3.1. THEORETICAL PROVISIONS OF SOCIAL AND CLINICAL psychology FAMILIES NECESSARY FOR A SPECIALIST TO WORK WITH THE PROJECTIVE METHOD "FAMILY SOCIOGRAM"
Family definition.
Areas of her psychological study
Family- this is a cell of society (small social group) and the most important form of organizing personal life. It is based on marital union and family ties- relations between husband and wife, parents and children, brothers and sisters and other relatives living together and leading a joint household [Soloviev N. Ya., 1977].
In psychological science, the family is studied primarily within the framework of social and clinical (medical) psychology.
The subject of social psychology of the family- these are psychological patterns, features of behavior, interaction and communication of people, due to their inclusion in the family as a social group, as well as the characteristics of the family as a small group.
Subject clinical psychology families are the features of family functioning in their significance for the diagnosis, treatment and prevention of diseases, as well as the preservation and promotion of the health of family members [Nikolskaya I. M., / 1m) \ 2009].
The most important characteristics of a family are considered to be its functions, structure and dynamics [Eidemiller E. G., Yustitskis V., Eidemiller E. G. et al., 2003]. The functions show what the family "does" on a daily basis, the structure - how the family works, the dynamics - how it changes in the process of its development.
In addition to these characteristics, in this section we will also consider the ionic indicators of the family as a system: the structure of family (shley, external and internal boundaries, family subsystems, etc.)
family functions.
Concepts of normally functioning
And a dysfunctional family
Function- This is the life of the family, associated with the satisfaction of certain needs of its members. The fulfillment by the family of its functions is important not only for family members, but also for society as a whole.
Household function involves the satisfaction of the material needs of family members (in food, shelter, etc.). This helps to keep them physical health, recovery spent in different types activity of physical forces.
Sexual-erotic function family is to satisfy sexual and erotic needs. Taking into account social norms and requirements, it is important that the family at the same time regulates sexual and erotic behavior and ensures the biological reproduction of members of society.
educational function family concerns the individual needs of a man and a woman in fatherhood and motherhood, in contact with children and in their upbringing, as well as in the fact that parents can realize themselves in children. For society, this function ensures the socialization of children and the preparation of new members of society.
emotional function family involves meeting the needs of family members for sympathy, respect, recognition, emotional support, psychological security. This preserves mental health, promotes emotional and personal stabilization.
The function of spiritual (cultural) communication associated with the need for joint leisure activities, mutual spiritual enrichment and contributes to spiritual development family members.
Primary function social control ensures that family members comply with social norms. This is especially true for those who, due to age or clinical characteristics, are not able to build their own behavior in accordance with the norms of society.
The failure of the family to fulfill its basic functions leads to violations of the physical and mental health of family members, adaptation disorders, and family breakdown. For example, a violation of the sexual-erotic function not only leads to marital conflicts and divorces, but also provokes the occurrence of severe neuropsychiatric disorders in family members. Failure of parents to fulfill the function of primary social control in relation to their children can be the cause of deviant and delinquent behavior.
With this in mind, based on the concept of family functions, two main types of families are distinguished: normally functioning and dysfunctional [Eidemiller E. G., Dobryakov I. V., Nikolskaya I. M. 2003].
Normally functioning family- this is a family that responsibly and differentiatesly performs all its functions, as a result of which the need for growth and change is satisfied both for the family as a whole and for each of its members.
dysfunctional family- this is a family in which the performance of one or more functions is impaired. As a result, the needs of family members and the family as a whole are not met. This hinders the personal growth of family members, blocks the need for self-actualization, leads to the appearance of symptoms of neuropsychiatric disorders in them, and the family can lead to disintegration.
Severe family dysfunction contributes to the formation family role "symptom carrier", assumed by the member of the family who has the least social status due to various physical or psychological reasons. In the role of a “symptom carrier”, this family member acts as an important link in the complex mechanism of pathological adaptation of both an individual with neuropsychiatric disorders and a dysfunctional family as a whole.
dysfunctional family It's a rigid family system. Regardless of changes in external and internal conditions, it stubbornly tries to maintain the usual standards of interaction between elements of its subsystems and other systems. The "carrier of the symptom" allows the family to maintain the old established relationships between its members. His symptomatic behavior is involuntary, unconscious and beyond the control of the patient. It has a relatively strong influence on other people and can be conditionally beneficial not only to the patient, but also to family members. The carrier of the symptom acts as "identified patient"- a family member whose clinical, psychological and behavioral problems force the family to unite and seek psychological help. However, if the family is viewed as a self-regulating system, and the asymptomatic is regarded as a mechanism of regulation, then if the symptom is eliminated, the entire system will be temporarily unregulated and will be forced to move to another level of functioning. A specific feature of a dysfunctional family is its rigidity, the desire to maintain the status quo, so often it will unconsciously resist change and try to keep the symptom, despite its appeal to a specialist for help.
Family structure
Structure- this is the composition of family members, as well as the totality of their relationships. In our country, the most common structure is in which a family consists of adults (husband, wife, and in some cases grandparents) and children (usually there are one or two children in a Russian family).
The structure of the family is based on two types of relationships:
domination - subordination (hierarchy, or distribution of v power);
closeness - remoteness (connection, or emotional distance between family members).
Hierarchy, or the distribution of power, shows who in the family is in charge, who is the executor, how rights and duties are distributed among family members. From the point of view of structure, families can be distinguished where leadership is concentrated in the hands of one family member, and families where equal participation of several family members in management is expressed.
According to V. N. Druzhinin, the dominant family member provides security, is responsible for maintaining normal relations between family members, determines the prospects for life and instills faith in the future. The dominance of one of the spouses is a necessary condition for the stability of the family.
In a patriarchal family, the father dominates, while in a matriarchal family, the mother dominates. In a child-centered family, the child is psychologically dominated by his needs or whims.
When determining dominance, it is important not only who dominates, but also the hierarchy of power-subordination itself (in order of dominance), for example, Father - mother - child; Father - child - mother; Mother - father - child; Mother - child - father; Child - father - mother; Child - mother - father.
Every married couple faces the problem of separation of power and the creation of a hierarchy in the family. The concept of power is associated not only with dominance, but also with caring for other family members, the responsibility for their change. Spouses share power among themselves in different ways. For example, if in a family decisions related to home and upbringing are taken by one of the spouses, then decisions related to money and relationships with friends are in the sphere of power of the other.
When living in the family of the parents of the husband or wife, dominance becomes more difficult. More often, the maternal grandmother or paternal grandfather takes power in the family. The grandmother replaces the functions of the mother in the family, which begins to perform some of the functions of the father. The father, in turn, comes into conflict with the mother and grandmother for the right to actively participate in family life.
In cases of difficulties in the relationship between parents, a son or daughter often becomes a resource in the struggle for power between spouses, who equalize parents and occupy the highest step in the family hierarchy. In the face of children's troubles, marital problems are at least temporarily removed, it becomes possible to look at themselves as the parents that their child needs. It turns into a source of special care on the part of parents, who direct all their efforts to change behavior in better side. Violations in the behavior of children can thus be seen as protective, helping to save the family from impending disaster. In other words, the child (identified patient) "as if" comes to the rescue of both parents at the same time, unaware of his significant role.
The family, devoid of the duality of the hierarchical organization, when the position of the highest level in relation to the children is returned to the parents, becomes harmonious if the mother and father work together to change the children's behavior. In a family organization, parents need to occupy a higher position in the hierarchy than children, since they are in a position of seniority and unconditional responsibility for the child.
It is assumed that in a stable family, the same subject has power and responsibility, and family members are psychologically closer to him than to each other.
It happens when one of the spouses arrogates to himself the right to single-handedly decide the main issues on which the life of the family depends, while the other becomes powerless and enters into a coalition with the child, which undermines the power of the head of the family.
Sometimes the source of power is the illness of one of the family members (depression, alcoholism, fears, psychosomatic disorders). It acts as a means to help achieve a relative balance in the possession of power.
The family will exist harmoniously in those cases when the distribution of power established in it does not interfere with the performance of its main functions aimed at meeting the needs of family members.
Connection(cohesion) is the psychological distance between family members. At different stages life cycle family it is different, reflecting the changing needs of its members. The general rule is that if the psychological distance is very close (symbiosis) or, on the contrary, very far (separation), this can lead to family dysfunction. Symbiotic relationships prevent the formation of self-images of family members and block the need V growth and change. Disunity as an autonomous existence does not allow the family to perform its main functions: emotional, spiritual (cultural) communication, primary social control, etc.
Family structure disorders make it difficult for the family to fulfill its functions or interfere with it, which also leads to the appearance of family dysfunction. For example, when the usual family composition changes (the death of a mother, the absence of a father, childlessness), the family is immediately placed in the “risk” group, since the performance of educational and other functions suffers. No less problems can be associated with disruption of relationships. So, too much distance between parents and children leads them to a lonely autonomous existence, gives rise to a feeling of low value and insecurity. Another example is the struggle for power between spouses, which is the first impetus for quarrels in two out of three divorced couples. Another example is the unequal distribution of domestic duties among family members, which leads to an overload of women, their unbearable psychological stress.
It should be remembered that with the development of the family, its functions naturally change: some are lost, others appear in accordance with new social conditions. As a result, the structure of the family also changes. According to sociologists, at present in our country there are simultaneously functioning trimodel family, differing in their structure: patriarchal, child-centric and matrimonial [Golod S.I., 1998]. In reality, they are mutually intertwined, however, in the practice of family counseling and psychotherapy, one can often meet with extreme variants of such families that have both sanogenic and pathogenic effects on their members.
patriarchal family the most archaic. It is characterized by relations of domination-submission: the dependence of a wife on her husband, children on their parents, younger child from the elder. And this connection is a rigid consolidation of family roles.
Marriage is outwardly stable, the family consists of several generations: grandparents, parents and children. Large families are welcome, since the household function is one of the most important for this family.
The husband is considered the main one in the family: all the economic resources of the family are concentrated in his hands, he makes all the main decisions. The wife takes the surname of her husband, obeys him and treats him with respect. Its main functions are to give birth and raise children, to run a household. The family is distinguished by parental authority and an authoritarian system of education.
The rigid hierarchical structure of the patriarchal family can lead to the fact that subordinate family members, especially the wife and children, will be dissatisfied with the distribution of power that prevents the satisfaction of their needs. As a result, this family can become dysfunctional, with all the ensuing consequences. For example, the problem of domestic violence, which is relevant for many regions of our country, is directly related to living in a family with this structure.
Child-centric family elevates the role of privacy, intimacy and values of children. Relations between husband and wife are more or less equal, sexuality practiced in marriage is not limited to procreation. The husband and wife regulate the timing and frequency of conception and jointly decide on the number of children. Socialization takes on a different meaning, since there can be only one child in a family, who often spends most of his time with his parents, and not with his children.
He turns into an object of special parental care and enduring affection, they try to give him the best possible education. Main function families - educational. Parenting styles are diverse: from authoritarian to pampered. In general, children enjoy a large number material and spiritual wealth than their parents, and can act as the main meaning of the family. When children grow up, they can separate from their parents, however, having separated, they do not lose contact with the parental family. Parents provide material and moral support to their children, hoping that if necessary, they will act towards them properly.
The central position of a child in a child-centric family can in some cases lead to the fact that he receives more power than his parents, and begins to manage them at his own discretion, dictating his will. Another problem with this family model is that too close a distance, often a symbiotic relationship between parent(s) and child can lead to their mutual emotional dependence. As a result, an egocentric adult child from such a family is often unable to live without the support of his parents, and parents, in turn, may prevent his separation, fearing to lose the main meaning of his existence and experiencing anxiety to remain alone, relinquishing parental obligations.
changed in the 20th century. the social status of women, her struggle for equal rights with men led to the emergence marital family model. matrimony- this is a personal interaction of a husband and wife, regulated by moral principles and their inherent internal values. Such interaction is characterized by the symmetry of rights and at the same time the asymmetry of the roles of husband and wife,
The husband's conscious encouragement of his wife's individuality is associated with an increase in the significance of her personal characteristics for him. Of particular importance for the husband was the sexual expressiveness of the wife, and not only her economic and practical qualities and health, which in the past were of decisive importance when choosing a spouse.
Husband and wife ceased to unconditionally subordinate their own interests to the interests of children, sexuality ceased to be reduced to childbearing, eroticism became characteristic of all marital relations in Poland. The marital model of the family has opened up wide opportunities for autonomy and self-realization of each family member: the interests of the husband and wife have become more diverse than family ones, and their needs and social circle go beyond marriage.
The frequency of regular communication of spouses with their parents, grandparents, brothers, sisters and other relatives in this family is low.
In some cases, spouses may deliberately refuse to have children, believing that the appearance of a child can interfere with their close relationships, successful professional careers, personal and spiritual growth.
A decrease in the sexual attractiveness of a partner and a loss of interest in him often become a factor leading to the disintegration of a married family. If a child grows up in it, then quite often close relationships between spouses and their priority lead to his autonomy and personal instability.
psychoanalytic approach. The focus is on child-parent relationships, which determine the development of the individual and the success of her family life in the future. The unit of analysis is a personality in its relationship with a partner, the main patterns of these relationships are the Oedipus complex and the Electra complex. It is assumed that in marital relations, patients unconsciously tend to repeat the basic patterns of relationships with their own parents. By the way, it is this circumstance that is the reason for the transmission of family experience and the construction of family events from one generation to the next. The achievement of autonomy by the individual and the restructuring of relations with the family of origin is the main goal of the therapeutic process. Psychological work is focused on the reconstruction and recreation of the past, awareness of the repressed and repressed. Symptoms of marital difficulties are seen as a marker of past unresolved conflicts and repressed drives in relationships with parents. In psychoanalysis, symptoms act as the basis for identifying the causes, great importance is attached to the client's tracing the mechanism of symptom formation and awareness of the causes of the difficulties experienced, building bridges between past conflicts and the problems of today's family relations.
behavioral approach. The importance of the balance of mutual exchange (give and receive) is emphasized. The unit of analysis here is the personality in relationships and interactions with family members. The emphasis is shifted to the ability to resolve problem situations and the formation of special performing competence (communication skills and problem solving skills). The genetic-historical aspect of the emergence of the problem within the framework of behavioral counseling is insignificant. The focus here is not on deep causes, but on the erroneous behavior and actions of family members, which act as an obstacle and an obstacle to solving problem situations. Within the framework of behavioral psychotherapy, we can talk about the theory of social learning (A. Bandura) and the theory of operant conditioning (B.F. Skinner). Accordingly, the main mechanisms for the formation of incorrect behavior leading to family problems are recognized as inadequate social patterns behavior in the family, ineffective control and reinforcement. If we take into account such an explanation for the emergence of problems and difficulties in the family, the focus of the work of family behavioral psychotherapists on child-parent relationships becomes shattered. Within the framework of the behavioral approach, various forms of training work with parents have become widespread. Work with suvrugs is based on the theory of social exchange, according to which each individual seeks to obtain the maximum reward at the lowest cost. The principle of reciprocity - the equivalence of exchange - suggests that marital satisfaction increases when the number of rewards received compensates for the costs. A well-designed and operationalized system for diagnosing the characteristics of the mutual behavior of spouses and parents with children, clear behavior modification procedures, a carefully thought-out system of homework and exercises provide a fairly high efficiency of the behavioral approach in helping families solve their problems. A feature of behavioral work with the family is the preference for dyadic interaction as a unit of psychological analysis and influence. The choice of a dyad (for comparison, in systemic family psychotherapy, work is carried out with a triad that includes spouses-parents and a child) is justified by the supremacy of the principle of social exchange in the analysis of the patterns of family functioning.
Phenomenological approach. The individual in the family system is considered as a unit of analysis. The basic principle of "here and now" requires focusing on the events taking place in the present moment.
families in order to achieve a high level of their feeling and experience. The reality of communication and interaction as a system of verbal and non-verbal emotionally loaded communicative acts is the subject of psychological analysis and psychotherapeutic influence (V. Satir, T. Gordon). Identification of the content, rules of construction, the impact of communication on the life of the family as a whole and on each of its members is the content of work with the family. The formation of communicative competence, skills of open effective communication, increased sensitivity to one's feelings and states and feelings of a partner, amplification of the experience of the present are the main tasks of family psychotherapy within the framework of this approach.
Experience-based family therapy (K. Whitaker, V. Satir) focuses on personal growth, achieving autonomy, freedom of choice and responsibility as the goals of psychotherapy. Family dysfunction is derived from violations personal growth its members and in itself should not be the target of exposure. Interpersonal relationships and interactions constitute the conditions for personal growth when communication is open and emotionally rich. The causes of difficulties in communication turn out to be insignificant, the work focuses on revising beliefs and expectations, stimulating their changes.
Systems approach. The family is seen as complete system, its main characteristics are the family structure, distribution of roles, dominance and power, family boundaries, communication rules and its recurring patterns as the causes of family difficulties, which are primarily seen in the dysfunctional family and are resolved in the reorganization of the family system.
Structural family psychotherapy (S. Minukhin), as one of the most authoritative areas in family psychotherapy, is based on the principles of a systematic approach. The family acts as a system striving for the preservation (the law of homeostasis) and the development of relationships. In its history, the family consistently and naturally goes through a series of crises (marriage, the birth of a child, the child entering school, graduation from school and self-determination, separation from parents and leaving, etc.). Each of the crises requires the reorganization and restructuring of the family system. The family is considered as a basic system that includes three subsystems: marital, parental, and sibling. The boundaries of the system and each of the subsystems are the rules that determine who and how participate in the interaction. Boundaries can be too rigid or flexible, which consequently affects the permeability of systems. Excessive flexibility leads to boundary diffusion, i.e. to fuzzy patterns of interaction, and makes the family system or subsystem vulnerable to outside interference. Behavior that intervenes due to the blurring of family boundaries leads to the loss of autonomy and the ability of family members to solve their problems on their own. On the contrary, excessively rigid boundaries make it difficult for the family to contact the outside world, make it isolated, disunited, handicapped contacts and mutual support.
Family dysfunction is defined as the inability of a family to meet the needs of all its members, which is reflected in the symptomatic behavior of any of them. Behavioral disorders and emotional and personal disorders of one of the family members, according to structural family psychotherapy, are an indicator of family dysfunction as a single holistic organism. The therapist's attention is focused on the processes taking place in the family at the present time, without distant excursions into the past. The way to overcome the problems of the family is to change inadequate patterns of transactions, loosen the old family system and establish new boundaries that ensure its balanced functioning.
Strategic family therapy (D. Hailey) is an integration of problem-oriented therapy with communication theory and systems theory. The unit of analysis here is the family as an integral system striving to maintain homeostasis and patterns of interaction. The emphasis is shifted to the present, the here-and-now principle works, since the dysfunction of the system is supported by current interactions. Finding causes is not the task of therapy, since the existence of problems is supported by ongoing interaction processes that must be changed. Symptom - a metaphorical expression of the problem and the designation of a certain stereotype of behavioral reactions, which, by agreement between family members, performs a certain function in interpersonal interaction, is one of the forms of controlling the behavior of family members. The role of the therapist is active, in the process of work he offers family members directives or tasks of two types - positive, if the family's resistance to change is small, and paradoxical, encouraging the symptomatic, i.e. inadequate, the behavior of family members, if the resistance is great and the implementation of negative tasks is likely to be blocked. The widespread use of metaphors in working with the family helps to establish an analogy between events and actions that, at first glance, have nothing in common with each other. Metaphorical understanding of the family situation allows you to identify and see the essential characteristics of the family process.
Transgenerational approach. Aimed at integrating the ideas of psychoanalysis and systems theory. The unit of analysis is the whole family, in which relations between spouses are built in accordance with the family traditions of the parental family and the models of interaction learned in childhood. The choice of a partner and the construction of relations between spouses and parents with children is based there on the mechanism of projection of feelings and expectations formed in the previous object relations with parents, and an attempt to "adjust current relationship in the family to previously internalized models of family behavior (d. Framo). The principle of historicism within the framework of the transgenerational approach is the key one. Thus, an intergenerational family (M. Bowev) is considered as a family system, and the difficulties of family functioning are associated with a low level of differentiation and autonomization of the individual from the family by birth. Past relationships influence current family dynamics. The processes of personality differentiation, triangulation as the formation of a triangle of relationships and the family projective process, according to Bowen's theory, determine the emergence of family problems and open the way for their resolution. Interpretation and analysis of transference as key techniques of the transgenerational approach indicate that focusing on the causes of difficulties in family life is an important principle of it.
Despite the significant differences between the above approaches in terms of views on the causes and ways to overcome problems, in theoretical explanatory models, one can single out the general goals of family psychotherapy:
Increasing the plasticity of the role structure of the family - the flexibility of the distribution of roles, interchangeability; establishing a reasonable balance in resolving issues of power and dominance;
Establishing open and clear communication;
Solving family problems and reducing the severity of negative symptoms;
Creation of conditions for the development of self-concept and personal growth of all family members without exception.
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3. Behavioral model
Unlike the psychoanalytic model, the behavioral (behavioristic) model of family counseling does not aim to identify the deep causes of marital disharmony, research and analysis of family history. Behavioral counseling is aimed primarily at changing the behavior of partners, using the methods of conditioning and learning. The main theoretical provisions of the behavioral approach are presented in the works B.F. Skinner, A. Bandura, D. Rotter, D. Kelly.
The behaviorist approach to counseling is based on applied behavioral analysis - a method of researching the client and his environment. This method includes two stages: operationalization of behavior and functional analysis.
Operationalization of behavior allows you to very clearly define the problem and analyze behavior, presenting it as a chain of individual actions. This is done through observation of the family, during which the frequency of manifestation of certain types of behavior is recorded. The goal of operationalizing behavior is to translate vague, vague grievances and complaints from family members into objective, observable actions.
functional analysis involves tracking the sequence of events and is carried out according to the three-term formula:
♦ background;
♦ resulting behavior;
♦ the consequences of this behavior.
By establishing functional causal relationships, one can understand the sequence of events that underlie external behavior. Thus, marital behavior is influenced by stimuli that preceded marriage and stimuli that appeared after it. Properly chosen methods of influencing the behavior of spouses are the most important condition for effective family counseling.
...Here is an example of how a behavioral consultant conducts a functional analysis (i.e., finds out what preceded the act, what act took place and what is its result), described by A. Ivey, M. Ivey and others.
Psychologist: So, as I understand it, you are depressed, you feel tired and stiff. Can you bring specific example situations where you felt like this? I want to know what exactly happened before you got these feelings and what happens as a result. First, tell me about a recent similar case.
Client: It happened yesterday... (sighs). I came home from work and felt good. When I came in, my wife was not at home and I sat down to read.
Psychologist (interrupting): What is your reaction to the fact that your wife was not at home?
Client: I was a little disappointed, but not much. I just sat down.
Psychologist: Go ahead.
Client: Half an hour later, the wife came and walked by. I said hello, but she's been angry with me since last night when we had an argument. It's funny, but I feel relieved after we argued...
Client: I tried to talk to her, but she didn't answer. After about 10 minutes, I became very sad and dreary. I went to my room and lay down until supper. Before dinner, my wife came to me and said that she was very sorry ... But my depression did not decrease.
Psychologist: Let's try to build a sequence of events. You returned home in a good mood, but your wife was not at home, and then she did not react to your words, because she was angry. You tried to get an answer from her, but without success (preceding event), then you felt longing, went into the room and lay down (resultant action), she continued to ignore you for a while, then she came to you, and you ignored her (consequence) . The picture is similar to what you told me before: 1) you tried to do something, 2) she does not react, 3) you are discouraged, there is a feeling of depression - sometimes even tears and 4) she comes to you to apologize, but you you ignore her.
Thus, behavioral counselors believe that each person has their own system of rewards and punishments. If a psychologist can understand this system, he can influence behavior. Also, within the framework of the behavioral model, it is described “ good family” (which relationships can be considered “good”).
Wille, Weiss And Patterson characterize as “good” such family relationships in which spouses more often exchange positive emotions than negative ones, and due to the frequency of manifestation positive emotions reinforce themselves. Azrin, Naster And Jones identify the following principles underlying marital disharmony:
♦ spouses receive few reinforcements in marriage;
♦ marriage satisfies too few needs;
♦ reinforcement in marriage does not bring satisfaction;
♦ new behavior is not reinforced;
♦ one of the spouses receives more than he gives;
♦ punishment prevails over reinforcement;
♦ extramarital sources of pleasure compete with marital ones.
The main directions of behavioral counseling the following: parenting skills training, communicative marital training.
Parenting training It is used in work with a family in which there are problems with a child. It aims to teach parents the basic ways to influence behavior. By learning to apply these methods, parents, in turn, will change the behavior of the child. An essential feature of the family within the described model is the fact that the training is based on careful observation. The object of psychological work is parents and ways of their response, and the goal psychological help- Changed behavior of the child.
Communicative marital training aims to improve communication in the family, which contributes to problem solving. The following main strategies for teaching spouses are distinguished:
♦ spouses are taught to express their grievances in true behavioral terms rather than unstructured complaints;
♦ spouses are taught new ways of communicating, emphasizing the effectiveness of positive reinforcement as opposed to negative reinforcement;
♦ spouses are helped to improve communication;
♦ spouses are encouraged to establish clear and effective ways distribution of power and responsibilities;
♦ Spouses are taught strategies for dealing with future problems.
Each of these strategies aims to increase the mutual satisfaction of family members based on positive reinforcement.
4. System approach
The systemic model of family counseling is considered to be one of the youngest schools that received its recognition at the end of the second half of the 20th century.
In this model, the family is considered as a kind of social system, as a complex of elements and their properties that are in dynamic connections and relationships with each other. This approach assumes in the process of psychological counseling reliance on the family as a unit of influence.
The conceptual basis of a systems approach to understanding the family is the general systems theory. In the late 1960s and early 1970s, there was talk of a systemic revolution and a systematic approach that characterized the new style and new methods of scientific and engineering thinking. When they characterize something as a system, they say that it is a complex unity in which the constituent parts - elements, as well as the scheme of connections or relationships between elements - the structure can be distinguished.
Founder of the systems approach, Austrian biologist L. von Bertalanffy put forward the doctrine that the concept of a system is determined by a view of the world not as a mechanism, but as an organism (“organismic view of the world”). L. Bertalanffy in one of his works states that the system is closed if no information enters it; it can be considered open if there is an export and import, while changing its components.
Within the framework of a systematic approach to counseling, families can be distinguished as independent models:
♦ structural school;
♦ gestalt approach;
♦ experience-based counseling.
Structural School
...It is founded S. Minukhin. In the late 1960s, together with his co-workers, he conducted psychotherapeutic classes in a boarding school for boys with delinquent behavior from single-parent families. From 1965 to 1978, S. Minukhin headed the psychological and pedagogical consultation in Philadelphia. He is still called the "Star of Family Counseling". It is generally accepted that thanks to his work, family counseling (in the context of family therapy) is recognized by the psychological community as an independent movement.
In the very term structural» focuses on using the concept of the family structure to provide counseling intervention. From the point of view of S. Minu-hin, the structural model gives the psychologist a specific conceptual map that allows him to see what is really happening in the family.
...« The family is a natural troupe in which stereotypes of interaction arise over time. These stereotypes create a family structure that determines the functioning of its members, delineates the range of their behavior and facilitates interaction between them. One way or another, a viable family structure is necessary to fulfill the main tasks - to maintain individuality, while at the same time creating a sense of belonging to the whole.
Each individual member of the family, at one level or another of awareness and concreteness, is familiar with the geography of the family territory. Each member of the family knows what is allowed, what is the control system. But, being a lonely wanderer both in the territory of his family and in the world around him, he rarely perceives such a system as a complete whole. However, this system of intra-family interactions appears to the family therapist in all its complexity. He sees the whole. The family as a whole seems to be something like a colonial living organism - a creature consisting of various life forms, but at the same time they all form a composite organism, which in itself is a life form.».
The basic concepts of the structural model, according to S. Minukhin, are presented as follows:
♦ family structure;
♦ family subsystems(holons);
♦ borders.
Family structure. It is formed by interaction stereotypes that determine the range of behavior, requirements and rules for the functioning of the family as a whole. The structure of the family includes a set of conscious and unconscious rules that determine the interaction in the family. A family structure functions effectively when rules are in place and behavior is predictable.
family subsystems. The structure of the family in its composition has three differentiated subsystems (parts): marital, parental and children. (In his works, S. Minukhin uses the term “holon” proposed by him, which has a similar content, instead of the concept of “subsystem”.) The first of them includes marital subsystem. This subsystem arises earlier than others and determines the features of the functioning of the family as a whole. It arises at the moment when a man and a woman unite to create a family. The main functions of the marital subsystem are to ensure mutual satisfaction of the needs of the spouses without compromising the emotional atmosphere necessary for the growth and development of two changing individuals. This happens due to the development of boundaries that protect each spouse from the interference of other family members (children, relatives) and leave him the territory necessary to meet his needs. The viability of the family as a structure is determined by how adequate these boundaries are. The foundations of the subsystem are interaction stereotypes, patterns of transactions associated with showing attention to each other. Some stereotypes of interaction are developed easily (if the spouses, for example, both come from patriarchal families). Other stereotypes are the result of convention. Any deviation that differs from the usual causes a feeling of resentment, betrayal.
From the point of view of S. Minukhin, the marital subsystem influences the development of the child. It is in the marital subsystem that the child sees examples of how to show love, express affection, how to overcome conflicts on the basis of equality. In pathogenic situations, when the functions of the marital subsystem are disturbed, the child may be involved in a coalition (alliance) with one of the parents against the other.
The second family subsystem includes parent subsystem. It arises in connection with the birth of a child and is associated with the functions of care and upbringing. The composition of the parental subsystem can vary and include, in addition to the father and mother, an uncle, aunt, grandmother, and grandfather. One of the parents can be excluded from the parental subsystem (for example, upbringing functions can be delegated to the grandmother). Thanks to the parental subsystem (interacting with it), the child forms a sense of his adequacy. He begins to understand which types of his behavior are approved, encouraged, and which ones are negatively evaluated and blocked. The subsystem of parents changes and adapts to the changing (due to growing up) needs of the child.
One of the problems that this subsystem faces is management problems, since parents have the right to make decisions regarding the life of the family as a whole.
subsystem of children. For a child, his brothers and sisters (siblings) form a special group in the family in which he exists as an equal. Siblings develop their own interaction patterns. These stereotypes will be of great importance in the future when children begin to exist in non-family groups of equals (at school, at work).
The allocation of subsystems allows you to clearly identify the structure of the family. Relationships between subsystems are governed by boundaries. S. Minukhin highlights three types of borders:
♦ clear;
♦ rigid;
♦ diffuse.
clear boundaries allow subsystems of the family to feel a certain autonomy. They make it possible to establish effective communication between subsystems and facilitate the process of adaptation and coordination with each other, since the nature of the behavior of a representative of each subsystem with clear boundaries is known and easily predictable.
Rigid boundaries, compared to clear boundaries, separate family members from each other and from society as a whole. Subsystems function autonomously, without interaction with each other. Children raised in such families have difficulty negotiating and aligning efforts and resources with others when necessary.
diffuse boundaries provoke the phenomenon of psychological fusion, when, for example, children take the feelings of their parents for their own. In such a family, the boundaries of the marital subsystem dissolve into the parental subsystem. From the point of view of S. Minukhin, it is difficult for children from such families to create their own family, as they are deprived of the opportunity to build their own boundaries and lose the opportunity to experiment with relationships. According to S. Minukhin, the therapist, working with the boundaries of the family, can himself create subsystems with various goals. For example, a therapist might tell a grandparent that, because they have a lot of life experience, he would be interested in hearing their thoughts after they have watched the parent-child argument without interfering.
The therapist may ask the child, who sits between father and mother, to switch places with one of the parents in order to give them the opportunity to talk to each other directly as husband and wife, and not through his head.
A characteristic technique for S. Minukhin is acceptance of boundary setting. It consists in changing the spatial arrangement of family members during the session and is considered a fairly strong methodological technique, since it is non-verbal, unambiguous and creates the level of emotional tension necessary for the change. The author's ("proprietary") action of S. Minukhin consists in transferring people from place to place during the session and moving himself, demonstrating changes in his emotional ties with family members. One of the patterns identified by S. Minukhin is as follows: vertical coalitions are dysfunctional and horizontal coalitions are functional. This means the following: when the proximity of people of the same generation in the family is much less than the intergenerational proximity, the development of both the entire family system and the development of children drawn into alliances with one of the parents against the other parent is disturbed.
The goals of structural psychological assistance to the family, according to S. Minukhin, following.
♦ Creation of an effective hierarchical structure in which parents are the authority for children.
♦ Establishing an effective parent coalition in which parents support each other in making demands on their children.
♦ Expansion of the subsystem of children into the subsystem of peers.
♦ Create an age appropriate environment for children to experiment with autonomy and subsystems.
♦ Separation of the subsystem of the couple from the subsystem of the parents.
The main strategic direction that the psychologist should follow in the process of family counseling is to encourage the development of the family structure. There are three phases in family counseling.
First phase implies joining the psychologist to the family (to the style of communication, to the hierarchy of values), including himself in its structure as a leader. The psychologist is in the same boat as the family, but he must be at the helm. In most cases, the family agrees to regard the counselor as the leader in the partnership, but he must earn this leadership. Like any leader, he will have to adapt, coax, support, guide and follow others.
Second phase counseling – study of family structure. It is revealed from the psychologist's analysis of the interaction of family members with each other (including the verbal and non-verbal components of communication).
Third phase structural assistance to the family in the process of counseling - changing the structure of the family. A change in the family structure can occur through the direct intervention of the counselor, when he suggests changing the style of communication (recommends, for example, parents to talk to each other, not allowing the child to interfere). The psychologist can express his suggestions and interpretations regarding the "map" of the family, giving an assessment of what he saw.
The general idea of S. Minukhin regarding work with the family consists in a kind of appeal with which the psychologist ultimately addresses family members: “Help the other person change, and this will allow you to change in your relationship with him, and will change both of you within the subsystem.”
Gestalt approach
The ideas of the structural approach are meaningfully close to the field theory K. Levin, on which the Gestalt approach to counseling is based. You can find an idea in K. Levin living space. Living space contains the totality of possible events that can affect human behavior. It includes everything you need to know to explain and understand the specific behavior of a person in a given psychological environment at a given time.
K. Levin's field theory contains the idea borders and their role in the separation of the organism and its environment. The difference between open and closed systems is determined by the nature of the boundaries. According to K. Levin, fixed rigid boundaries have closed systems, while open systems have changeable, permeable boundaries. This is consistent with the statements of a famous biologist (methodologist, founder of a systematic approach) L. Bertalanffy that only open systems can be alive that support themselves by exchanging information with environment, constantly building up and destroying its components.
The ideas of K. Levin were used in the practice of counseling F. Perls. Although F. Perls has a negative attitude towards theorizing, his approach is based on basic ideas about the process of self-regulation of the organism and the ways of its contact with the environment. The process of self-regulation leads to the formation of a figure (gestalt). Gestalt – system concept, it can be defined as a pattern, structure, configuration, as a specific organization of parts that make up a certain whole, which cannot be changed without its destruction.
Under the gestalt understand the figure that the subject creates in his contact with the environment. The figure is determined by what a person organizes depending on their needs, desires or unfinished situations at the moment. When the need is satisfied, the gestalt closes, and what was a figure passes into the background. (Thus, for example, the feeling of hunger makes us focus on food, but as we are full, we can get in touch with other needs.) Incomplete gestalts are a source of personality neuroticism. Unfinished gestalts include the following: unreacted feeling, unfinished conversation, unfinished relationship. Thus, a psychologically incomplete divorce prevents contacts of former spouses with other men and women.
Gestalt counseling is a process that aims to accompany or restore the client's ability to control the figures, to build the figures in adequate relation to the background, to allow them to unfold and come into contact with them.
One of the leaders in the application of the Gestalt model in working with married couples and families is D. Zinker. He directed the Center for the Study of Small Systems in the United States. Key principles of family counseling according to J. Zinker - observation And residence. The implementation of these principles in practice means the following. The psychologist, together with the patients, participates in a joint creative process. He takes part in the interaction of family members as an observer. The purpose of psychological intervention (intervention) is to awaken the participants' awareness of how they interact with each other. The therapist's remarks are directed primarily to revealing the strengths of family members (what they can do well), and then to what they should learn. The counselor organizes the situation in such a way that spouses or family members communicate directly with each other, without paying attention to him.
In his monograph “In Search of a Good Form”, D. Zinker highlights a number of principles which can help the psychologist navigate the Gestalt approach to family counseling. These principles are based on systems theory and the author's own experience.
♦ There is no linear progression in human relationships, there are no direct cause-and-effect relationships, but there is a complex set of interactions.
♦ All events, including human relationships, are in constant process.
♦ Relations tend to triangular configuration.
♦ The history of the family is not history, it is a lot of events happening at the same time.
♦ Even in complete isolation, each person exists in interconnection with other people.
♦ Any event (small or large) that occurs in a family has an impact on all others. No event can be viewed in isolation from the others.
♦ Decreasing the importance of what is happening is dangerous because it tends to hide problems or stimulates polarization and the desire to destroy the other.
♦ Only people who have achieved autonomy are able to have strong relationships with other people. Conflict relations (fusion) destroy the spirit.
♦ The couple and family are a “scattering structure” as they tend to deplete their energy at a certain stage of their development. The ideal change in the structure of these stages involves moving up more high level functioning.
The model of the work of a gestalt consultant with a couple or a family as a whole is based on the understanding of the dynamics of the formation of gestalts developed by F. Perls. D. Zinker calls this the Gestalt cycle of experience (see Fig. 4).
......Rice. 4. Gestalt cycle of experience(main phases):
1 - Awareness, 2 - Energy / actions, 3 - Contact, 4 - Resolution / completion, 5 - Exit, 6 - "New" awareness
...D. Zinker notes that this figure illustrates the “normal” cycle of experience: “ Ideally, our awareness should be clear and distinct. When awareness is fueled with sufficient energy, we can move directly towards what we want. Actions lead to contact with the environment and are accompanied by a sense of satisfaction, resolution and completion. We can get out of the situation, relax and leave. A clear and complete exit gives us a fresh experience and is not accompanied by a painful feeling of incompleteness. Then a new awareness comes and the cycle starts again. The task of the therapist is to help the couple or family understand how and where the system„slows down“its movement and how to use collective awareness and energy to overcome the place of inhibition of its interaction».
Let us cite as an example one of the episodes of D. Zinker's work with a married couple who came for a consultation because a “crack” appeared in their relationship, boredom and indifference to each other appeared. The counselor in this episode helps the couple identify the problem - state it, and then understand each other's position.
Counselor: I would like you to turn to each other and talk about something that is important to both of you. I will sit by and listen, and if you find it difficult or need my help, please contact me, I will be happy to help you. Fine?
John: I've talked to her hundreds of times and always heard back that it was all my fault, that I was saying or doing something wrong.
Consultant: I'm glad you were able to say that. Now say the same to Diana, and I will see if something like this really happens between you. I promise to comment on this.
John: Like I said, you always blame me for everything.
Diana(starts crying softly): I'm a romantic woman, and when we were in New York last summer, I asked you to go with me to one special place, a place for the two of us. And what? We went there with other people. Why did you do this to me?
John: I took you everywhere with me, I paid for you everywhere. I thought you would appreciate my generosity.
Diana: I'm not talking about your generosity.
After this remark, there was a long silence, the spouses were depressed and discouraged.
Consultant: You both started wrong and now you've reached a dead end. In the beginning, you were quite energetic. Is this what happens at home?
Diana: Yes. After a while, we both get tired, and then we are silent for a long time.
Counselor: You have strong feelings, but you don't listen well to each other. Each of you says something important, but the other does not accept it. Is not it?
When analyzing this episode, it is obvious that the spouses failed in trying to understand each other. This is due to the fact that they spent their energy too early and got into the phase of awareness. Their difficulty lies in the fact that they are not able to talk for a long time and maintain a conversation, while maintaining energy. Further work A gestalt counselor may be focused on helping couples hear each other, explore experiences together, and build rapport. Each family has its own style of going through the phases of the cycle of experience. From the point of view of D. Zinker, in a period of trouble, all families have characteristic points of inhibition of the process of normal life. The counselor helps the family to experience the successful full completion of the cycle, developing a sense of fulfilling existence.
Family systems psychotherapy Theoretical provisions
Proponents of an expanded understanding of the content of family psychotherapy believe that any individual psychotherapeutic effect on family members, pursuing the goal positive influence on the family as a whole, should be considered as one of the options for family psychotherapy (Bach O., Scholz M., 1980; Kratochvil S., 1985, 1991). This assumption turns out to be true if the psychotherapist, listening to the patient and putting forward a hypothesis about a family diagnosis, thinks in terms of an integral family structure and, therefore, preliminarily assesses how this or that effect will affect family relationships as a whole" (Stolin V.V., 1981).
In addition, the meaning of the principle of systemicity is clarified in the light of the idea of "circular causality" (i.e., the mutual determinism of personality and interpersonal relationships) in a family, according to which the style of communication, the nature of interaction, the type of education, on the one hand, and the personal characteristics of family members, on the other, form a closed, constantly reproducing homeostatic cycle (Andolfi M., 1980). Family therapy is an attempt to break this cycle and create constructive options for family functioning.
Currently, the system direction is considered to be one of the most widely represented, promising, cost-effective and therapeutically effective areas of family psychotherapy.
The largest representatives of family systemic psychotherapy are Mara Selvini-Palazzoli, Luigi Boscolo, Gian-Franco Chekkin, Jay Haley, Clu Madanes, Salvador Minukhin, Hana Weiner, Allan Kuklin, Gil-Gorel Varne and others.
A significant influence on the development of this area of family psychotherapy was provided by the provisions general theory systems (Prigozhiy I., 1991) (see Chapter 2, section "Violation of the mechanisms of family integration"),
in psychotherapy in the first half of the 20th century. mechanistic reductionist theories of the “stimulus-response” type, as well as psychoanalytic theories about a person as a “lone hero” dominated: mental pathology was considered as a consequence of unresolved intrapsychic problems, individual behavior as a reaction to internal and external circumstances, a family with a violation as collection of individuals with disabilities.
Many family therapists have felt the limitations of this approach. One of the first to show interest in systems theory was Murray Bowen (1966). Somewhat later, Salvador Minukhin proposed the paradigm "a person in circumstances", meaning by this not the impact of a person on circumstances, but the impact of circumstances on a person.
In the USSR, much earlier than these scientists, V. N. Myasishchev wrote about this (Myasishchev V. N., 1935), who, in our opinion, is a major figure who predetermined the development of "pathogenetic psychotherapy" (personally-oriented psychotherapy by B. D. Karvasarsky , G. L. Isurina and V. A. Tashlykov) and family psychotherapy (including systemic - in the USSR and Russia).
In modern psychoneurology, a prominent place has been occupied by the theory of multifactorial etiology of neurotic and somatoform disorders (ICD-10), in which the psychological factor plays a leading role.
To the greatest extent, the content of the psychological factor is revealed in the pathogenetic concept of neuroses and the "psychology of relations" developed by V. N. Myasishchev (1960), according to which the psychological core of the personality is an individually holistic and organized system of subjectively evaluative, active, conscious, selective relations with the environment. environment.
V. N. Myasishchev saw in neurosis a deep personality disorder due to violations of the system of personality relations. At the same time, "attitude" was considered by him as a central system-forming factor among many mental properties. “The source of neurosis both physiologically and psychologically,” he believed, “are difficulties or disturbances in the relationship of a person with other people, with social reality and with the tasks that this reality sets before him” (V. N. Myasishchev, 1960).
What is the place in history of the concept of “relationship psychology”? This concept developed in a totalitarian society. While the leaders and ideologists of the USSR, relying on the provisions of the teachings of K. Marx, consciously or unconsciously created the conditions and justification for the enslavement of the citizens of their country, V. N. Myasishchev, having inherited the scientific methodological potential of his teachers - V. M. Bekhterev, A F. Lazursky and his colleague M. Ya. Basov, turned to the living thing that was in the philosophy of K. Marx - to the thesis of K. Marx that "the essence of man is the totality of social relations." According to L. M. Wasserman and V. A. Zhuravl (1994), this circumstance helped V. N. Myasishchev to return to scientific use theoretical constructions A. F. Lazursky and the famous Russian philosopher S. L. Frank about the relationship of the individual to himself and to the environment.
If the concept of “relationship” for I.F. Garbart, G. Gefting and W. Wundt meant “connection”, the dependence between parts within the whole - “psyche”, then for V. M. Bekhterev the concept of “relationship” (“correlation”) meant not so much integrity as activity, that is, the ability of the psyche not only to reflect the environment, but also to transform it.
For A.F. Lazursky, the concept of “relationship” had three meanings:
1) at the level of endopsychics - the mutual connection of the essential units of the psyche;
2) at the level of exopsychics - phenomena that appear as a result of the interaction of the psyche and the environment;
3) interaction of endo- and exopsychics.
M. Ya. Basov, until recently a student of V. M. Bekhterev and a colleague of V. N. Myasishchev, almost unknown to a wide circle of the psychiatric community, sought to create a “new psychology” based on the approach that later became known as the system approach. He considered "the division of a single real process of life into two incompatible halves - physical and mental - one of the most amazing and fatal illusions of mankind." The relations of the organism/personality and the environment are mutual, and the environment is an objective reality in its relation to the organism/personality.
Schematically, it may look like this (Fig. 31).
Rice. 31. Interaction of subject and object.
In his teaching, V. N. Myasishchev not only integrated the ideas of V. M. Bekhterev,
A. F. Lazursky and M. Ya. Basov, but also put forward his own. He singled out the levels (sides) of relations that are formed in ontogeny:
1) to other persons in the direction from the formation of relations to the neighbor (mother, father) to the formation of relations to the distant;
2) to the world of objects and phenomena;
The attitude of a person to himself, according to B. G. Ananiev (1968, 1980), is the latest formation, but it is this that ensures the integrity of the system of personality relations. Relationships of the individual, united among themselves through the attitude towards oneself, form a hierarchical system that plays a guiding role, determining the social functioning of a person.
There are three components in the structure of relations (Karvasarsky B.D., 1980): cognitive, emotional and behavioral. Normally, a person at the cognitive level knows something about the object, at the emotional level he experiences an emotion corresponding to knowledge, at the behavioral level he builds a behavior/reaction corresponding to knowledge and emotions. In pathology, the components of relationships are usually not coordinated. Hence the neurotic disorder (in the understanding of the school
V. N. Myasishcheva) is a psychogenic disease in which a certain constellation of symptoms (syndrome, or form) is caused by certain types of psychological conflict, disturbances in the system of personality relations and inconsistency of the components of these relations. The disorder of the system of relations, leading to neurosis, is a violation of the integrity of the system of relations (their hierarchical structure); the presence of conflicting relationships that are equally significant for the individual; violation of communication between blocks of relations; and a qualitative or quantitative change in such characteristics of individual relations as activity, selectivity, consciousness (which leads to inadequacy of relations to the object). All this is a source of neurotic conflicts and neuropsychic tension, which is controlled to a certain extent with the help of psychological defense mechanisms and channeled through the formation of symptoms. The main importance in neurotic decompensation is acquired by a violation of self-attitude, manifested in a reduced and contradictory self-esteem at all stages of personality ontogenesis (Isurina G. L., 1984; Eidemiller E. G., 1994).
In the pathogenetic concept of neuroses, a typology of neurotic conflicts is proposed, taking into account the personal mechanisms of their development - the concept of personality profiles in the form of personality radicals in children and personality accentuations in adolescents and adults (Leongard K., 1981; Garbuzov B. I., 1977; Eidemiller E. G. ., 1994). We consider the concept and typology of personality accentuations as internal conditions for the formation of neurotic disorders in Chapter 2 of this book.
V. N. Myasishchev proposed to divide neurotic conflicts into three types: hysterical, neurasthenic and obsessive-psychasthenic. A hysterical conflict is an unconscious insoluble contradiction between “I want” (an overestimated level of claims) and “I can” (underestimation of one’s capabilities and the real situation). The neurasthenic conflict is characterized, on the contrary, by increased demands on oneself that exceed the real possibilities of the individual (the conflict between “should” and “can”). Obsessive-psychasthenic - associated with the inability to make a choice between actualizing drives and normative attitudes (the conflict between "should" and "want"),
Currently, with the noted clinical pathomorphosis of neuroses (Ababkov V.A., 1994), neurotic conflicts in their pure form do not occur, and researchers talk about a multidimensional neurotic conflict (Karvasarsky B.D., 1990).
Based on the above provisions, an indispensable condition for the restoration of broken relationships during the conduct of "pathogenetic" or personality-oriented (reconstructive) psychotherapy is the awareness of internal contradictions and the verbalization of the emotional component of the relationship, teaching the client to test reality, including impulses and sensations in his own body, understanding the surrounding reality and own goals.
Summing up what has been said, we can state the interconnection and mutual conditioning of the external and internal (in relation to the personality) systems of relations, thanks to which the impulses, content and forms of development of the personality/organism are created.
Following V. M. Bekhterev, V. I. Myasishchev devoted great attention the study of childhood, the formation of the psyche at different stages of ontogenesis, the influence and interaction of society and microsociety in the formation of a system of personality relations in normal and pathological conditions. V. N. Myasishchev was the first in the USSR and Russia to discover that marital and family conflicts played a leading role in the origin of neurosis (in 80% of the examined patients with neuroses).
In the late 60s - early 70s. 20th century the most favorable conditions were created for the development of family psychotherapy in the USSR and Russia - both at the theoretical and methodological, and at the organizational and practical levels (Myager V.K., Zakharov A.I., Mishina T.M., Spivakovskaya A.S., Eidemiller E. G.). The development and evolution of family psychotherapy in Russia, its paradigms and methods are similar to the development of the family approach in the USA, Great Britain, Germany and other countries. At first, these were psychoanalytic, psychodynamically oriented models of family psychotherapy, directive counseling methods, then they were replaced by systemic and eclectic models.
At present, the "psychology of relations" continues to develop in Russia and contributes to the development of the concept of personality-oriented (reconstructive) psychotherapy (Karvasarsky B. D., 1985), family psychotherapy, activity psychology (Leontiev A. N., 1977; Leontiev D. A ., 1994), psychology of communication (Bodalev A. A., 1983). "Psychology of relations" was the starting point of psychotherapeutic research of personality in Poland (Leder S, 1990), Germany (Lauterbach W., 1995) and other countries.
Modern psychoanalysts note a significant similarity of the concept of V. N. Myasishchev with the concepts of 3. Freud, A. Freud, 3. Fawkes. But most forte the teachings of V. N. Myasishchev are an understanding of the personality as an integral biopsychosocial structure, where the social, psychological and biological components are closely interconnected, which necessitates the impact on all three components.
In family systemic psychotherapy, the family is viewed as an integral system, which, like all living systems, strives both to preserve the established relationships between elements and to evolve them. Paraphrasing the provisions of classical thermodynamics and the systems approach, it can be argued that the family as living system exchanges information and energy with the external environment (Prigozhiy I., 1991; Minuchin S., 1974; Minuchin S., Fishman H. C., 1981). In such a system, fluctuations (both internal and external) help to acquire a new level of complexity and differentiation, usually accompanied by a reaction that returns the system to its steady state. When fluctuations intensify, a crisis state may occur, the transformation of which will bring the system to a new level of functioning. As a result, the psychotherapist is faced with the task of joining the family, capturing its vibrations, then, together with the family, amplifying them in order to give impetus to change and cause frustration for the therapeutic purpose.
Throughout its existence, the family goes through natural “development crises” (Caplan G., 1964, cited by: Semichev S. B., 1972): marriage, separation from parental families, wife’s pregnancy, childbirth, child’s arrival in preschool and school institutions, adolescence in a child’s life, his graduation from school and choosing “his own path”, the separation of the child from his parents, their retirement, etc. It is during these segments of their existence that families are unable to solve new problems in the same ways and therefore face the need to complicate their adaptive reactions.
Families perform their functions with the help of certain mechanisms: the structure of family roles, family subsystems and the boundaries between them. The structure of family roles prescribes to family members what, how, when and in what sequence they should do, entering into relationships with each other. Repetitive interactions set certain standards (“interaction standards” according to Minukhin S, 1974), and the standards, in turn, determine with whom and how to interact. IN normal families the structure of family roles is holistic, dynamic and has an alternative character. If the needs of family members within the framework of the existing structure cannot be satisfied, then efforts are made to find alternative options for fulfilling family roles. According to our data, in 66% of families of adolescents with borderline neuropsychiatric disorders, either the structure of rigidly fixed pathological family roles was noted, or the initial absence of structure as such. By pathological family roles, we mean those that, due to their structure and content, have a traumatic effect on family members (Eidemiller E. G., Yustitsky V. V., 1990).
Family subsystems (“holons”) (Minuchin S., Fishman C, 1981) is a more differentiated set of family roles that allows you to selectively perform certain family functions and ensure the life of the family. One of the family members can be a member of several subsystems - parental, marital, child, male, female, etc. Simultaneous functioning in several subsystems is usually ineffective. When a mother scolds her son for a bad grade he got at school, and at the same time remarks: “It’s because your father is a dead man, he doesn’t want to show what a real man is,” she unconsciously begins to function in two subsystems at once - parental and marital . This behavior leads to the fact that neither the son nor the husband does not perceive criticism in their address, but take measures, sometimes together, to defend themselves from it.
The boundaries between subsystems are the rules that determine who and how performs family functions. In normal families they are clearly defined and permeable. In the families we examined, either rigid or blurred boundaries between subsystems were observed. In cases of rigid boundaries, communication between subsystems is sharply limited, there is no exchange of information. With blurred boundaries, stresses experienced in some subsystems easily spread to others.
The main principles of the Milan Institute for Family Studies, founded in 1967 by Mara Selvini-Palazzoli, are:
1) advancement of therapeutic hypotheses;
2) the principle of circularity;
3) neutrality;
4) positive interpretation of symptoms or problems of the client and his family (Selvini-Palazzoli M. et al., 1978).
Before the first family session psychotherapists who are part of the therapeutic team, after listening to family members, put forward a number of hypotheses about the paradoxical relationship in the family, leading to the formation of symptoms of the disease in one of its members (in our understanding, this is “family dysfunctionality”) (Eidemiller E. G., Yustitsky V V., 1990).
Circularity is understood both in an etiopathogenetic sense (see "principles of circular causality" by Mario Andolfi, 1980) and in a practical sense, when participants in psychotherapy are questioned in a circle. If a participant says, for example, “When my mother frowns, I feel bad,” the therapist asks other family members, “What do you feel when your mother frowns? And you yourself, mother?
The therapist maintains an accepting, neutral stance towards all family members.
Finally, the patient's symptomatology is seen as a way of adaptation, so the task of psychotherapy becomes the search for other ways of adaptation for the patient.
Based on these principles, it is possible to formulate the main steps of family systemic psychotherapy (Eidemiller E. G., 1994):
I. Uniting the psychotherapist with the family, joining him to the structure of roles presented by the family.
1. Establishing a constructive distance - the free location of family members.
2. Connecting through breath synchronization to the family member who claims problems.
3. Techniques of "mimesis" (Minuchin S., 1974) - direct and indirect reflection of postures, facial expressions and gestures of psychotherapy participants.
4. Attachment, according to the prosodic characteristics of speech, to the applicant of the problem, the identified patient (speed, loudness, intonation of speech).
5. The use by the psychotherapist in his speech of predicates that reflect the dominant representational system of the applicant of the problem and other family members. This text is an introductory piece.
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From the book Psychology and Psychotherapy of the Family author Eidemiller EdmondFamily psychotherapy for addictions According to A. Yu. Egorov, addictive disorders, which include chemical, non-chemical and nutritional forms of addiction, are characterized by six main features (Egorov A. Yu., 2007):
From the book Game and Reality author Winnicott Donald Woods From the book Ontopsychology: Practice and Metaphysics of Psychotherapy author Meneghetti Antonio9.1. Theoretical provisions For group psychotherapy - its duration is approximately one and a half hours - the participants are located in a semicircle, in the center of which is the figure of the leader. The psychotherapist is a leader chosen and accepted
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author Team of authorsChapter 20 20th century Its pioneers were not satisfied with the classical (psychoanalytic, behavioral) approaches to helping a person who finds himself in
From the book Psychotherapy. Tutorial author Team of authorsFamily Psychotherapy The significant prevalence of marital conflicts, divorces, alcohol abuse, drug addiction, etc. in the families of people with combat and non-combat PTSD, determines the importance of conducting family psychotherapy (FP) as a modification of relationships in
From the book The Human Project author Meneghetti Antonio From book Systemic psychotherapy couples author Team of authorsFamily therapy with spouses Family therapy with spouses is the main configuration of family therapy. In his article Merging and Differentiating in Marriage, Phil Klever (Klever, 1998) proposes the following work strategy based on Family Systems Theory
From the book The Theory of Family Systems by Murray Bowen. Basic concepts, methods and clinical practice author Team of authorsSystemic family therapy when symptoms are present in one family member The method of systemic family therapy began to develop primarily due to the growing interest of specialists in the study of schizophrenia and the desire to include this disease in a wider
From the book Sex in the family and at work author Litvak Mikhail EfimovichThis approach to family psychological therapy and counseling is associated with the ideas of classical psychoanalysis (3. Freud) and neopsychoanalysis (K. G. Jung, A. Adler and others).
The main emphasis in the psychoanalytic direction is on the ability to recognize and clarify the unconscious impulses of a person, to recognize ways to protect against them. Despite the fact that the psychoanalytic tradition in psychotherapy and counseling was originally designed for an in-depth study of the individual, this theory was also widely used in work with the family (X. Sterlin, R. Skinner, M. Nichols, N. Epstein, G. Grünbaum, U Meisner and others).
The theoretical principles that make up psychoanalytic family therapy and family counseling are based on the concepts of the psychology of drives 3. Freud, ego psychology (E. Erickson, G. Sullivan) and the theory of object relations (M. Klein, R. Spitz, D. Bowlby) .
Psychoanalytic theory 3. Freud. The main point of 3. Freud's theory is the concept unconscious. The concept of the unconscious allows us to describe the complexity and ambiguity of human life.
aim psychoanalytic family psychotherapy and psychological counseling is the liberation of family members from unconscious restrictions. As a result of its successful completion, family members should learn to communicate with each other as whole, healthy individuals.
Main tasks psychoanalysis are the identification and study of the subconscious realm that governs man. The psychologist, working with the client from the position of psychoanalytic theory, seeks to ensure that the client is aware of his subconscious processes and learns to influence them. mental processes that flow at the unconscious level should be as deeply revealed and presented to consciousness for integration into an existential organization. In this case, it is considered that the goal of interaction between the psychologist and the client has been achieved.
In the process of psychoanalytic therapy with the family, changes in the object relations of the family are very important. These changes as a result of psychotherapeutic work should change in the direction of individualization and differentiation of family members from each other.
The two main mechanisms that contribute to family behavior change are ipsite(insight, sudden insight) and expression of unconscious pent-up impulses. Psychoanalytically oriented family therapists and family counselors encourage their clients to ipsight and try to uncover material that is not conscious or is in the past.
Among basic techniques, which are used by psychoanalytic family therapists and consultants, we can distinguish:
- - analytical neutral listening;
- - interpretation inner experiences client;
- - the history of these experiences, the features of their challenge.
At the final stages of psychotherapeutic and counseling work, you can use the technique emotional relearning, which allows you to encourage the family and its individual members to use new intellectual insights for them in everyday life.
The most important thing here is that, according to psychoanalytic theory, certain neurotic personality traits can be formed as a manifestation of various psychological defenses, the identification of which helps the psychologist to understand the nature of non-adaptive styles of behavior, which will contribute to the effectiveness of psychological assistance. The presence of psychological protection in an adult leads to difficulties in interaction in the family and adaptation at work, in children - to new school conditions, in the family as a whole - to problems with other people and the desire to isolate and close family boundaries. A psychologist who practices not only in the traditions of psychoanalysis must necessarily know and understand psychological defenses and be able to identify them in a client.
We list the main protective mechanisms.
Denial - information that worries the client may lead to internal conflict, denied, not accepted.
Crowding out - true, but unaccepted motives are forced out, rejected in order to be replaced by others acceptable from the point of view of society. The repressed motive creates emotional tension, which is subjectively perceived as a state of indefinite anxiety and fear.
Projection- unconscious attribution to another person own feelings, desires, inclinations, in which a person does not want to admit to himself, realizing their social unacceptability.
Rationalization - a pseudo-reasonable explanation by a person of his desires, actions, actually caused by reasons, the recognition of which would threaten the loss of self-respect. In particular, rationalization is associated with an attempt to reduce the value of what has not been achieved or to exaggerate the value of what is available.
Identification - unconscious transfer to oneself of feelings and qualities inherent in another person, but desirable for oneself. Through identification, the symbolic possession of a desired but unattainable object is also achieved. Identification in the extended sense of the word is an unconscious adherence to patterns, ideals, which allows you to overcome your own weakness, a sense of inferiority.
Inclusion - the significance of the traumatic factor is reduced due to the fact that the old system of values is placed as part of a new, more global system. The relative importance of the traumatic factor decreases against the background of other, more powerful ones.
Isolation - isolation within the consciousness of traumatic human factors. Access to consciousness is blocked for unpleasant emotions, so that the connection between any event and its emotional coloring is not reflected in consciousness.
Regression - a form of psychological defense, which consists in returning to early types of behavior associated with childhood, the transition to previous levels mental development. Successful responses in the past are updated.
substitution- shifting an action directed at an inaccessible object to an action with an accessible, safer object.
Jet formation - a person defends himself from forbidden impulses by expressing opposite impulses in behavior and thoughts. Socially approved behavior is seen as exaggerated and inflexible.
Sublimation- translation of the energy of instincts into a socially acceptable channel.
It is possible to use psychoanalytic theory in understanding conflicts between husband and wife, the determinants of which are not satisfaction with communication with each other, but a binge relationship with one's own father or mother.
Individual psychology A. Adler. The main components of A. Adler's concept, embodied in consultative practice, are the principle of integrity, the unity of an individual life style, social interest and the orientation of behavior towards achieving a goal. A. Adler argued that goals and expectations influence behavior more than past experience.
In consulting practice, it is very important to understand the client's social interest and his desire for excellence. A. Adler noted that a child in a family often experiences a feeling of inferiority, in an attempt to overcome which and assert himself, his goals are formed (to become strong, inaccessible, etc.). It is important that the striving for superiority, arising from the feeling of inferiority, is combined with social interest, i.e. striving for superiority should be socially positive, including striving for the well-being of other people.
Goals of the client(family or individual) psychological counseling according to Adler:
- reduced feelings of inferiority;
- development of social interest;
- correction of life goals and motives;
- correction of negative feelings;
- change or (most often) the introduction of constructive elements into a person's lifestyle.
A. Adler believed that the concept of "life style" is very important in consulting practice. It is he who influences the success and failure of a person's functioning in various spheres of life, including in the family. Lifestyle, noted A. Adler, is the meaning that a person attaches to the world and himself, his goals, the direction of his aspirations and the approaches that he uses in solving life problems.
Lifestyle is based on the so-called private logic (in some sources - personal logic). Private logic- these are the attitudes, the worldview of the individual, assimilated in the parental family. Examples of private logic: “I must always be in opposition”, “I must always get what I want”, “I am an innocent victim”, etc. Adler emphasized the creative, active nature of the individual in the formation own life and the social nature of human behavior. Correction of the life style of family members will largely contribute to the constructiveness of emotions and behavior in life.
Stages of work with family and individual client. Adler noted that when working with a client, it is important to understand the style of his life; help him understand himself and his feelings, emotions, plans and goals in life. This work is carried out in stages.
- 1. Grade. Establishing trusting relationships - respect, faith in the capabilities and abilities of a person, active listening, manifestation of sincere interest, support, etc. Further - the collection of information, its analysis and the hypotheses about the possible private logic and the style of life based on it. As a result - the development of a plan of work with the client.
- 2. insight. The main goal is to help the client become aware of his private logic and the lifestyle based on it.
- 3. Reorientation. At this stage, the client is helped to formulate a new private logic (which is sometimes extremely difficult to do) or the constructive elements of the old private logic, to show the unattractiveness and destructiveness of the latter, and, consequently, the lifestyle.
- 4. Retraining. At this stage, with the help of various techniques, the client is taught to set new constructive goals, new constructive behavior.
Among the techniques most commonly used in Adler counseling are:
- 1) technique "early memory:”, which allows you to “go out” to the private logic and lifestyle of the client;
- 2) "family history”, which also makes it possible to understand the private logic of the client, which he learned in his family;
- 3)"positive tracking» - working with this technique helps the client to identify the positive aspects of his life in order to strengthen them, to realize his own resources and reorient himself to positive experiences;
- 4) "metaphors" these are images, pictures that offer an alternative view of the problem presented;
- 5) "restoration of positive rituals" - allows you to restore the lost patterns of positive interaction in the family;
- 6) "rituals of unification" the client, together with the psychologist, determines rituals that will help unite the family around some kind of joint business;
- 7) "transition to a new life" - emphasizes the transition from one period of life to another, allows you to form new expectations, rules, norms, roles, goals, etc.
- Skinner R., CleeseJ. Family and how to survive in it. M.: Klass, 2004.
