Working With Patterns in Family Therapy: An Example From My Work as a Family Therapist in Boulder
I want to discuss here how a hurtful circular pattern in a family that I have been working with as their family therapist (I’m a family therapist in Boulder) can be worked with. Some of the details were changed to protect clients’ confidentiality. The father contacted me to help his son with depression. The son is a college student whose academic performance is suffering from his emotional state. The academic requirements, together with the lower functioning, cause the son much stress.
When the son came to see me he described the following circular pattern in his relationship with his father:
1. The son starts to feel stressed and or/depressed (his moods shift drastically throughout the day). 2. The father sees the drastic change in the son’s mood and tries to fix it. He might say to the son that he needs to be grateful for what he is already got, or that other people have a much more difficult life. 3. The son gets angry and raises his voice at the father while saying hurtful things on purpose. 4. The father gets angry and says hurtful things to the son. 5. The cycle repeats.
This pattern is problematic for the family members since no one is getting their needs met. The son stated in the sessions that he just wants to feel heard and seen, without his father trying to fix the situation. However, the father's default behavior is to try to fix the situation by attempting to encourage the son. In his attempts to be a good father, the father's un-helpful strategy to fix the situation is verbally minimizing the suffering of his son, which in turn makes the son feel unseen and invalidated. The father's attempts to show the son that he cares about him are seen by the son as a lack of care and understanding. When the son tries to vocalize his hurt and frustration by the father's reactions to his suffering, he is choosing to raise her voice and say hurtful things, to let the father know that his words hurt him. However, this way of communication is not efficient because it just dysregulates the father, who's in turn just dysregulates the son even more. They are both caught in a perpetual cycle that hurts them both.
This pattern is paradoxical. While the intentions of both family members are positive, they bring about an unintended result; The father wants to support the son and relieve his stress and depression but instead just alienates him and contributes to more stress and depression. The son is desperately trying to communicate his need to be treated gently and attentively by his father, but instead, he just pushes her father away. By doing so, the son is not allowing his father to connect with him on a deeper emotional level.
In my work with them, I used two interventions that were helpful. First, I suggested to the father and the son to practice in the session a different communication way. Vetere (2001) says about structural family: "Thus an aim of this therapy is to alter the organizational patterns, particularly where the modes of communication are thought to be unhelpful and where behaviors are considered to be abusive and neglectful or to have to be potential to be so." (p. 2). I believed that their modes of communication were unhelpful and decided to see what happens when these modes are altered. I asked the son to tell the father directly what he would like to hear from him instead. When the son replied that he does not know, I asked him to tell me about something helpful that his friends say. The son said that he feels better when his friends tell him that they are sorry that he is having such a hard time and that they are there for him. I requested the father to repeat precisely the same thing to the son. When the father repeated his son's words, the son smiled. He did not roll her eyes as he did at the beginning of the session while listening to the father. He looked genuinely connected and reported that it felt good to hear.
The second intervention was examining and reframing the meaning that the father held about the time when the son felt reluctant to help him at his job. Both family therapists and symbolic interactionists are interested in the roles and the meanings that are behind the family members' actions. The many roles with their multiple responsibilities may lead to stress: Voydanoff (1987) addresses specifically the strain between family roles and work, and in the case of my clients there is the strain between being a son and a student. While the father thought that his son does not want to help him because he does not care about him, the son was stressed because of two finals that were coming up. Reframing the father's assigned meaning was helpful, and I asked the son to tell the father directly what was the reason for his reluctance to help: "Through reframing, a negative often can be reframed into a positive." (Smith, Stevens-Smith, & ERIC, 1992, p. 3). The son shared that he felt it was his duty to help his father, but the upcoming finals made harder for to do it wholeheartedly. This was very different from what the father thought, and creating that clarity led to a deep and meaningful discussion.
Sasha Raskin, a therapist in Boulder, provides individual ,family, and couples therapy / counseling in Boulder, Colorado, and worldwide via video and phone calls, drawing from over ten years of clinical experience. Schedule your free 20-minute phone consultation with Sasha Raskin
Durbin, N. E., & Voydanoff, P. (1987). Work and Family: Changing Roles of Men and Women. Teaching Sociology, 15(3), 350. doi:10.2307/1318361
Smith, R. L., Stevens-Smith, P., & ERIC Clearinghouse on Counseling and Personnel Services, A. M. (1992). Basic Techniques in Marriage and Family Counseling and Therapy. ERIC Digest.
Vetere, A. (2001). Structural Family Therapy. Child and Adolescent Mental Health,6(3), 133-139. doi:10.1111/1475-3588.00336