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Multigenerational Family Therapy

By Holly Matthews,2014-05-09 21:12
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Multigenerational Family Therapy

    Chapter 4 - 178 Multigenerational Family Therapy

     Introduction

     Key Concepts

     Therapy Goals

     Therapist‟s Role and Function

     Techniques

     The Quest Family

     Summary

     Gender & Cultural Issues

     Suggested Reading and References

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    Multigenerational Family Therapy

INTRODUCTION

    Murray Bowen was one of the original developers of mainstream family therapy. His approach is often referred to as Multigenerational (transgenerational or intergenerational) Family Therapy. His approach is more theory based than any other model we will consider. For Bowen, effective clinical practice followed from an effective theoretical orientation. Bowen and his associates introduced much of the mainstream language for family systems therapy, including concepts and clinical practice related to multigenerational assessment, family life-cycle development, ordinal birth position, genograms, triangles and triangulation, emotional cutoff, and differentiation of self: All of these ideas will be addressed below.

     Bowen began his training in a psychoanalytic model, and some of his ideas can be traced to that background. In fairness, Bowen would have seen his approach as a departure from psychoanalytic therapy. His approach operates on the premise that a family can best be understood when it is analyzed from at least a three-generation perspective, because a predictable pattern of interpersonal relationships connects the functioning of family members across generations. According to Bowen, the cause of an individual's problems can be understood only by viewing the role of the family as an emotional unit. A basic assumption in Bowen family therapy is that unresolved emotional fusion (or attachment) to one's family must be addressed if one hopes to achieve a mature and unique personality.

     Betty Carter is both a Bowen family therapist, now retired, and a feminist. She has an M.S.W. and was the Director of the Family Institute of Westchester in Mount Vernon, New

    1York. Betty Carter‟s contributions to Bowen therapy include an integration of gender issues

    as a part of family therapy, an appreciation for diversity of culture, differentiation in the consideration of death and loss, and together with Monica McGoldrick, the development of

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    the family-life cycle perspective (Carter & McGoldrick, 2005). In a consultation session she conducted at the 1997 annual conference of AAMFT, Betty worked with a bi-cultural couple in relation to blending their two families (Carter, 1997).

     In this session, Tito, age 40 and a Puerto Rican who was raised in New York, is married to Diana, age 27, a Caucasian who was raised in south Florida after her parents moved there from the northern part of the United States. Tito had a previous marriage to Mary, who also came from Puerto Rico. Tito and Mary had a difficult and painful divorce, partly because Tito was already seeing Diana. Diana, too, had been married before to a man who divorced her when their children were born. One of her children died at 2 months of age. Her only son is Robin, age 6. Tito‟s children include Lenny, age 19, currently in the Air

    Force; Tammy, age 18, his only daughter; Andre, age 15, who assumed the role of peacemaker for a while; and Isaac, age 13. Isaac lived with his mother, Mary, in Puerto Rico after the divorce, but returned to the United States and to Tito, because he does not read or write Spanish well enough to effectively participate in Puerto Rican schools.

     A genogram is a family map that outlines both the structure and the emotional processes of the family. Table 1, presented below, provides a guide to the symbols used in a genogram.

    Place Bowen Table 1 about Here

     A partially completed genogram of Tito and Diana‟s blended family looks like this:

    Place Bowen Figure 1 about Here

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     Just looking at this genogram, a host of questions and possibilities may come to your mind. What are the issues surrounding the blending or merging of families, and how might they be present here? Should the role of a stepparent be different than that of a biological parent? In what ways? How important is it for the therapist to have resolved issues with her own family of origin before she works with this family? How might the therapist‟s own life experiences become involved in this therapy session?

     In addition, there is another set of important questions to use that address cultural issues in the family. What effect will different cultures have on this family‟s interactions? What place will issues related to being male from a Hispanic culture have in the family: Will these issues affect Tito‟s relationship with his sons and daughter, with Mary, or with Diana? Will the culture define in some way Isaac‟s relationship with his mother? What might you expect from the different cultures in terms of emotional expression? What do you think about children being removed from their culture of origin, no longer knowing the language or customs that were part of their parents‟ or grandparents‟ lives? What effects do differing cultures between a therapist and her clients have on the counseling relationship?

     In reviewing Tito and Diana‟s genogram, Ms. Carter offered the following hypotheses based on Bowen theory.

    ; The goal of therapy seems to be for the new family to accomplish a more effective

    blending, to live happily together, or at least not be in turmoil all the time;

    ; The attitude of Tito‟s four children toward the situation most likely reflects the

    unresolved attitudes that Tito and Mary still express toward each other;

    ; To the degree that the old marriage is unresolved, it is dead baggage in the new

    marriage;

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    ; There hasn‟t been enough time and space for Tito and Mary to achieve joint

    parenting for their children;

    ; In this situation, Diana becomes the scapegoat, Mary stays in a victimized position,

    the children defend and stay loyal to their mother, and it is hard for everyone to

    move on.

     Betty: Okay, let‟s work. We‟re just going to jump right in, right off the diving board

    and right in. I‟m visiting from New York, so I am going to swim into your

    lives and swim right out.

     Tito: From New York City?

     Betty: In Westchester, just above New York City.

     Tito: I grew up in the Bronx.

     Betty: Oh, you did? We are definitely neighbors, definitely neighbors. So you‟re a

    New Yorker?

     Tito: Well, yes and no.

     Betty: What does that mean?

     Tito: I wasn‟t born there, but I lived there a good deal of my life.

     Betty: You‟re from Puerto Rico originally?

     Tito: Si.

     Betty: Si. My Spanish isn‟t as good as it should be coming from New York. So

    how did you get mixed up with a Southerner? You see, that‟s a story I

    should tell too, because my husband is from Tennessee, so I am interested in

    how we native New Yorkers get mixed up with Southerners.

     Diana: I‟m from Orlando.

     Tito: She‟s a native Orlandoan, but her parents are from Michigan and Canada.

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     Betty: I see. I guess everyone in Florida comes from out of town. (Pause) Now,

    here is what I [want you to] know. I really want to be, first of all, helpful to

    the two of you. It is sort of like a little opportunity to get together and talk.

    I work with lots of stepfamilies, families who are mixing and blending like

    your [family] is trying to do.

     Tito: Ours is mixing like oil and water.

     Betty: Like oil and water, huh? Well, I‟ve heard that story before too. What I have

    here, what I‟m looking at—have you seen this before?—is a genogram. It‟s a

    family diagram, and it gives the basic facts of your family. (Showing the

    genogram to Tito and Diana) So this diagram, Tito, shows me that you were

    divorced from a woman named Mary, who‟s now in Puerto Rico. And

    you‟ve got four kids: the oldest, Lenny, 19, going down to Isaac, 13. Okay,

    and Diana, you were divorced in about 1980, right?

     Diana: Right.

     Betty: And you have one living son, Robin, age 6. And all of you together (Lenny is

    in the air force, right?): so it‟s the other three kids and Robin and the two of

    you, trying to figure out how to make that into a family, I guess. Were you

    divorced, Tito, in September, 1985? Is that right? [Tito: Yes.] So that‟s very

    recent. (Pause) I have a lot of questions, and there‟s a lot of information I

    want to hear [about] how you are handling this stuff, which is very complex.

    But first, I would like to hear what you think is the most important thing that

    you can talk to me about. What would be helpful to you todayeach of you?

    It may be different things.

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     Tito says that Isaac‟s rejection of Diana is most on his mind, and he goes on to explain that Isaac is the youngest, very loyal to his mother, and that accepting Diana would be for him an act of disloyalty. Diana agrees that her main concern is with Isaac, because he also seems to be an influence on the other children. Initially Tammy was quite hostile toward Diana, but Diana has noticed in recent months that Tammy is being nicer to her. And Lenny, who is away, has always accepted her as his father‟s spouse. Andre, the middle boy,

    seemed to be more like Lenny in attitude, but since Isaac‟s return, he has started to follow Isaac‟s lead. Mary told Isaac that if he came to live with his father and Diana, it would mean that he didn‟t love her anymore. And since he returned anyway, if he did anything to upset Diana, Mary told Isaac that Tito would beat him. Diana feels that Mary sets all of the kids against her, and that she cannot win.

     Betty: It sounds to me as if Mary doesn‟t feel adjusted yet, huh, hasn‟t accepted the

     divorce?

     Tito: I think she has. I think she‟s accepted it.

     Betty: As a fact, yes, but emotionally?

     Diana: I think you‟re right there. I don‟t think she‟s accepted it emotionally.

     Betty: What about you, Tito? Do you think that you had enough time to finish

    your first marriage before the two of you started? It sounds like maybe you

    were going in two directions at the same time for a while.

     Tito: Yes. That‟s when I first [went to see a counselor].

     Betty: You were torn and were going in both directions there. One of the

    complications may be that there wasn‟t enough time for Mary. The divorce

    wasn‟t her idea, I guess. Maybe she hasn‟t had enough time to get over it or

    something . . . to be more supportive about moving on.

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     Tito: Even though she is the one who divorced me.

     Betty: Was it her idea to get divorced? Well, it‟s an upsetting process even if you

    are the one who decides. But she‟s the one who decided. And what do you

    think was the cause of that? Why do you think she decided that? Because of

    the relationship you had with Diana?

     Tito: Yes. And because we had had long talks, and she knew our relationship was

    breaking up. Definitely.

     Betty: Now, what kind of communication do you have with her? With Mary.

     Tito: I talk to her on the phone.

     Betty: You do. And how does that go? I mean, fighting . . . or . . . ?

     Tito: It‟s down to business now.

     Betty goes on to explore the reasons that Mary returned to Puerto Rico. Mary seems to have felt that it was too hard to make it in America financially. She incurred a $2000.00 debt on a Visa card before she left that Tito and Diana are trying to handle. She took a number of trips before leaving, but mainly, her return seems to have been to regain the support of family and friends in Puerto Rico.

     Betty: As you go through the ordinary day-by-day, who‟s mostly in charge of the

    children?

     Tito: I am.

     Betty: You are. So it‟s not a problem then where Diana has to come in and do

    disciplining or . . .

     Diana: I‟m not even allowed to do that. And that‟s one thing I don‟t like about it.

    When Isaac tells me to “shut up,” I can‟t say anything, because I don‟t want

    to start anything. So in order to avoid it, I just ignore it.

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     Betty: I see.

     Diana: But the bad thing about it is that I‟m worried about [the influence on] my

    son, because he‟s treating his peers badly at school. He‟s not respected in the

    home. Isaac‟s always making fun of him and calling him names, and telling

    him to “shut up,” and nobody says anything about it. And I can‟t.

     Betty: When you say, “you can‟t,” [is it that] Tito has asked you not to do the

    disciplining?

     Diana: (nodding) I can‟t say anything. If he swears in front of me or if he wants to

    disobey in front of meeven for what his father‟s told him to do—I‟m just

    totally not allowed to do anything. And I feel like a child myself.

     Betty: I see. So you feel kind of undermined by having no authority.

     Diana: Well, I don‟t really want to have authority a lot. I just want to be able to

    correct, when necessary, and say, “don‟t tell me to shut up.” Or “show a

    little respect, please!”

     Betty: So what do you do about that when they‟re disrespectful to you?

     Diana: When it gets really bad and keeps on getting out of hand, I wind up running

    to him, as if a tattle-tale child would run to him, and say, “Daddy, would you

    please tell him not to tell me to shut up.” And I feel like that. I don‟t like

    being in that position, because he [Isaac] can do the same thing, and then it‟s

    my word against his.

     Betty: So, it‟s like you‟re the oldest daughter, running to complain about the other

    kids.

     Diana: Yes. And he will actually pick on me to make me get upset.

     Betty: Who will, Isaac?

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     Diana: Isaac.

     Betty: So he baits you.

     Diana: He does. Like he‟ll be doing his homework, and it‟s 8:30 at night—he usually

    doesn‟t go to bed until 1:00 AM—and all of a sudden, he‟ll want me to get

    off the couch, so he can make up the bed and go to sleep. And he‟s in the

    middle of doing homework, and he has dishes to do after that, and all of a

    sudden, he wants to uproot me and make me go somewhere else. And he‟ll

    say things, like “GET UP!” It just starts getting to me sometimes. I‟ve lived

    there since June, and there‟s been a lot of hate and a lot of hardship, but I‟ve

    very rarely even stood up for myself. I‟ve always been patient. I‟ve tried.

    It‟s been hard, especially with that kind of baiting going on.

     Betty: Well, it sounds like it‟s been hard. . . . Do you feel that Tito appreciates how

    difficult it is for you?

     Diana: I think he does more now, but I don‟t think he was aware of it.

     Betty: What do you mean by “now”?

     Diana: He still thinks I have total control over the situation. By leaving the room: I

    am in total control by not letting him get to me, not letting him bate me.

    Well, that‟s hard to do over and over again, when you keep on getting tried.

    It‟s hard to do. He still sometimes blames me and thinks I have control.

     Betty: So you don‟t feel entirely supported by him. Maybe at least, he doesn‟t

    appreciate how hard your position is. It‟s not simple.

     Diana: I guess I don‟t feel entirely supported. Also, my son needs to be supported.

    I need to be supported so that I can give support. My son is going through

    as much of that as I am. It kind of bothers me, because I don‟t know what

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