"Living with" the past: coping and patterns in families of Holocaust survivors

This exploratory study looks at how families of Holocaust survivors work through the traumatic past by considering the coping patterns adapted by family members. Life-story interviews (Rosenthal, 1993) with 57 individuals from 20 families, in which there were two to three generations, were used in order to learn about the significance they attach to the Holocaust past. The interviews were analyzed using Rosenthal's methods and Danieli's (1988) typology of post-war adaptation (victim families, fighter families, those who made it, and numb families). Results showed that in order to differentiate between the coping styles exhibited by the families, two new categories had to be added to Danieli's typology. These were entitled "life goes on" and "split families." It was concluded that survivor families exhibit heterogeneity in the ways in which they cope with the Holocaust past.     

Psychotherapy without the self–a Buddhist perspective,by Mark Epstein

This article seeks to explore how John Rolland's Family Systems Illness Model can be utilized by counselling psychologists working with individuals or families experiencing medical problems. Based on systemic theory the model provides a psychosocial typology of illness and examines how the demands of an illness over time can provide a number of hurdles to be overcome by the client and his/her family. Specific examples and techniques are described to illustrate how the application of the model can be used to guide the interventions employed in a counselling session. the model applies a biopsychosocial approach to health care, and the applicability of this within a British NHS healthcare setting is discussed with the conclusion that such an approach may be in its infancy in this country. Limitations and ideas for expansion of the model from chronic physical illness into spheres of mental health are discussed.     

Vicarious and post‐memory practices in adopting families: The re‐production of the past through photography and narrative

In this paper, we explore how adoptive parents manage and order visual information relating to their adoptive child's birth or foster family. More specifically, our task is to make sense of the ways in which the memories that children have of their past families are (re)constructed and managed within the context of present adoptive parental concerns. Life story books have become a dominant way in which narratives of the child's past family are formed. The aim of this book is to provide the child with relevant information, objects, possessions and images of the past and to create a coherent narrative between the past and the present. Parents are encouraged to make use of visual images, consisting mainly of photographs of birth families and foster carers to order the autobiography of the child. To date, there is no research that has examined how the process is experienced by parents and children. In order to examine how parents made use of visual information in particular, we carried out two focus groups with adoptive parents who participated in an adoption agency support group. A social remembering approach informed the questions asked, and a discursive analysis of the data was developed. The main analytical focus in this paper is on how photographs, objects and places serve as active participants in the production of the adoptive children's memory. Copyright © 2008 John Wiley & Sons, Ltd.     

Helping Couples Fulfill the “Highest of Life’s Goals”: Mate Selection,Marriage Counselling,and Genetic Counseling in United States

This article traces the history of modern genetic counseling to mate selection and marriage counselling practices of the early-20th century. Mate selection revolved around a belief that human heredity could be improved and genetic diseases eradicated through better breeding. Marriage counselling, though interested in reproduction, was also concerned with the emotional and psychological well-being of couples. These two practices coalesced most obviously in the work of well-known geneticist Sheldon Reed. Even as marriage and genetic counselling diverged in the post-WWII period, vestiges of these practices remain in contemporary counseling experiences with family planning and genetic screening programs. Emphasizing points of continuity between “positive” eugenic ideologies and modern genetic practices elaborates the diverse origins of genetic counseling. It also exposes how genetic counselors have become involved in genetic enterprises beyond standard clinical settings, and prods at key issues in the interaction between genetic science and social values.     

From directive expert to non-directive partner: A study of facilitating change in the occupational self-perceptions of health visitors and school nurses

A group of health professionals participated in a ten-week course in counselling skills for working with families whose children have special needs. A comparison group received no such training. Occupational self-perceptions were measured during training and at one-month follow-up. Significant shifts were found in perceptions of self as 'expert' to self as therapeutic 'partner'. In particular, training produced positive changes in self-perceived counselling skills, internal locus of control, and self-esteem. It was concluded that training conceived along interdisciplinary lines can promote a belief amongst health-care professionals in the efficacy of working in partnership with families; that such an effect provides further support for working in such a way; and that appropriate provision of similar courses therefore should be incorporated into strategic health-care planning.     

Evaluation of a counselling skills course for health professionals

A counselling skills course run by a London hospital for 11 health professionals was evaluated. The course covered family counselling skills and child management techniques. Qualitative and quantitative measures were used at five times of testing over a period of 10 months. It was found that participants improved self-perceptions of their counselling ability, increased their knowledge of counselling theories, and considered the course to be helpful in their subsequent work with families. There was no significant change in trainees' self-concept scores. Regular supervision was regarded as helpful in consolidating skills and exploring aspects of practice in a safe environment. Issues relating to evaluation research are discussed.     

‘The experiencing of experience’: a Pragmatic reassessment of Rogerian Phenomenology

This paper draws on a study that asked twenty family users about their first session of family therapy. Analyses of the interviews indicated that families entered therapy with a pre-existent knowledge about therapy, which did not always chime with those of professionals and which positioned speakers in ways which governed their expectations and perceptions of therapy. This paper, therefore, is concerned with the acquisition and deployment of knowledge: specifically, the knowledge involved in being a user of family therapy. Three key discourses were identified through this analysis: medical, counselling and consumerist. We aim to illustrate how these discourses served as a resource for members of the family in constructing therapists, therapy and themselves in relation to their experience. The examination of the rhetorical, ideological and practical effects of the positions chosen and the objects constructed, in terms of how speakers wanted to present themselves, with what enhanced or diminished status as patients, shows users actively engaging with the power of therapeutic institutions. Users’ accounts suggest that while most speakers felt anxious about the prospect of therapy, there were clear differences in overall satisfaction/dissatisfaction with the experience according to the synchrony between speakers’ construction of the therapist, and themselves as client/patients. Those who seemed to take a traditional view of therapy within a medical discourse valued therapists who offered diagnosis and a cure; those who sought and experienced a counselling relationship with the therapist found their experience to be constructive in terms of enhanced self-knowledge. We believe that the research findings discussed in this paper have implications for family therapists in accommodating to parental and child positions to maximise the effectiveness of therapy and so minimise drop-out.     

Critical Interaction Therapy: Couples Therapy in Combat-Related Posttraumatic Stress Disorder

There is a need for family therapy interventions that are specific to the conditions found in families of traumatized people such as combat veterans. In these families, the historically "real" event of the trauma often continues to exert influence on the family system despite collusive arrangements that serve to keep it hidden. In families of combat veterans, a situation develops whereby the veteran becomes triangulated with a dead buddy without the spouse's knowledge. The discrepancy between past and present emerges in what we call the critical interaction between the spouses. This article outlines a method of couples therapy that attempts to demystify this critical interaction, and begins to integrate the discrepant narratives of each spouse. The establishment of a nascent mutuality of perspective within the couple releases energies that can be directed toward support rather than symptom-formation in the family system.     

Power and influence in the environment of family therapy

This paper explores some of the ways in which family therapy theory and practice limits an appreciation of the contexts of families and family therapists. It focuses particularly upon how the rules which underline patterns of relationships in social systems are made and maintained more by one part of a system than by another, and considers this (a) within families, (b) within various aspects of the social environment of families, and (c) within the organizational contexts of family therapists. It then proposes that the systemic thinking which family therapists apply to families is potentially applicable to wider contexts including international relationships.     

Power and influence in the environment of family therapy*

This paper explores some of the ways in which family therapy theory and practice limits an appreciation of the contexts of families and family therapists. It focuses particularly upon how the rules which underlie patterns of relationships in social systems are made and maintained more by one part of a system than by another, and considers this (a) within families, (b) within various aspects of the social environment of families, and (c) within the organizational contexts of family therapists. It then proposes that the systemic thinking which family therapists apply to families is potentially applicable to wider contexts including international relationships.     

The Parent's Nazi Past and the Dialogue Between the Generations

This paper considers the impact of the Nazi past on the succeeding generation in Germany and on the dialogue between the two generations, using the theoretical framework of the dynamics of delegation — missions entrusted to parents by their children. Those issues became manifest in the course of conjoint family interviews with adolescents and young adults whose parents had been identified with the Nazi past.     

The Development of a Methodology for Examining the Process of Family Communication of Genetic Test Results

It is important to study communication processes in families where members are undergoing testing for genetic conditions because the information received from such testing is crucial not just to the individual concerned but also to other members of the biological family. This topic has received little research attention, in part because of the complexities of methodology required. In this paper we present the development of a method specifically designed for the examination of the content and process of communication of genetic information in families. The method aims to maximize ecological validity as far as is possible. We describe how participants and other family members are recruited and how data were collected. We outline three main data analytic strategies: a graphic to show how genetic information changes as it flows from clinic and through the family, an intensive qualitative analysis of the meaning and impact of the genetic information to different family members, and an informative genogram which plots key family dynamics. This method will be illustrated in relation to a study of ten family-groups where one individual has been found to carry a genetic mutation predisposing them to hereditary breast and ovarian cancer.     

Internet and computer technology hazards: perspectives for family counselling

Families are increasingly integrating computing technologies into their everyday activities, expanding the range of external influence upon them. For many families, basic notions of 'home' are undergoing shifts as large-scale cultural and economic changes occur that are related to the 'Information age' and as family members spend more time on the Internet and with advanced communications technologies. The Internet is also providing the backdrop for a number of critical family problems, as many counsellors are discovering in their therapy efforts. This article explores the social construction of the various computer hazards that households are encountering, such as computer addiction and children's access to on-line pornography. For example, some parents label deep-seated family issues as 'technological' problems because of the involvement of the computer, while others overlook or deny the possible influences of technologies. The article discusses these issues in terms of constructivist counselling perspectives that are sensitive to cultural and environmental contexts. It outlines some of the specific strategies for countering these problems that counsellors can utilise with their clients (such as solution-focused approaches). It also discusses how counsellors can help household heads to define and deal with their rapidly changing responsibilities in these new realms.     

A cross-cultural study of family functioning

The Family Assessment Device (FAD) was used to compare patterns of family functioning in two cultural settings, North America and Hungary. The sample size consisted of 95 nonclinical North American families and 58 nonclinical Hungarian families. No cross-cultural differences were found in the families' general functioning nor in their affective involvement or affective responsiveness as measured by the FAD. Hungarian families, however, perceived their functioning as significantly better than the North American families in problem-solving and in communication. North American families rated themselves significantly better than the Hungarians in setting family rules and boundaries and in meeting their family responsibilities. Results from this study suggest that cultural values can affect a family's functioning and that differences in areas of family functioning can be captured using the FAD. A discussion of broad societal values of the two cultures was used to interpret the contrasting patterns of family functioning.Cross-cultural studies serve many purposes. In general they provide knowledge about the different cultures under investigation. As such, they broaden and enrich our perspectives of ourselves and the world around us. More specifically they highlight similarities and differences across cultures, information that can be helpful in further refining our understanding of the impact of diverse and varying socio-political forces.A topic of particular interest to family therapists and researchers is family functioning in different cultural settings. In spite of continuing research in this area, few studies examine cross-cultural patterns of family interactions and even fewer do so with instruments specifically designed to assess family functioning.From a family perspective, particularly looking at pathology in family functioning, cross-cultural comparisons can be used to highlight areas of dysfunction common to families irrespective of the cultural context. From a cross-cultural perspective, family comparisons can be used to point out the cultural effects and emphases given to different dimensions of functioning within a common system (i.e., the family unit).Both conceptual and methodological problems have contributed to shortcomings in previous cross-cultural studies (Fabrega, 1974; Kleinman, 1987; Flaherty et al., 1988; Rogler, 1989). A basic criticism of such studies has been the assumption that meanings and values in one culture are equivalent to those in another.Another issue, which is particularly pertinent to our study, is the use of an instrument which is developed in one culture and administered in another cultural setting. A potential problem this raises is inferring cultural differences between groups when the translated and the original instruments are not actually comparable in meaning. In fact, one objective of the study was to see whether our own self-report measure of family functioning, the Family Assessment Device (FAD, Epstein et al., 1978, 1983), could be successfully used in another cultural setting.The following report is part of a larger research project, conducted in 1986–87, that compared depressed and nonclinical families across two cultures. The findings presented here are comparisons between nonclinical Hungarian and nonclinical North American families. In our earlier study differences in family interactions between clinically depressed and nonclinical families were evident in both cultural settings (Keitner et al., in press). It was not clear, however, if significant cross-cultural differences in family functioning would be found for the normal group of families and, if so, how these would differ from their ill counterparts. Inclusion of the normal families thus served two purposes, as controls in the larger study to test within cultural differences and as comparison groups in a separate analysis to test between cultural differences.A specific objective of this study was to contrast patterns of perceived family functioning in nonclinical Hungarian families and North American families. Another objective was to determine if the Family Assessment Device (FAD), a self-report measure of family functioning, could be successfully used in different cultural contexts. Hungary was chosen as an appropriate country of study for several reasons. It is at the crossroads of East and West, sharing enough similarities with western culture to validate comparisons, yet different enough in both its cultural and sociopolitical system that some differences could be expected to emerge. Because it is likely that the Hungarian social system is less familiar to readers than that of North American, the results are discussed with particular reference to Hungary.We would like to thank Drs. J. Furedi and T. Kurimay for help in translating the Family Assessment Device and Professors J. Szilard and Muszong-Kovacs for their support of this study. This work was supported in part by the Firan Foundation.     

A culturally sensitive approach to therapy with immigrant families: the case of Jewish emigrants from the former Soviet Union

This article is based on accumulated clinical experience in Israel with families that emigrated from the former Soviet Union. It describes a culturally sensitive systemic intervention with two such families: a single-parent family, and a family that exhibited physical violence. Relevant cultural characteristics of family patterns and parent-child relationships in Jewish-Soviet families are reviewed. It is demonstrated how a cross-cultural perspective may affect the interpretation of presented problems and result in a less pathological perspective. It is further illustrated how universal intervention techniques combined with culturally sensitive approaches may produce positive effects in therapy.     

The memory of concentration camp survivors

This study is concerned with the question whether extremely emotional experiences, such as being the victim of Nazi concentration camps, leave traces in memory that cannot be extinguished. Relevant data were obtained from testimony by 78 witnesses in a case against Marinus De Rijke, who was accused of Nazi crimes in Camp Erika in The Netherlands. The testimonies were collected in the periods 1943–1947 and 1984–1987. A comparison between these two periods reveals the amount of forgetting that occurred in 40 years. Results show that camp experiences were generally well-remembered, although specific but essential details were forgotten. Among these were forgetting being maltreated, forgetting names and appearance of the torturers, and forgetting being a witness to murder. Apparently intensity of experiences is not a sufficient safeguard against forgetting. This conclusion has consequences for the forensic use of testimony by witnesses who were victims of violent crimes.     

Modelling the dynamics of reasoning processes: Reasoning by assumption

To model the dynamics of cognitive processes, often the dynamical systems theory (DST) is advocated. However, for higher cognitive processes such as reasoning and certain forms of natural language processing the techniques adopted within DST are not very adequate. This paper shows how an analysis of the dynamics of reasoning processes can be made using techniques different from those of DST. The approach makes use of temporal traces consisting of sequences of reasoning states over time to describe reasoning processes. It is shown for the example reasoning pattern ‘reasoning by assumption’, how relevant dynamic properties can be identified and expressed using a temporal trace language. Example traces have been acquired in two ways. Firstly, empirical traces have been generated based on think-aloud protocols of a subject solving a number of cases of a reasoning puzzle. Secondly, a simulation model has been developed and executed for the same cases of the reasoning puzzle. For all these traces, the dynamic properties can and have been analysed automatically, using a software environment that has been developed. Thus the feasibility of the approach was shown.     

What difference does counselling make? – The perceptions of drug‐using clients on low incomes

Context: This paper reports on a qualitative study looking at the perceptions of clients who use drugs and are on low income. Research suggests that counselling services can experience difficulties in reaching and retaining such clients, and outcomes of counselling can be disappointing. Aim: To learn from clients who had engaged in counselling for over six months what difference it had made to their lives. Method: Grounded theory methodology was used to analyse semi‐structured interviews with six participants. Findings: Findings included changes in the clients’ internal world, their connectedness with society, their familiarity with counselling, and their perception of the relationship with the counsellor. Factors within the counselling process which helped and hindered change were identified. The study documents how participants were able to use counselling to improve their lives.     

Family work for schizophrenia: some issues for Chinese immigrant families

This paper discusses some specific issues relevant to immigrant Chinese families in the context of family work for schizophrenia. The issues include shame and guilt, isolation and mistrust of officials, the importance of negotiation before details of problem-solving are worked out, high academic ambitions for children, and apparent ‘overprotectiveness’ in the Chinese culture. It is argued that cognitive-behavioural, goal-orientated family work could be adapted well for immigrant Chinese families with a member suffering from schizophrenia. A case study is presented to illustrate how such a family was helped.     

Family therapy ‘lite’? How family counsellors conceptualise their primary care family work

A number of current developments in the field potentially provide opportunities for preventative relationship and family interventions to be integrated into primary care. In this context, it is important to understand what family counselling is and how it might differ from family therapy. Thus, this paper investigates how the service of one low-intensity family counselling provider, Relate, is conceptualised and practised by counsellors on the ground. Questions about practice were posed to five focus groups of family counsellors and these were analysed using thematic analysis. The findings suggest that Relate family counselling is seen as ‘family therapy lite’, with a flexible, eclectic and integrative use of concepts and techniques within a systemic framework. Implications of this conceptualisation of family counselling for training, practice and research are discussed.