Gladding Ch. 9 - Psychodynamic Family Theory

Question 1

Prominent Theorist: Nathan Ackerman

Answer 1

◆ Founder & the most influential advocate of Psychodynamic Family Therapy.
◆ During the 1930’s was when Ackerman shifted his interests from child psychiatry to
families and their influences on mental health.
◆ Ackerman’s initial clinical work was at the Menninger Clinic in Topeka, Kansas.
◆ Ackerman was mostly interested in the psychosocial dynamics of families and utilizing
the application of psychoanalytic principles.
◆ In the 1950’s and 1960’s, Ackerman was the leading family therapist for the East Coast.
◆ In 1957, Ackerman opened the Family Mental Health Clinic at Jewish Family Service in
New York.

Question 2

Nathan Ackerman, ctd

Answer 2

In 1960, Ackerman opened the Family Institute in New York.
◆ In 1961, Ackerman was announced as the cofounder of the first family therapy journal,
Family Process.
◆ Ackerman influenced many psychodynamically oriented professionals and clinicians by
encouraging them to see the intrapsychic conflict that divided family members
underneath the perceivable unity of the family.
◆ Established the American Academy of Psychoanalysis in 1955, which allowed nonmedical
specialists access to the field of psychoanalysis.
◆ Concepts that Ackerman emphasized/initiated:
(1) Scapegoat (2) Tickling of Defenses (3) Complementarity
(4) Focusing on Strengths (5) Interlocking Pathology

Question 3

Guiding Principles & Premises

Answer 3

➔ Based on the work from Sigmund Freud
◆ Theorists Heinz Kohut, James Framo, Ivan Boszormenyi-Nagy helped apply Freud’s
approach to families.
➔ Conflict arises from negative emotions
◆ To resolve conflict: (1) defenses must be strengthened against a conflicted wish, and (2) a
relaxation of defenses to authorize gratification.

Question 4

Guiding Principles & Premises, ctd

Answer 4

➔ Interlocking Pathology
◆ Explains how families remain dysfunctional.
➔ Object Relations Theory
◆ Bridges Freud’s theory and family therapy
◆ Generational relationships can be explained
◆ Provides reasons for marital and family patterns
➔ Splitting
◆ Representations are either all good or all bad

Question 5

Techniques & Interventions

Answer 5

➔ Emphasize the unconscious, early memories, and object relations.
➔ Therapeutic techniques utilized include:
(1) Transference (6) Confrontation
(2) Underlying Issues (7) Focusing on Strengths
(3) Dream Analysis and Day Dream Analysis (8) Life History
(4) Divergent Subjective Experiences (9) Complementary
(5) Projective Identification (10) Interpretation

Question 6

Role of Therapist

Answer 6

he Role of the Therapist
➔ Teacher
◆ Teaches the family basic psychoanalytic terms and how they apply personally and
interpersonally.
➔ “Good enough mother” (now referred to as a “good enough parent”)
◆ Therapist acts as a nurturer by providing encouragement
➔ Catalyst
◆ Therapist initiates challenges, confrontations, interpretations, and integration of family
processes.
➔ Therapists must be especially intentional in emphasizing family and individual interactions.
Crucial for family members to have extensive and free-flowing interchanges and the therapist is
not overly involved in or central in the process

Question 7

Course, Processes, Outcomes

Answer 7

➔ Key goal in psychodynamic family therapy is to liberate the members of a family from
unconscious restrictions.
◆ This goal is achieved via the therapist’s interpretation of important events and insights at
the preconscious level.
➔ A secondary goal in psychodynamic family therapy is to help family members interact with one
another based on current realities in healthy manners.
◆ This goal is accomplished once unconscious restrictions have been worked through.
◆ The outcome of this goal is displayed through changes described as, dif erentiation of
self.
➔ IF the goal of differentiation of self is not achieved, crisis resolution is the next course of action.
◆ Focus is on symptom reduction, supporting defense mechanisms, and the enhancement
of communication

Question 8

Unique Aspects

Answer 8

➔ Prioritizes on how much the unconscious influences human behavior.
◆ Interventions and treatments help increase a family members’ awareness of how invisible
loyalties encourage cohesion or divergence.
➔ Analyzes twelve basic defense mechanisms and how they contribute to family dynamics.
(1) Repression (5) Undoing (9) Reaction Formation
(2) Identification (6) Projection (10) Displacement
(3) Denial (7) Rationalization (11) Dissociation
(4) Regression (8) Intellectualization (12) Compartmentalization
➔ Emphasizes historical origins of family dysfunction.

Question 9

Comparison w/ Other Family Approaches

Answer 9

➔ Follows a more linear approach (i.e., making the unconscious conscious).
➔ Focuses on a cause and effect relationship.
➔ Demands more commitment in regard to time and finances.
➔ Requires a higher level of intellectual ability.
➔ Favors non-empirical and non-quantitative studies rather than empirical research.

Question 10

Multicultural Implications

Answer 10

➔ Not always applicable to family systems.
◆ Limited to only the individual or is not comprehensive enough to include family life.
➔ May be counterproductive for clients with collective identities.
➔ Unavailable to family clients with a lack of time and money.
➔ Potentially inappropriate for family clients who think more concretely than abstractly.
➔ Lack of empirical evidence/research.

Question 11

transgenerational

Answer 11

one of 2 theories considered to be transgenerational (other is Bowen family therapy). examines interactions of families across generations as a way to understand current problems and predict future challenges

Question 12

founders

Answer 12

ackerman, boszormenyi-nagy, framo, lidz, paul, williamson, skynner, wynne

Question 13

heart of treatment

Answer 13

belief that changes in families and their members occur best when the family is examined in the context of its history and development. conscious and unconscious process are collectively and individuall the focus of therapeutic interventions.

Question 14

Ackerman initated and emphasized…

Answer 14

concepts such as the scapegoat, tickling of defenses (provoking family members to open up), complementarity, focusing on strengths, interlocking pathology

Question 15

resolving conflict

Answer 15

1. strengthening of defenses against a conflicted wish

2. sufficient relxation of defenses to permit some gratification

Question 16

human nature

Answer 16

based on drives. mental conflict arises when children learn and mislearn that expressing basic impulses will lead to punishment. conflict is signaled by unpleasant affect: anxxiety or depression

Question 17

interlocking pathology

Answer 17

unconscious process takes place between fam members that keeps them together

Question 18

object relations theory

Answer 18

bridge betewen freudian theory, with its emphasis on individual drives, and family therapy, with its emphasis on social relationships.

Question 19

object relations theory, ctd

Answer 19

“relations between persons involved in ardent emotional attachments. these attachments can exist in the outer world of reality or as residues of the past – that is, inner presences, often unconscious, that remain vigorious and very much alive with us.” an object is something that is loved, usually a person.

Question 20

object relations theory, ctd

Answer 20

relationships across generations can be explained. humans have fundamental motivation to seek objects, starting at birth. as children grow, they internalize (interject) good and bad characteristics of these objects win themselves

Question 21

splitting

Answer 21

object representations are either all good or all bad. result is a projection of good and bad qualities onto persons within one’s environment.

Question 22

transference

Answer 22

projection of feelings, attitudes, or desires onto a significant other such as a therapist. used in family therapy in order to understand dominant feelings w/in a family unit and delineate what emotions are being directed toward which people.

Question 23

major goal of psychodynamic family therapy

Answer 23

to free family members of unconscious restrictions. outcome is sometimes achieved through therapist’s interpretation of events and insight on the part of family members regarding events. interpretation is best offered by the therapist at a preconscious level

Question 24

differentiation of self

Answer 24

individuals have reached a level of maturity at which they can balance their rational cognitive and emotional selves and can separate themselves from others in a nonanxious way.

Question 25

what sorts of interactions does psychodynamic theory focus on

Answer 25

cause-and-effect interactions

Question 26

premise

Answer 26

unconscious processes link family members. unconscious forces must be worked through; interlocking pathologies must be broken up

Question 27

treatment

Answer 27

individuals are the units of treatment. goal to break dysfunction interactions. transference, dream analysis, confrontation, focus on strengths, life history, complementarity, interpretation

Question 28

process/outcome

Answer 28

work through unconscious restrictions and insights; assist family members to interact on basis of current realities

Question 29

emphases

Answer 29

potency of uncionscious in influencing behavior

defense mechanisms

historical perspective on development of problems

Question 30

compaarison

Answer 30

primarily linear; focuses on individuals

expensive

not for concrete thinkers

lacks empirical research