Attachment and the Emotional Unit

Until recently, the mother-child relationship was assumed to be the primary relationship affecting the outcome of an individual. This resulted in the mother-child dyad being seen and studied as separate from the family system in which it is embedded. This article asserts that, in order to understand this dyad adequately, one must understand "how" the family functions as an emotional unit that is guided by processes found in evolution and in relationships between living things. It goes beyond describing the family as a system of influence and seeks to account for the universal processes that occur in natural systems. It posits that the triangle is the basic building block of the emotional unit, and proposes a new theoretical dimension for understanding how attachment extends beyond dyads (such as parent-child) to include the emotional unit as a whole. Through triangles, the parent-child relationship is continually influenced by relationship forces operating within the system as a whole.     

Family Functioning Following Wildfires: Recovering from the 2011 Slave Lake Fires

Natural disasters are increasingly becoming a common occurrence; but there remains a paucity of information about how families as a unit recover from disasters in general and from wildfires in particular. The work presented here investigates family recovery after a devastating wildfire in a rural community in Alberta, Canada. The goal is to examine the experience of families, parents and children, in the aftermath of the wildfire including the evacuation and recovery. The study was conducted within a research program that is focusing on understanding the links between disaster recovery and community resilience. We interviewed 27 parents and 26 children representing 19 families and conducted extensive community fieldwork. Data analysis included an inductive coding process. Findings indicate commonalities among affected families. In particular, six main themes related to family recovery were generated: different life goals and priorities, new routines, changes in attitudes, changes in interactions within the family unit and with the community, as well as new values and perceptions. Results also indicate parents’ and children’s recovery is marked by their own experiences and particular needs. The discussion of these findings highlights the important role of parents in family recovery, but also the necessity of examining the family unit and the changes it undergoes in re-establishing family routines while acknowledging children’s concerns about protecting their parents. The study enhances our theoretical understanding of the social impacts of wildfires and is useful for those involved in disaster planning and recovery in preparation for future wildfire events.     

The Present Moment in the Primary Triangle

ABSTRACT

Daniel Stern described the present moment as “what happens here, now, between us” (BCPSG, 2010, p. 41). Stern considered the present moment as the basic unit of intersubjective communication or the sharing of inner states for both mother-infant pairs and therapist-patient dyads. He emphasized the importance of implicit processes for fostering change in relationships. Evidence collected during the last three decades in the Lausanne Centre for Family Studies points to a parallel, but collective form of intersubjective communication in the family that originates in infancy, thanks to the previously unknown competence of the young infant for multipartite interaction and sharing inner states with others. Collective intersubjectivity opens up new avenues for the understanding of development and change in the family, as well as for family therapy. These results are illustrated in several case vignettes and discussed in reports of conversations with Daniel Stern.     

Ambiguous Roles in a Stepfamily: Using Maps of Narrative Practices to Develop a New Family Story with Adolescents and Parents

Stepfamilies are increasing in number in Canada and around the world. Adults and children, specifically adolescents, can be challenged by the ambiguous roles that may happen in new family dynamics. Stepfamily members need to discover and discuss the perceptions and expectations of the individuals within the stepfamily to avoid distressful feelings and behaviours. Understanding how society can influence the perceptions of a family, and the effects of this influence, is explored. Family therapists can map the use of narrative techniques of re-membering, and re-authoring as described in Michael White’s Maps of Narrative Practice to help bring a stepfamily to new understandings about each other and the family unit.     

An evaluation of a partial training program in psychiatric residency on the later practice of marital and family therapy

Abstract

This paper reports on the results of a survey of psychiatrists and residents who received marital and family therapy training during their second year of residency. The data indicate that such training has an immediate positive effect on practice and is carried forward into later practice. Practicing psychiatrists trained in marital and family therapy during residency report spending 25% of their caseloads in marital and family therapy which was seen as producing positive change in patients. In line with previous training, practicing psychiatrists define the unit of treatment as more than an identified patient and treat marital and family therapy cases themselves or refer to others for such therapy. Variations in practice and techniques raise questions regarding the structure and content of marital and family therapy training in psychiatry residency programs and point out the importance of such training in the later practice of psychiatry.     

Compulsive and addictive sexual disorders and the family

In the treatment of sexual addiction and compulsivity, the family unit is often neglected. Yet this disorder has a major impact not only on the identified patient, but also on the spouse or partner (the coaddict) and on the family as a whole. Moreover, the family unit is the context in which the sexual addict continues to live, and the mental health of the partner has a significant impact on the sexual addict's recovery. Increasing evidence points to a family history of addiction or dysfunction as a primary contributor to both sexual addiction and coaddiction in adulthood. When compulsive sexual behaviors are present within a family, treatment of both members of the couple improves the couple's relationship as well as the mental health of each partner. In addition, treatment of children in such a family can help break the cycle of sexual addiction and prevent its perpetuation into the next generation.     

Alternative strategies for creating "relational" family data

A major problem facing family clinicians and researchers is creating data that will reflect the family as a unit. To address this problem, we present a framework for family assessment based on three measurement strategies: individual family member assessment, relational family assessment, and transactional family assessment. Within this context, we present several categories of methods for combining individual family member data into "relational" scores that reflect the couple or family as a unit. The problems and benefits of each method are presented, and it is suggested that the choice of method is dependent upon the content of the assessment, the theory underlying the content, and the statistical properties of the individual family member scores.     

The Paraprofessional and Family Therapy

The new career movement in the community mental health field will increasingly demand that training programs provide the paraprofessional with a clinical role that avoids the temporary and mostly erroneous advantages of being an “indigenous” worker. Clinical functions taught in training need to be related to the problems of the urban poor; it is this group that needs a concept of service that can combine management of reality with beneficial restructuring of psychological systems. The resulting role is that of the paraprofessional family therapist — a new career that offers service to the troubled family unit of the urban poor and vocational definition to the person who is so trained.     

Brief Therapy: Two's Company

The triad is a key element in family therapy. It is clinically useful to conceptualize it as a unit with a structure of its own. This paper suggests that a typical triadic system consists of a pair of allies and an isolate, or "odd-man-out," all of whom are "stuck" in a rigid pattern that has become dysfunctional. The therapist can break the pattern by developing interventions specifically designed to create new alliances and thus broaden the family's behavioral repertoire.     

The Family and the School: Utilizing Human Resources to Promote Learning

There is a continuing challenge in our complex society to bridge the gaps that exist between various subsystems. Only by overcoming segmentation can common problems be mutually addressed and the full resources of each subsystem be utilized in finding viable solutions. The project described here brings together members of the family with public school professional staff and a consultant from a family therapy unit. Each system learns from and about the others in an open, sharing environment. The processes of family therapy are utilized with the goals of reversing maladaptive school behavior of children and facilitating constructive interactions both between the family and the school and among school personnel.
The uniqueness in this effort lies in the treatment of the staff of a school as a live, dynamic, interacting system having some of the characteristics of a family. The need for mutual respect on the part of consultant and school personnel is documented. Defining and observing boundaries, clarifying roles and creating a non-critical atmosphere provide the security that permits and encourages individuals to share relevant material within agreed-upon parameters.
Changes in traditional practices have been achieved. School psychologists have taken on new roles while principals and staffs have learned new techniques and skills for relating to each other and for approaching family-based school learning problems. The non-blaming approach recognizes the child as a member of both a family and school organization. Bringing the family and the school together for dialogue and planning unburdens the child as a conveyor of information and values between the two systems. Thus far, there have been substantial benefits from the project to the schools, to the families, and to the body of professional knowledge from which we all learn and grow.     

建立“社区卒中单元”的必要性

"社区卒中单元"是以社区医疗机构为支撑,以患者家庭为中心,以此二者双向互动为轴线,以提高卒中患者的生活质量为目的。"社区卒中单元"与通常意义上的"医院卒中单元"不同。在这一模式中,患者及其家属的康复自助的积极性、主动性具有决定意义。     

Serial migration and its implications for the parent-child relationship: a retrospective analysis of the experiences of the children of Caribbean immigrants

This study addressed the potential impact of serial migration for parent-children relationships and for children's psychological well-being. The experience of being separated from their parents during childhood and reunited with them at a later time was retrospectively examined for 48 individuals. A series of measures (e.g., self-esteem, parental identification) associated with appraisals at critical time periods during serial migration (separation, reunion, current) revealed that serial migration can potentially disrupt parent-child bonding and unfavorably affect children's self-esteem and behavior. Time did not appear to be wholly effective in repairing rifts in the parent-child relationship. Risk factors for less successful reunions included lengthy separations and the addition of new members to the family unit in the child's absence.     

Stressors, Stress Mediators, and Emotional Weil-Being Among Spouses of Soldiers Deployed to the Persian Gulf During Operation Desert Shield/Storm

The Family Factors Field Study of Operation Desert Shield/Storm (ODS) was designed to collect data on the impact of the Persian Gulf deployment on soldier/family well-being, and the effectiveness of Army and community resources in assisting and supporting families of deployed soldiers. In October 1990, a task force was assembled, and multi-agency research teams visited several Army installations. Informal individual and group interviews were conducted with spouses, unit family support leaders, unit rear detachment personnel, garrison leaders, and local Army program/service providers. The questions were aimed at identifying key stressors which spouses and children experienced in relation to the sudden deployment, as well a stress mediators such as social supports and personal coping skills. Anecdotal information collected during the site visits, combined with findings from previous research on Army families, was used to develop a questionnaire designed to quantify those variables which emerged as relevant to a study of stressors and stress mediators in the context of the ODS deployment.     

Parenting,Protecting, Preserving:Mission of the Adolescent Female Runaway

This paper presents a systemic framework for therapy with families of adolescent female runaways. The runaway adolescent is viewed as serving three functions within her family. First, she often parents her parents and siblings. Second, she protects her parents' marriage and regulates marital distance. Third, she preserves her family unit at the preadolescent developmental stage. Interventions are described that remove the adolescent from those roles by empowering the parents to take charge of the adolescent, by changing the communication process such that the couple deal with their marital issues without the help of the teenager, and by facilitating the family's movement toward a new stage of separation and individuation.     

Creating a Secure Family Base: Some Implications of Attachment Theory for Family Therapy

The aim of this article is to make attachment research findings available in a form that family therapists can use. In attachment theory, parents are conceptualized as providing a secure base from which a child can explore. Family therapists, however, need a systemic concept that goes beyond the parent/child dyad. The concept of a secure family base is proposed, in which a network of care is made available for all family members of whatever age so that all family members feel secure enough to explore, in the knowledge that support is available if needed. Factors that contribute to the security or insecurity of the family base are outlined. The overall aim of therapy is to establish a secure family base from which the family can explore new solutions to family problems both during and after therapy. The role of the therapist is to help to resolve conflicts that threaten relationships, and to explore relevant belief systems that may be contributing to a sense of insecurity. The conceptual framework presented allows for an integration of family therapy techniques and ideas into a coherent whole. A new school of family therapy is not proposed.     

The role of proxies in treatment decisions: evaluating functional capacity to consent to end-of-life treatments within a family context

Psychology as a profession has entered the arena of palliative and hospice care later in the process than other health care professions. Through the use of Familial Advance Planning Evaluations (FAPEs), however, psychologists can assist individuals and families in facing end-of-life transitions in important ways. Hospice and palliative care philosophy treats the patient and family as the unit of care. End-of-life decision-making is therefore a family matter as well as a normative developmental transition. Yet, little is known about the decision-making process. This paper reviews the literature regarding informed consent, advance care planning, and proxy decision-making and outlines a theoretical model for familial decision-making. Previous models of end-of-life capacity evaluations and family assessments are presented and serve as the basis for a comprehensive assessment of familial decision-making at the end of life. Functional capacity evaluations of individuals at the end of life regarding decisions about life-sustaining medical treatments enable both the individual patient and one identified proxy from his or her family to discuss important issues families may face during medical crises at the end of life. The information gleaned from such evaluations has the potential to assist psychologists and other professionals in designing family-specific interventions to reduce caregiving distress, improve quality of life for dying patients, and ease the transition to bereavement for caregivers.     

The matryoshka: The three-generation soviet family in Israel

Among the 200,000 immigrants who entered Israel in 1990 were a considerable number of families headed by single mothers. Their most prominent feature was the fact that a three-generation system—a single Soviet mother, her own mother, and a single child—formed the family unit. Rooted in changes occurring in the Soviet family life cycle over the past 70 years, this configuration is uniquely self-contained. This article is an early inquiry into a new family structure that will become part of the social fabric of the multi-ethnic society in Israel. The challenge will be to help in the absorption process by recognizing, encouraging, and facilitating the strengths this type of family brings with it and to plan support networks to substitute for those left behind.A previous version of this article was presented at the Third World Family Therapy Congress, June 2–6, 1991, Jyvaskyla, Finland.     

A Fourth Subject Position of Care

Analyses of care work typically speak of three necessary roles of care: the care worker, the care recipient, and an economic provider who makes care materially possible. This model provides no place for addressing the difficult political questions care poses for liberal representative democracy. I propose to fill this space with a new caring role to connect the care unit to the political sphere, as the economic provider connects the care unit to the economic sphere. I call this role that of the “care claimant.” The labor of claiming care consists in the development, expression, and advancement of the interests of the care unit. The argument for employing this fourth care role begins by comparing Nel Noddings's phenomenological care unit to Sara Ruddick's family‐based analysis. It then moves to discuss the way Eva Kittay emphasizes the dependency of the charge and its political ramifications to illustrate the need for a care claimant. After distinguishing the care claimant from the other roles of care, I examine the power relationships in the care unit and the position of the care claimant in the public sphere.