Using Genograms Creatively to Promote Healthy Lifestyles

ABSTRACT

Family therapists have used Genograms as an assessment tool for years to examine the interactions and relationships of family members across generations. This article discusses how a therapist can use a genogram creatively to help clients examine the impact of family relationships on healthy and unhealthy lifestyle patterns and how those relationships may be influencing the manner in which clients are currently managing their lives. The integration of a creative genogram can assist clients in recognizing inherited health-disease risks, learned lifestyle patterns, and parental behavior modeling. This technique can assist clients in developing a healthier lifestyle.     

Pregnancy,Intimacy, and the Family Constitution

SUMMARY

The psychological effects of pregnancy and birth have a profound effect on the parents' relationship, especially on their experience of intimacy. The nature of the impact on the couple depends on the developmental stage of each parent and the couple's ability to adapt to new circumstances. Three developmental stages are described and the “family constitution” is presented as the body of goals, rules and roles that governs the behavior of the family and effectively managing the constitution is introduced and applied to two sets of circumstances related to pregnancy. Finally, the implications of the above concepts for therapists and counselors are delineated.     

The Journal of Couples Therapy Entelechy Institute CEU Quiz

SUMMARY

The majority of gay male couples are not monogamous. Relationship clinicians can help gay male couples to have a healthy sexually open relationship by working from a family systems perspective. This approach requires the therapist to have an understanding of family systems theory, the Enneagram (a personality topology), gay male sexual culture, as well as being clear of negative countertransference. Assessment of functionality of sexually open gay male relationships is described.     

Telling the Truth About Power

SUMMARY

In this culture, those in power do not usually talk about it and the rest of us tend not to recognize it either. A similar situation exists in therapy, where the therapist herself may not be aware of her own power-over tactics. This article suggests methods that may help therapists to acknowledge their power and also to change from power-over actions to mutually empowering relationships. From this line of thinking, there follows an exploration of altering the concept of boundaries in therapy into mutually constructed agreements between patient and therapist. This article was presented at the Summer Training Institute of the Jean Baker Miller Training Institute, June, 2003.     

Couples' Experience of Enactments and Softening in Marital Therapy 1

Abstract

Beginning therapists are not prepared to deal with the complexity that families bring to the therapeutic setting and have a reductionistic approach to understanding what is occurring in a family. In order to move beyond a simplified approach, therapists with the assistance of a supervisor have the power to leave the security of their own being and can learn to take risks. This paper explores the development of a “therapeutic story” with the goal of assisting the beginning therapist in approaches that can be utilized to incorporate all available resources that will help to empower a family to change.     

The Balloon Theory

SUMMARY

This article outlines a method for helping couples to grow in their capacity to be intimate. The Balloon Theory describes a four step method to help the therapist facilitate growth and understanding, by identifying the underlying fears and defenses, which thwart intimacy and create distance in relationships. The Balloon Theory provides a metaphor for growth, which helps to educate couples about how to enhance their own efforts at increasing intimacy, and resolving conflict, long after they have left the therapist's office.     

Sexuality and Intimacy in Couples Therapy

SUMMARY

In ages past, spiritual seekers left their close relationships for the seclusion of a monastery or a solitary journey, facing their dragons essentially alone. Today, however, many of us face the dragons within us as we undertake the tasks of differentiation and individuation. Thus, our relationships, if we allow them, can become the loci of our deepest self-exploration, leading to deepening intimacy with our partners.     

Constructive Metatheory: II. Implications for Psychotherapy

Abstract

The implications of constructive metatheory for the conceptualization and practice of psychotherapy are briefly outlined. It is argued that the constructivist therapist construes the client as an active and developing process, and that psychological problems are approached not as piecemeal flaws or deficiencies, but as expressions of current discrepancies between an individual's adaptive capacities and the challenges she or he faces. Likewise, the process of psychotherapy is portrayed as one of trial-and-error experimentation with different (novel) ways of “being in the world.” Ideally, the client and therapist create an intimate and emotionally charged alliance in and from which the client can explore and experiment with self and world relationships. These practical features dovetail with many assertions of the major me-tatheories of psychotherapy, and it is argued that constructive metatheory may be uniauely suited to facilitating attempts at conceptual integration     

Trauma and processes of separation from parental figures

Abstract

Extreme conditions in some young persons' life-experiences might postpone or even hinder the natural process of mourning of lost childhood omnipotence, ambivalent feelings towards and separation from parental figures. The psychic mechanisms behind these youngsters' flight from the loving grip of their parents to the conflicting situations which later traumatise them are described. The traumatic events following their choice of leaving the parental home were later unconsciously experienced as punishment—a direct consequence of the forbidden separation. Guilt problems otherwise within the normal range of development, here get a special colouring which can be recognised among others in the difficulties to establish a working-alliance with the therapist and problems in establishing intimate relationships later in life.     

Making Menarche Positive and Powerful for Both Mother and Daughter

Abstract

Psychotherapists who treat mothers with preadolescent daughters are in an excellent position to positively influence mother-daughter relationships at a time when Western societal influences are pushing them apart. Therapists are encouraged to help mothers process their own experiences with menarche, development of secondary sexual characteristics, and attitudes toward their bodies. By exploring these areas with their clients and then by encouraging the mothers to have early intimate discussions with their daughters, therapists can learn valuable information about their clients and can lay the groundwork for healthier mother-daughter relationships. Examples are given to help therapists encourage mothers to begin these difficult dialogues with their daughters. Suggestions are presented to help mothers overcome their daughters' reluctance to discuss sensitive topics of bodily maturation, menstruation, and emerging sexual development.     

Honoring Protective Responses: Reframing Resistance in Therapy Using Polyvagal Theory

Therapists often conceptualize resistance as client behaviors that impede progress; this perspective threatens the therapeutic alliance, especially in couple and family therapy where increased resistance and multiple alliances are present. Polyvagal theory reframes and normalizes resistant behaviors as preconscious, protective responses emerging from our autonomic nervous system. The theory also explains how humans reciprocate safety cues to connect with each other; therapists can use concepts of polyvagal theory to manage their own emotional regulation and foster safety and connection in therapy. Polyvagal concepts deepen our understanding of protective behaviors presenting in couple and family therapy; therapists can help couple and family clients to recognize protective behaviors in their own relationships and facilitate safer connection and engagement. Clinical implications are presented: psychoeducation can help clients normalize and understand their protective processes; therapist presence and immediacy acknowledges and normalizes protective behaviors as they arise; therapist and client self-regulation skills support connection; therapist genuineness is a precondition to client safety; and understanding of polyvagal theory enhances assessment of conflict and enactments in couple and family therapy.

     

Applying developmental previewing to the principles of family therapy

This paper discusses the application of principles of infant psychiatry to the diagnosis and treatment of multigenerational family conflict. Using a technique referred to as previewing, the therapist can focus on the interpersonal meaning that the infant's development precipitates in the family and determine how the parents' relationships with the infant replicate their relationships with their own families of origin. The therapist may then use these insights for overcoming conflict and for acclimating parents to new developmental skills in an optimal manner. Specific suggestions for how parents may promote more adaptive patterns of interaction with the infant using previewing are offered.     

Sources of influence on the professional development of psychologists and psychiatrists in Norway and Germany

Background: There are many professional psychotherapists, but no psychotherapy profession. The psychotherapists’ professions vary between countries, the most frequent being psychiatry and clinical psychology.

Aim: As these professions have different basic training and also may be impacted differently by other factors, we wanted to study potential differences as to perceived influences on their development as psychotherapists across career level, theoretical orientation, and gender.

Methods: More than 2500 Norwegian and German psychiatrists and psychologists reported data on their professional development in the DPCCQ/2000, a lengthy multi-part survey instrument developed within the ‘Collaborative Research Network’ of the Society for Psychotherapy Research. The four groups were compared for differences, and a series of multiple regression analyses were conducted to examine the impact of profession on a variety of aspects of therapist experiences.

Results: Although a few therapist experiences (e.g. teaching, treating patients, institutional conditions) had a significantly different impact between the two professions, as a main effect, they only accounted for less than 1% or the variance.

Conclusion: Profession seems to have little influence on perceived development as a psychotherapist, and it is reasonable to conclude that other therapist qualities, often personal qualities, are more important for therapeutic processes and outcomes.     

The Nonhuman Environment in Normal Development and in Schizophrenia by Harold F. Searles

Abstract

Somatic psychology, the interplay of the body, the mind, the emotions, and the social context, significantly contributes to the theory and practice of group therapy. The processing of sensory experiences in the here-and-now of the therapy group helps group members to develop self-awareness, the ability to understand their relationships with others, and the capacity for empathy. When group members know what they experience, they can understand how others feel and resonate emotionally with those feelings. Neurobiology, sensory processing, and attachment theories help us to understand how the sense of self develops somatically. Principles of somatic therapies are applied to group therapy practice in working with attachment disorders, transference impasse, and trauma. The importance and implications of the group therapist’s embodied attunement are explored.     

Face It Head On

SUMMARY

This article focuses on key clinical ideas to help couples face directly the painful issues brought about by infidelity. The author discusses key relational processes related to infidelity along with desired outcomes. The emphasis is on helping couples change key relational dynamics that facilitate the healing process. Couples are encouraged to engage in the healing process head on, and not avoid or skirt around the issues. The article illustrates these desired changes by means of a case Study.     

Ego Development at the Crossroads: Identity and Intimacy Among Black Men and White Women in Cross-Racial Relationships

This study addressed the ego development of White women and Black men who were in cross-racial relationships. Twenty-one participants completed in-depth, individual interviews, focus group inquiries, and the Sentence Completion Test (SCT). The results indicate that a majority of the participants scored at the higher levels of ego development: 50% of the Black males and 67% of the White females were at the conscientious stage of ego development, 25% of the Black males and 22% of the White females were at the individuated stage. The results from the interviews and the focus groups substantiated the participants' scores on the SCT, exemplifying the complexity in which Black men and White women perceive themselves as individuals and others in relationships. Loevinger (1976, Ego development: Conceptions and theories. San Francisco: Jossey-Bass.) contends that these higher stages represent a complex means of understanding oneself and of interacting in intimate relationships. The terms of African American heritage, African American, and Black are used synonymously and interchangeably, as are the terms of European American heritage, European American, and White.     

Utilizing artistry in a therapeutic relationship

Abstract

In many humanistic approaches, therapeutic change involves utilizing the relationship between the client and therapist as a tool for personal growth. Like any relationship, the therapeutic relationship is one that is co‐created between those engaged in it, namely, the client and the therapist. Utilizing this co‐created relationship requires a sense of artistry on the part of the therapist. A therapist must be willing to engage in this meaningful relationship with the client. A therapist must also be aware of the personal values that he or she brings into therapy, and how they influence the therapeutic relationship. Finally, a therapist must acknowledge the power that the therapist and the client possess in the relationship, and understand how that power can be used to validate and invalidate the therapist's and the client's personal meanings. These aspects of therapeutic artistry are discussed and the use of therapeutic artistry in Eron and Lund's (1996) narrative solutions approach is presented.     

Putting down roots: the significance of technical adaptations in the therapeutic process with fostered and adopted children‡

Severely neglected and traumatised children have also suffered from a lack of the parental nurturing which is needed for ordinary emotional development to take place. Often their past experiences make them unable to utilise the nurturing that foster and adoptive families try to give them and they are delayed or stuck in their development. In therapy, when the early small signs of new emotional development start to emerge, they may be heralded by technical challenges to the therapist. Two examples are given in this paper, which are discussed in the context of Stern et al.’s ideas about moments of meeting, Winnicott’s concepts about transitional phenomena and playing, and Hurry and her colleagues’ thoughts about the therapist as a developmental object. It is argued that it is important for the therapist to be alert to the possible significance of these technical adaptations in terms of the child’s capacity for new emotional development. These often indicate that a watershed in the treatment has been reached and if positively responded to, that the patient is in the process of ‘putting down roots’ in the ground of the therapeutic relationship and starting to grow across a spectrum of developmental pathways.     

Divorce Therapy in Context

Abstract

Partners trying to decide whether to continue or end their marriage rely on the expertise of therapists to help them evaluate their alternatives. Research on what predicts divorce and what consequences divorce has for parents and children is reviewed so therapists are informed in the guidance they give clients. Attention is given to the environmental context of marriage as well as its interior quality. Implications for therapists doing divorce therapy in the context of a “pro-marriage” climate are also discussed.     

The associations between autistic and communication traits in parents and developmental outcomes in children at familial risk of autism at 6 and 24 months of age

BackgroundSeveral studies have explored relationships between parent broader autism phenotype and offspring communication, and have reported that autistic-like traits in parents are related to offspring communication difficulties and autism severity. However, past research has focused on studying such associations in childhood and we know very little about them in infancy. With accumulating evidence that interventions administered during infancy may be most effective in reducing ASD symptoms, it is imperative to examine whether relationships between parent autistic-like traits and child communication appear even earlier during this critical period of life.MethodThis longitudinal study collected data from infant siblings of autistic children (N = 32) and infants with no family history of autism (N = 45) to explore how autistic-like traits in parents related to child developmental outcomes during infancy.ResultsParental communication difficulties and autistic-like traits were found to be associated with a range of child behaviours in the first two years of life, including social-emotional difficulties at 6 and 24 months, lower communication and emerging cognition at 24 months, and increased autistic behaviours at 24 months.ConclusionsBased on the results, it appears that some of the difficulties seen in parents are relayed to children genetically. These findings contribute to ASD research concerning early communication development in children and heritability of ASD traits and may have important implications in monitoring child development. Furthermore, since the current study found a significant association between autistic traits in parents and child social-emotional behaviour as early as 6 months of age, it provides evidence of the value of assessing interventions that target infancy.