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Helping Families Heal

By Philip Classen, Ph.D., C. Psych., RMFT & Diane Marshall, M.Ed., RMFT

For trained marriage & family therapists psychotherapy is always a family affair. Family therapists deal with a great variety of clients: some come as individuals, some as couples, some as families; clients here in Ontario come from a huge range of nationalities, ethnic groups, and religious affiliations; some are Christian, some Jewish, some Muslim, some of other faiths, and some who are not members of any faith community. At first glance, these clients seem to have little in common except for a desire to improve their emotional and relationship life through therapy. But clients in fact have a lot more in common than that. No matter what their issues, or background, or social class, or culture, all clients have families of which they are a part.

We are all members of families, and we learn to become social beings through our early experiences of family. Even the most isolated individual can still be understood as a family member. Family ties and influence of family structures are powerful, even when remote in time and distance. While therapists may see clients as individuals, and while some clients may see themselves as living in splendid (or not so splendid) isolation from community, “family systems” approaches to therapy have proven to be an essential level of help to people suffering with a wide variety of emotional and relationship difficulties.

Increased consciousness of the power and importance of the influence of ones family is often crucial to moving to deeper understanding and more responsible control of ones life. This work is rewarding and also very difficult for both the client(s) and the therapist. Additionally, by recognizing that people act and react within larger structures such as partnerships, marriages, families of origin, families of choice, faith communities, socioeconomic classes, workplaces, and so on, one can acknowledge the broader circles that influence, and are influenced by, each person’s very existence. Add to this the potent influences such a genetic, bio-chemical, and medical factors, and the texture and variety of each person’s experience may be best seen as a complex human tapestry.

Many of our clients suffer from various forms of depression, anxiety, ongoing conflict in relationships, and stress from either severe trauma or from difficulty regulating the small traumas of everyday life. Family therapists find that many of these difficulties can be helped by addressing the family based origins that impact how closeness, intimacy, power, control, and respect have been experienced by clients throughout the various stages of their lives.

One family systems model that I have found useful in my work is the “Beavers Scale of Family Health and Competence,” named for its originator, psychiatrist W. Robert Beavers (see, Beavers, 1977 & Beavers & Hampson, 1990). His central notion is that different family systems operate at differing, but very clearly recognizable, levels of health and competence. Any given family can be understood in light of core issues of power, control, and intimacy. Beavers sees flexibility and structure as being key aspects of family health.

The Beavers scale describes five family developmental levels ranging from “Severely Disturbed families,” at one end to “Optimal families” at the other (with “Borderline,” “Midrange,” and “Adequate” families in between). Beavers’ model provides a way of describing and understanding both dysfunction and strengths that can occur in families. Though families often maintain these enduring qualities for generations, it is crucial to point out that any family can temporarily regress to dysfunctional levels if they are inflicted with enough stress or deprived of basic needs; on the other hand, many families can and do grow in health and competence through, for example, constructive outcome of crises that can lead to re-evaluation and change, influences from positive community life (including healthy faith communities), and interventions which interrupt cycles of abuse or addiction.

Beavers describes families with the least maturely developed health and competence as “Severely disturbed.” These families are chaotic; they are emotional systems in a state of confusion and turmoil, lacking clear rules or any sense of leadership and without ability to effect change. Families at this level of development exist in an amorphous world, a world without any reliable or even discernible governance. No member of the system is capable of achieving clarity, and feelings of apprehension and danger dominate the family. Unresolved sorrows, unmourned losses seem to overshadow any capacity to live life in the present. Even expectable losses associated with passage of time (such as children growing up or the decline of aging parents) are frequently denied. Because of the fear that change and loss will prove intolerably painful, the family continues to do things in a rigid way, lacking flexibility or the capacity to adapt creatively to new situations.

In a step of developmental progression, but still embodying tremendous dysfunction, the “Borderline family” desperately tries to master the disorder of severely disturbed systems, but tragically the pendulum swings in an extreme opposite direction, gravitating toward a rigid form of authority. Beavers “Borderline families” are highly authoritarian. In this form of family functioning the rules are clear, authority is defined, but no one can challenge or change the way things are structured. There is a prevalent dread that once control is lost, the system will go completely haywire and the family itself may splinter and fall apart. In these families there is more coherence, but little room for individuality, openness, sharing, or difference from an imposed “norm;” instead, intimidation and control are central to the family’s emotional functioning.

Moving up the continuum, in “mid-range families,” the issues of coherence and control have been resolved; these families are neither formless nor confused, but a problematic form of control is powerfully encouraged within each member of the family group. Midrange families use the power and influence of close relationships to maintain a code of family values. This emotional system is rule-bound; people have a strong code of “shoulds” and “oughts”: everyone knows what one is supposed to do and what is expected of one. Beavers terms this the “invisible referee” – a faceless judge or an imagined audience who scrutinize every aspect of one’s thoughts, feelings, and behaviour. In the midrange family, feeling worthy, loved and lovable, is contingent on obeying the dictates of the emotional system. The central problem with this type of family system is that true intimacy can never happen unless individual members are encouraged to come to grips with who they really are and what they actually think and feel (as opposed to knowing what they “should” think and feel).

In Beavers’ adequate and optimal families, the highest levels of family functioning, members of the family are able to be comfortable with both their loving feelings and their feelings of annoyance and frustration. As members of an intimate group, each one takes personal responsibility for his or her mixed, ambivalent thoughts and feelings. The family thus displays flexible responses to life events and are able to focus on their issues with goal-direction and clarity. A deep sense of emotional security allows these families to resolve conflicts because they have a sense that “we can work it out.” There is a sense of respect that the needs of the self, and the needs of the group, can be resolved in a cooperative way. Instead of using emotionally coercive tactics such as intimidation and guilt, adequate and optimal families share power and allow for the expression of a wide range of feelings and thoughts. Differences are welcomed as enriching everyone. Thus intimacy is safe. Members are free to be both separate and connected.

How do we help families move up the scale?

In working with a variety of family forms and emotional systems, we family therapists often find ourselves helping members of the family to learn to accept one another as being different, as having differing needs, as needing to learn to listen to one another. Teaching communication skills is an essential component of doing family therapy. Developing cooperative rules for resolving conflicts and fair fighting rules to manage anger in non-destructive ways, are all part of the tools of the therapeutic trade. Often we are required to help parents understand the developmental stages of their children, to help adolescents understand their biological changes, to help couples understand the socializing into rigid gender roles that inhibit their relationship. Often our task is simply to help family members hear one another in a safe, neutral environment.

When issues of racism, sexism, or some other prejudice wound a family member’s self-esteem, our challenge is to help the family to be a place of healing and hope. When drugs, alcohol, gambling, sex addictions, or affairs threaten to tear apart the fabric of family relationships, the family therapist’s role is to help the family find a path for healing. When severe depression, mental illness, or physical illness or accidents impede the functioning of the family, our role may be that of working collaboratively with other professionals to ensure medical treatment, appropriate medication, and safety of all members of the family.

We give our clients a lot of credit for survival, for coping, and for the courage to face their own truths despite the difficulty of doing so. We enjoy seeing them gain insight, recapture joy; decide to make whatever changes they need to, and then make them. We enjoy seeing our clients gain (or regain) self-respect, a sense of competence, a sense of adventure in living, and spiritual connection.

When individuals, couples, parts of families, or whole families come for therapy – often referred by their doctors, clergy, or friends – they can be aided in their growth and recovery by understanding how their family of origin operated, how their current family relationships are functioning, and how they have come to see themselves as individuals within their family system.

Philip Classen, Ph.D., C. Psych. RMFT is a clinical fellow and approved supervisor of the Ontario Association for Marriage and Family Therapy, a division of the Registry of Marriage and Family Therapists in Canada, Inc.
Diane Marshall, M.Ed., RMFT is a clinical fellow and approved supervisor of the Ontario Association for Marriage and Family Therapy, a division of the Registry of Marriage and Family Therapists in Canada, Inc.

Philip Classen and Diane Marshall are in private practice at The Institute of Family Living in Toronto, Ontario.

 

Bibliography
Beavers, W. Robert. Psychotherapy and Growth: A Family Systems Perspective. New York: Brunner/Mazel, 1977
Beavers, W. Robert, and Hampson, Robert B. Successful Families. Assessment and Intervention. New York: W. W. Norton & Co., 1990


May 15, 2016