7. Assess & Challenge - RonaldMah

Ronald Mah, M.A., Ph.D.
Licensed Marriage & Family Therapist,
Consultant/Trainer/Author
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Roles, Rigidity, Repair, and Renovation in Relationships and Therapy
Chapter 7: ASSESS AND CHALLENGE
by Ronald Mah





The therapist needs to understand how the relationship, couple, or family and structure are dysfunctional.  "Assessment includes:

a) family members' preferred transactional patterns and available alternatives;

b) flexibility and the capacity to change, often based on responses to earlier demands for change within the family group;

c) family members' sensitivity to members' needs, behaviours, attitudes, and so on;

d) developmental issues, tasks and requirements;

e) the meaning and relational significance of symptomatic behaviour; and

f) the context of family life, with specific reference to sources of social support and sources of stress.  

Pitfalls within the assessment process can include:

a) ignoring the developmental processes of family members and changing family subsystems;

b) ignoring some family subsystems; and

c) joining and supporting only one family system" (Vetere, 2001, page 135).

The therapist should assess the relationship, couple, and family in the following areas: flexibility, territory, why, basic structure, resonance, and developmental stage.  Kelissa and Breland show low flexibility in how they respond to each other and to Soni.  Responses tend to be stereotypical.  They have an extremely hard time responding differently to each other.  With Breland living out of the house, what was formerly joint territory is now Kelissa and Soni's alone.  Soni has problems dealing with living in two systems (Kelissa and Soni's house versus Breland's apartment) with sometimes, contradictory rules.  The why of Soni's tantrums is that they serve to keep her allied with her father against her mother.  Breland is still angry and wishes to punish Kelissa.  The tantrums keep Kelissa in the victim role as being abused by Breland through Soni as proxy.  The basic structure is of a dysfunctional hostile co-parental dyad, an ineffective parental coalition between the parents, and an unhealthy coalition between Soni and her father, Breland.  As a result, Soni derives inappropriate power through her tantrums with her father's collusion.  There are two ineffective executive subsystems (one at each household), a child subsystem that has inappropriate power, and diffuse boundaries between father and daughter (enmeshed), and disengagement between mother and daughter and also, between mother and father.  The negative resonance is very strong in the system and subsystems.  Disruptions and stresses for any one member resonate throughout the system or subsystems.  Soni's tantrums affect both parents.  Breland's anger intimidates Kelissa.  Breland's sadness and hurt being out of the house distresses Soni.  Kelissa's frustration and low self-esteem empower Soni's tantrums.  Kelissa's resentment and blame anger Breland.  The entire family and the couple systems are in a developmental stage of reorganization.  The recent separation forces a developmental stage of reorganizing from one system to two separate systems.  And, Kelissa and Breland are in another developmental stage of reconnecting after separation.  There is incomplete development with unfinished anger, custodial arrangements, financial arrangements, and the potential threat of new romantic relationships creating a highly stressful stage for all individuals, the couple, and the family.

Therapy often needs to challenge the organization of the system.  The individual's intrapsychic system and the couple or the family system evolves through stages, each with its own functional and psychological characteristics.  The relationship is initially a pair of individuals who feel each other out for attraction and compatibility.  They become a committed couple eventually with common goals.  Possibly experiencing some problems, the relationship may nevertheless start out relatively stable.  This may be because of positive dynamics or perhaps, because of a willingness to overlook problems in the bloom of the new relationship.  Eventually, rules and roles have to be developed to manage the internal relationship between partners and their interactions with outside circumstances and people.  Individual traits and perspectives influence the development of the couple's dynamics and structure, and eventually of the family when children may arrive.  Differences between partners continually affect the interactional process of the system.  Hopefully, the individuals as the couple reach consensus about how to handle personal differences while striving to achieve common goals.  New circumstances, especially children being born add challenges to the system.  There will be a need to develop new roles for new concerns and in anticipation of later requirements.  There will be more relationships and greater complexity between family subsystems to handle ongoing changes.  Compromise often becomes necessary between partners and among family members.  Individual member problems and problems in the family subsystems create social stress and psychological problems for everyone.  The old responses, standards, or expectations persist until new rules are established for the demands of an evolving era of the family.

These standards change for example, if the couple break up or never join in a committed relationship or as co-parents.  Regardless whether there has been a two-parent family, remains a two-parent family, has always been or has become a one-parent family, standards inevitably change when children become autonomous and launch to be on their own.  Autonomy and dependence rules have to be adapted to allow for separation and independence.  This can be a major issue for the parent or parents.  Sometimes having had the illusion that having kids solves relationship problems, partners find that children just put these problems on hold until the children grow up and leave.  Or, add to or intensify problems.  Partners/parents may project relationship issues to their children.  An individual, couple, or family that has rigid attitudes and lacks the flexibility to make adjustments to behavior may have more problems.  "In general the family grows and develops through stages and situations and goes through a quasi-circular movement.  Each circle differs from others and the differences between the situations and circles mean, that each stage has its own tasks, and any change in family life obliges members to adapt to such change in family life obliges members to adapt to such change (Hoffman, 1981; Kost, 2001)"  (Simadi et al., 2003, page 474-75).  When developmental tasks and adaptive change are frustrated, the relationship, couple, or family can get stuck in dysfunctional patterns of behavior that are unsatisfying to one or all members.  Rather than pathologizing specific behaviors or blaming one member or the other, the therapist can challenge the organization of the entire system as ineffective or misguided.  Reframing the system, challenging the structure, and challenging the reality challenges the organization of the system.

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