Overview of Family Problems: Our family is ideally the group of people to whom we are closest, with whom we are most comfortable, for whom we have the greatest love and deepest concern. Ideally, we know we can always count on our family, share our thoughts and feelings, turn to them for support, and count on them to help us when we’re down and out. Our family keeps us strong when we weak, positive when we are in despair, and gives us the feedback we need. Ideally, our family if our refuge and our most important relationships are with our parents, siblings, spouse and children.
The Medical Model and Family Problems: Of course, the reality is that for many people, family is nothing like the ideal, and is instead associated with stress, anger, disconnection, misunderstanding, and unmet needs and expectations. And even for those people whose families who are generally close and supportive, things aren’t always perfect, and may sometimes be very difficult, challenging, frustrating and painful. From little irritations to buried resentments, from dramatic arguments to feelings of guilt, disappointment and anger we didn’t even know we had, our families – being so close to who we are, knowing us so well for so long, and yet never able to live up to the impossible ideal – often bring up the most intense emotions we experience, for better or worse.
Whether still living together or not (but especially if living together) family dynamics, if not harmonious most of the time, can greatly interfere with the functioning of every member of the household and even extended family. When two family members don’t get along, it affects everyone in the family; if more than two people are at odds, things can unravel quickly, leading to lasting difficulties with depression, relationships, and even basic household tasks like shopping, caring for children, working, cleaning, and taking care of health issues.
The difficulty of family problems is also a strength: No one person is responsible for the family’s problems (although one person often gets the blame!) This means that everyone must cooperate for a solution to be found; this need to cooperate is a challenge, but it is also a great opportunity to strengthen family ties and interactions.
Therapists take different approaches to family problems. Some may see the entire family at once for every session; other therapists may see different family members separately at certain times. Most therapy models seek to address both the communication (verbal and nonverbal) styles of the family, as well as any individual issues that may be interfering with the cohesiveness of the family system.
Case Examples of Family Problems:
The Jay family brings their daughter, Amelia, 13, in for therapy due to her “anger problem”. In session with her parents, as the parents discuss Amelia’s poor behavior, Amelia is by turns withdrawn and sullen, then suddenly talkative, sarcastic, and silly. Alone with the therapist in the second session, she is quiet and sad, but more direct and focused. The therapist begins family sessions again, this time asking that Amelia’s younger brother be present as well, and concentrating on communication patterns between the members of the family. Although the parents insist Amelia is the reason for their visit, with their young son in session Amelia is sweet and attends to him while the parent seem to have little to say to one another and barely make eye contact. The therapist is able to point this out to them privately, and soon begins couple’s work with them, seeing Amelia separately and not discussing her anger with her unless she brings it up, which she doesn’t. After two or three months, the family is getting along much better, and the parents have identified several areas of their marriage to work on in therapy.
John, 47, seeks help to deal with conflict with his adult siblings and parents. They seem to fight constantly whenever they are together, and his parents call him daily to “criticize” and “put me down”. The therapist takes a history and finds John’s family has always functioned somewhat like this, and informs John that there isn’t anything the therapist can do to change John’s family, but that she is willing to help John learn how better to deal with his family and the emotions John feels. John agrees to this, and the therapist works with him on communicating, self-care skills (such as eating right, relaxation meditation, and positive internal messages) and boundary-setting.
Therapy for Family Problems: There is a wide range of Psychotherapy Treatment Models or types of therapy used in the treatment of family problems. Most of these approaches fall into three historic camps of psychology: Psychoanalytic / Psychodynamic approaches; Behaviorism and; Humanism. Regardless of the type of therapy, there are some generally agreed upon elements of healthy therapy which are universal to all forms of psychotherapy. Before beginning therapy for family problems or any other issue, it is helpful to familiarize oneself with these elements.
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