Terapia sistemelor familiale

-o noua abordare teoretica a disfunctionalitatii si un cadru modern de tratare

a sa

Terapia sistemelor familiale s-a nascut din celebra idee gestaltista conform
careia intregul este mai mult decat suma partilor sale componente si are ca si
cadru stiintific de fundamentare celebra teorii a sistemelor fizice care isi
gaseste tot mai mult aplicare in cadrul societatiilor umane si indivizilor
umani. Entitatiiles ociale sunt intelese din ce in ce mai mult ca si sisteme
cibenetice complexe.Toata stiinta de tip vestic concepe si studiaza lumea
intr-un sistem ierarhic. Disciplinele traditionale sunt definite de sisteme
organizate intr-o anumita ierarhie cu legi specifice de organizare si
functionare.
Familia dar si orice alt grup social uman asupra caruia acest tip de terapie se
poate aplica sunt si ele vayute ca niste sisteme care, dupa cum am amintit
mai sus , principiul conform caruia intregul este mai mult decat suma
partilor sale componente. Acesta mod foarte bun de intelegere a cuplurilor,
familiilor, sistemelor educationale, grupurilor de munca si agentiilor a dus la
formare de numeroase scoli de gandiree care au metode specifice de
interventie terapeutica.
Filozofia de baza ale sisstemelor familiale o putem sintetiza in felul
urmator: simptomul este vazut ca avand sens numai in cadrul familiei sau
intr-un mai larg cadru social spre deosebire de conceptia clasica care punea
acentul in mod special pe individ.
In cadrul acestui tip de terapia familia este punctul cel mai important de
analiza si tratatre
Spre aceasta canalizandu-se atentia , pacientul identificat fiind doar un
individ asupra caruia problema familiei este reeflectata si care motiveaza
familia pentru schimbare.
De exemplu evitarea scolii de catre un copil poate fi mai putin o problema
interna a sa cat un rezultat al unei dinamici maladaptative a familiei din care
provine(un tata alcoolic, o mama incapabila de a-l disciplina, conflicte ale
parintilor cu institutia de invatamant, etc.)
Studiile stiintifice si practicarea acestui tip de terapie a avut loc numai in
occident, in tara noastra acest tip de terapie nefiind inca implementat, de
aceea orice afirmatie si mod de interventie trebuie interpretat in context
socio-cultural vestic si in mod special nord-american. Eu personal am asistat
la o prezentare a anumitor tehnici a terapiilor sistemelor si dupa opinia mea

pentru adaptarea acestui tip de tarerpie in Romania trebuie intreprinse studii

empirice care sa tina cont de diferenta de context socio-cultural.
Cum am mai amintit anterior terapia sistemelor familiale cuprinde
numeroase scoli de gandire cu tot atatea moduri de ctiune terapeutica si
tehnici specifice.
Una dintre cele mai importante scoli de terapie a sistemelor familiale este
terapia boweiana numta asa dupa autorul sau Murray Bowen. Terapia intiata
de el se concentrea in a-l ajuta pe pacient de ase diferentia de familia sa de
origine.Acesta considera ca ajutand oamenii sa nu fie inghititide de reguli,
roluri si si dinamica predictibila a familiei el ii poate ajuta pe indivizi sa
devina mult mai maturi in functionarea lor si de se simti satapanii propriei
sorti avand sentimentul ca ii detin controlul.
Dintre pionerii terapiei sistemelor familiale Murray Bowen a fost primul
care a inytrodus ideea ca asupra noastra nu actioneaza numai influente
sociale preaente dar si situatii trecute cu rol in creearea situatiilor prezente.
Bowen aintrodus 8 concepte inter-relationate in teoria siatemelor familiale:
1. Diferentierea sinelui
2. Trunghiurile
3. Procesele familiale ale familiei nucleare
4. Procesul proiectie familiala
5. Procesul de transmisie multi generationala
6. Pozitia individului intre fratii
7. Ruperea emotionala
8. Procesul emotional social
Diferentierea sinelui este abilitatea

Differentiation of self is the ability to separate feeling and thinking. Undifferentiated people can not
separate feeling and thinking. Their intellects are flooded with feelings, they can't think rationally, and they
can't separate their own from other people's feelings. Differentiation is the process of freeing oneself from
one's family, realizing one's own involvement in problematic relationship systems as opposed to blaming
others, but being able to be emotionally related to members.
Triangles are the basic units of systems. Dyads are inherently unstable as people in dyads vacillate between
closeness and distance. When stressed or under high emotion, dyads become distanced and triangulate a
third party to decrease anxiety or emotionality, in effect freezing the system in place. The lower the
adaptive level of functioning in a system, or ability to cope with stress, the more likely the people in the
system will triangulate. The person with the least differentiation of self, the most vulnerable, will be the
person most likely to get triangulated into some other dyad.
Nuclear family emotional processes refers to the emotional patterns that exist in a family over the years
that are passed on to each generation. Reactions to this family emotional process include;
1.reactive emotional distance
2.physical or emotional dysfunction in one spouse

3.overt conflict
4.projection of problems onto one or more children
Family projection process is the process by which emotional processes are passed on from one generation
to the next. The child that receives the projection will have difficulties differentiating, and thus his/her
differentiation is stunted. This will effect their interactions with their own spouse and/or children.
Multigenerational transmission process is the process by which family emotional processes are
transferred and maintained over three generations.
Sibling position is important as each child has a certain position in the family, and thus is less or more
likely to fit some projection of the family as well as interact with sibs
Emotional cutoff is separation by emotional or physical distance from the family of origin. The person cut
off may look/feel independent from the family but is not. The only thing that hurts Superman is Kryptonite,
a piece of his home planet. People who cut off from their original families are more likely to repeat the
same patterns in their own relationships
Societal emotional process are social expectations about races, classes, ethnic groups, gender, sexual
orientation... and their effect on the family
Normal Family Development
To Bowen, all families lie on a continuum, and there are no different "types" of families, such as "The
Schizophrenic Family." Optimal development occurs when members are differentiated, anxiety low, and
parents are in good emotional contact with their families of origin. Fogarty says adjusted families;
1.are balanced and can adapt to change
2.see emotional problems as in the system with components in individual members
3.are connected across generations
4.have a minimum amount of fusion and distance
5.have dyads that can deal with problems between them
6.tolerate differences
7.have differentiated members
8.are aware of what they get from outside and from within
9.allow each member to have their own emptiness
10.preserve a positive emotional climate
11.have members who think its a pretty good family
12.have members who use each other for feedback rather than emotional crutches
Behavioral Disorders
Disorders are seen as resulting from emotional fusion, an increase in the level of emotion and anxiety in the
family, or in an upset to a fused relationship that has formerly kept the triad stable. The child with the
symptoms is usually the least differentiated and most isolated member of the family. The adults who acts
out is most likely in a dysfunctional relationship with a spouse. Problems occur when "vertical" problems
passed on from parent to child interact with "horizontal" problems caused by environmental stressors or
transition points in the family development. Most people choose a spouse with an equal level of
differentiation.
Goals of Therapy
Treatment entails
1.placing the presenting problem in a multigenerational frame
2.lowering anxiety
3.increasing differentiation especially of the marital couples (increasing the parent's ability to control their
own anxiety and fortifying parental emotional functioning) by the therapist triangulating with them but
staying neutral
4.forming relationships with the dysfunctional member
5.opening closed ties and detriangulation of members
6.symptoms focus is avoided
7.evaluating progress

8.Feminists add addressing the power differential in the couple

You do this by attending to both process (patterns of emotional relations) and structure (interlocking
triangles), but not to details.
Conditions for Behavioral Change
1.Anxiety (which breeds emotional fusion) must be low, and understanding high as understanding (not
behavior) is the critical factor in change
2.The therapist must remain neutral and detriangulated
3.Differentiation of single members is often enough to spur differentiation of other family members. Often
motivated members are better able to change than families
4.If not the presence, then at least the awareness of the entire family
5.Development of a personal relationships with each of the extended family
6.Return to the family as an adult is often helpful
7.Overlapping triangles occur when dyads pull each available person into the dyad. When all available
people are exhausted, the therapist will be used.
Techniques
Questioning is the closest thing to a magic bullet in Bowen Family Theory. Bowen didn't like focus on
technique. Carter has assigned tasks to the couple to speed up their realizations. She may encourage letter
writing to members, visiting mother-in-laws... to speed things up. Guerin accepts the family's opinion of
who the i.p. is and works from there with a variety of techniques.
Family Therapy with Couples involves several techniques or caveats.
1.keep the emotional tone under control - lively but not too anxiety provoking, otherwise they may feel you
are taking sides no matter what
2.stay detriangulated! it will be hard when couples get emotionally stirred up, since they will work harder
to triangulate
3.do not allow open conflict
4.teach talking and listening
5.Guerin uses displacement stories or films to provide some other medium to project difficulties onto and
deal with decreasing anxiety
6.address feminist concerns about power deferential
7.descriptive labels like "pursuer-distancer" are often helpful to understand relationships. Don't follow a
distancer, work with the pursuer and his/her emptiness. The distancer will feel safe enough to enter back in.
8.coach or consult them, interrupt arguments, model skills...
9.use "I-positions" to teach them to do so, to teach them to state their needs and thoughts without overreacting. Saying what you feel is better than commenting all the time on what others are doing.
10.teach about emotional systems and slowly incorporate family of origin work into the relationship issues
Family Therapy with One Person should focus on differentiation; seeing other family members as
people, not images;observing triangles and detriangulating; realizing one's own involvement is problems.
Watch for emotional cutoff in denied emotional dependence on the family and exaggerated independence.
Prerequisites are a knowledge of family systems and strong motivation. Genograms are often helpful.