14. Ind Therapy in Cple & Fam Therapy - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Therapy can take it deeper psychodynamically or into man such as Carson's family-of-origin.  This is essentially a cross-cultural interpretation that references the couple or family's interactions to another set of interactions- Carson's original context of his family.  His family-of-origin may have multiple influences including his parents' models of gender roles, class or ethnicity influences, and the individual psycho-emotional temperament of each of his parents.  The therapist may find it prudent to get family-of-origin background at the beginning of therapy to discover the early influences affecting individuals current functioning.  "Initially, just as the development of attachment is thought to begin with the primary behavioral interactions between the child and parent, Adlerian theorists believe that the lifestyle originated in the behavioral combinations that a child tries in order to find a place in the family to get his or her needs met.  In the next phase of development, attachment behaviors become more organized into a working model of self and others, just as the private logic of the child—the methods for solving problems and confronting the tasks of life—is organized into a schema of apperception and eventually the lifestyle.  From this working model, the individual defines the quality and nature of his or her affective, behavioral, cognitive, and physical development... Finally, as the individual matures, an internal working model of the world is developed from the attachment style, just as the lifestyle is set and employed with friends, school, work, family, and other social settings..." (Peluso and Macintosh, page 253-54).

Carson and Vee are unaware they are operating from each of their internal working models.  The therapist can draw upon information previously discussed about the family-of-origin, and can say something like, "That's just like how your dad (or the neighborhood kids) made you nothing.  Hitting you with those words ignites your pain… they make it like you don't matter… again!  It must hurt a lot to be brought back there, especially with Vee doing it.  Vee, your wife who is supposed to be one you can turn to." The therapist can empathize with a man's deeper hidden pain, but only if they are not caught up with being angry with him for being verbally aggressive and hurtful to his wife.  Therapy can take multiple directions here, but essentially couple therapy for the time being becomes individual therapy for Carson.  Therapy can help him existentially process his feelings and create more insight and self-awareness.  Couples therapy may be a good approach to help men with significant issues otherwise targeted with individual therapy.  Isakson et al (2006) says, "The interaction effect suggested that when clinically disturbed males are seen in couple therapy the degree of disturbance experienced by their wife had little relationship to the gains they made in treatment.  Male patients seemed to benefit in couple and individual therapy, albeit more rapidly when seen with their partner (page 319).

In Carson's individual process, his wife becomes an observer.  This gives her an opportunity to discover that his behavior is not simply about not caring about her, wanting to be in control, or being a jerk, but from deeper experiences and sometimes trauma in his childhood.  Compelled to take a break from her defensive-offensive process, Vee for the time being lets go of her self-righteous litany of grievances against her Carson.  It may seem that therapy has shifted to go "after" him, but actually therapy has shifted from what he has done in the relationship, to what happened to him previously that explains why he is the person, man, and husband he is now.  Vee may be left wondering for the time being what is happening in therapy, but the therapeutic thrust does not condone his behavior.  While she wonders about that, it opens her up to giving up trying to recruit their therapist to agree with her.  Therapy can follow the psychodynamic or family-of-origin trail to find root models and issues.  This type of individual therapeutic inquiry may be the first time either Carson or Vee have connected his present relationship behaviors to his childhood experiences.  He may discover that his reactions to Vee are not really just about Vee, but rooted in attachment issues between him and his parents where he felt neglect, abuse, or trauma.  Vee is not the evil witch!  When Vee learns about Carson's childhood distress, she may feel compassion for the hurt little boy still inside the big man she has married. He's not just a big jerk!  

"Investigations of Emotionally Focused Therapy (EFT) indicate that an emphasis on expressing feelings is important to clients and leads to an improvement in perceived marital adjustment … Consistent with EFT, therapists can encourage the expression of feelings and needs and can help clients acquire understanding, take responsibility, and give and receive validation.  The authors concluded that the importance of expressing underlying feelings in couples therapy may lie in changing the partners' perceptions of each other, rather than changing an individual's self-view" (Estrada and Holmes, 1999, page 152).  Vee can be asked, "Did you know this was inside him?"  Partners who witness this type of process will often confirm that they knew of their partners' difficult childhood experiences, but had not previously connected it to their dynamics as a couple.  Anger and resentment is often replaced by empathy and sadness.  Hostility seeped out of Vee's body with her mouth with shaped with an almost audible "oh." She thought, "That's why he does that!"  

If Carson and Vee had brought their children in for family therapy, the therapist may also do individual work with Carson and Vee for the children to observe.  Seeing their parents being challenged and becoming vulnerable in exchange with the therapist may be a new revelatory experience.  The parents had always been authoritative if not authoritarian and previously never challenged.  Children may learn for the first time the deep motivations for their parent's behaviors.  Rather than seeing them as just being "mean," children may realize that their parents may be replicating their grandparents' models or trying to resist them.  Or, children may see that Carson's anger comes from feeling vulnerable like the little boy he had been- not unlike their vulnerability.  "Oh, that's why he does that."  At the same time, Carson as he gets in touch with his vulnerability and finds the origins of his anger, may recognize how his anger scares his children as he was scared as a child.  "Oh, that's how they feel… that's how I felt."  The other dynamics and guidance of family therapy align with these critical emotional connections.

ADDRESS:
433 Estudillo Ave., #305
San Leandro, CA 94577-4915
Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist, MFT32136
CONTACT INFORMATION:
(510) 614-5641 or (510) 582-5788
fax: (510) 889-6553
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