connections among Haitian immigrants. Recommendations are provided for clinicians working with Haitian immigrants to help them experience empathic family stress in a healthy manner.     

Experiences of Ambiguous Loss for Parents of Transgender Male Youth: A Phenomenological Exploration

Little research exists on the emotional experiences of family members in general, and in particular, the parents of transgender individuals during their disclosure or transition. The current literature on the family members of transgender individuals provides various models of emotional processing. These models are based on clinical work and experience with transgender individuals and their families, rather than on research. All of these models include many different emotional experiences and experiences of loss for family members. Thus, models describing loss and ambiguous loss are also helpful in understanding these experiences. This study explored parents’ experiences of ambiguous loss and manifestations of loss of their transgender male youth after the discovery or disclosure of the youth’s gender identity. Participants completed in-depth semi-structured interviews and data were analyzed using interpretive phenomenological analysis. Findings suggest some parents experience ambiguous loss while others do not. Findings also suggest that some parents experience feelings of grief as a manifestation of loss. Parents developed a variety of methods to cope with ambiguous loss; some of these methods were specific to the participant’s gender. Clinical implications are discussed, suggesting strategies for therapists working with parents of transgender youth.     

Entry and Emergent Agendas of Adults Visiting an Aquarium in Family Groups

ABSTRACT

Understanding visitors' agendas is important in providing insights about learning experiences in informal settings, particularly if we consider learning to be both a product (what they learn) and a process (how they learn it). Accordingly, a handful of studies have investigated the impact of visitors' agendas on learning. However, little attention has been directed to investigating the impact of individual and collective agendas on the nature of the visit experience for the adult members of family groups, or the dynamics and evolution of these agendas during and after a visit to an informal setting. This article examines the roles that personal agendas play in shaping and framing the aquarium experiences of the adult members of 13 family groups visiting the Vancouver Aquarium Marine Science Centre in Canada. It explores the dynamic and changing character of entry and emergent agendas within the family group context and the factors that constitute and shape such agendas. The roles of these agendas in the overall on-site learning experience of the adult members of the participating family groups, and the longitudinal impact of the aquarium visit are further discussed.     

“My Life is Too Chaotic to Practice What I Preach”: Perceived Benefits and Challenges of Being an Academic Women in Family Therapy and Family Studies Programs

The purpose of this study was to explore the experience of female faculty in family therapy and family studies graduate programs. Specifically, we were interested in how female faculty members in these programs experienced their roles as academics, partners, and/or parents. We conducted a discovery-oriented study qualitative study of 62 female academics in family studies and family therapy disciplines to identify the greatest concerns and benefits experienced by women in a family-studies-oriented academic field. Using a content analysis, we found that women in family studies/family therapy academic programs experience both high rewards and high demands and struggle with choosing among competing values. Additionally, the participants perceived support from colleagues, professional institutions, and family members as crucial to a female academic’s ability to perform up to expectations. We also offer suggestions for further research.     

Stages in the Family Therapy of Adolescents

Family therapy is considered from the systems point of view as a process with a series of stages including definitive beginning and end points. The stages are identified as crisis points in family therapy - i.e., moments in the therapy process when the equilibrium of the family is upset and when stress reactions among family members are most likely to be intense. Since times of crisis also provide special opportunities for growth and change, they can be utilized therapeutically provided the therapist is knowledgeable about the kinds of upheavals that a family may experience and the time sequence in which they may occur. Eight such crisis points and their relation to therapeutic intervention are presented. The purpose of this paper is to outline the role of the crisis as therapeutic opportunity in the course of family therapy.     

Familial patterns and the origins of individual differences in synaesthesia

The term synaesthesia has been applied to a range of different sensory-perceptual and cognitive experiences, yet how these experiences are related to each other is not well understood. Not only are there disparate types of synaesthesia, but even within types there are vast individual differences in the way that stimuli induce synaesthesia and in the subjective synaesthetic experience. An investigation of the inheritance patterns of different types of synaesthesia is likely to elucidate whether a single underlying mechanism can explain all types. This study is the first to systematically survey all types of synaesthesia within a familial framework. We recruited 53 synaesthetes and 42% of these probands reported a first-degree relative with synaesthesia. We then directly contacted as many first-degree relatives as possible and collected complete data on synaesthetic status for all family members for 17 families. We found that different types of synaesthesia can occur within the same family and that the qualitative nature of the experience can differ between family members. Our findings strongly indicate that various types of synaesthesia are fundamentally related at the genetic level, but that the explicit associations and the individual differences between synaesthetes are influenced by other factors. Synaesthesia thus provides a good model to explore the interplay of all these factors in the development of cognitive traits in general.     

How Does Migration Affect Mothers’ and Fathers’ Roles Within their Families? Reflections on some Recent Research

Collectively, the articles in this special issue reveal that immigration has diverse effects on individual family members that vary depending on their gender and age. Such findings underscore the need for intensive analysis and comparison on a number of levels—fathers versus mothers, sons versus daughters, parents versus children. This commentary highlights some of the findings that emphasise the centrality of gender in colouring the experience of immigration for different family members. Limitations of the findings are noted and suggestions are made for future research examining the effects of migration on families and family members.     

The epigenesis of the family system as a context for individual development

In this article, the concept introduced by Lyman Wynne, that the individual develops epigenetically within the family system, is discussed and validated with data from a study of the characteristics and relationships of 27 women with borderline personality disorder and their parents. Each stage of the epigenetic process is impaired in one way or another, adversely affecting subsequent stages. Early impairment of attachment-care-giving processes is at least partly attributable to a lack of empathic parenting; effective communication is married by family members' inability to experience or express feelings (alexithymia); this, in turn, makes it difficult to engage in joint family problem solving. Mutuality between family members does not occur in such a context, and there is an absence of intimacy between family members. These are often abusive family systems, with multiple abuse and intrafamilial sexual abuse more specifically directed at the daughter with BPD. The symptoms of the daughter can be understood systemically, as representing both predispositional characteristics and reactions to the family system. It is suggested that the epigenetic paradigm could be used to characterize the specific failure of developmental processes in many different disorders.     

A comparative study of the impact of education vs. process groups for families of patients with affective disorders

This clinical project compares the relative impact of two types of multiple family groups on psychiatric inpatients and their families. Forty patients with a diagnosis of affective disorder, and their family members, were randomly assigned to a traditional multiple family group with a process orientation that emphasized support, destigmatization, and self-help about common problems; or to a psychoeducational multiple family group that emphasized the provision of information about the patient's illness and methods of coping with it effectively. Both groups, which met for four hours on a Saturday afternoon, were an integral part of an ongoing inpatient program specializing in the treatment of affective disorders. Pre- and post-measures were obtained regarding family and patient knowledge about affective disorders, level of personal distress, attitudes about the illness, and dyadic adjustment. In addition, both patients and family members were asked to rate their satisfaction with the group experience. A number of differences in knowledge, attitude and dyadic adjustment were found in the participants of both groups immediately following their respective group sessions, but there were only a few statistically significant differences between the two groups. Those who attended the psychoeducational session, however, reported significantly more satisfaction with the experience.     

Latinx LGBQ Young Adults’ Coming-Out Experiences

Abstract

Marriage and family therapists (MFTs) must be culturally competent and sensitive to serve the growing Latinx population in the United States (US). To understand the sexual orientation disclosure experiences of Latinx LGBQ individuals, we interviewed 10 individuals. Using Moustakas’ (1994) phenomenology, we identified six themes: disclosure impacts family closeness, family members experience disbelief, control over the disclosure influences young adults’ perception of their coming-out experience, the coming-out experience is influenced by religion, the coming-out experience is influenced by traditional gender roles, and disclosure of sexual identity is a continuous process. We discuss clinical implications and areas for future research.     

A Family Experience of Personal Genomics

This article presents a personal journey of a close-knit family from Málaga, Spain who engaged with direct-to-consumer (DTC) genomic testing. Whilst the testing was initiated by one member of the family who works as a genome bioinformatician, none of the remaining family had any prior experience with DTC genetic testing. A thoughtful account, written in the first person, is offered on the experience of genome testing across the various members of the family together with a reflection on how it felt to be a custodian of the ‘family genome’. The way the family processed their genome information is explored and the difficulties and challenges that resulted are discussed. Whilst there is a wealth of literature that describes how families communicate information surrounding single genes, there is very little which explores the experience of communication about whole, shared genomes. The experiences described in this paper provide an insight into this new territory.