Pre-Internship

September 14, 2009

Today’s Outline…

• Guidelines presentation – Kent, Blake, & Tyson (1:00-1:30)

• Intro to Multigenerational Therapy (1:30-2:15)

• Break (2:15-2:30)• Case study (2:30-3:00)• Dyads (3:00-3:50)

Multigenerational Therapy: Background &

Assumptions

Background

• Major theorist - Murray Bowen

• Other contributors– Betty Carter & Monica McGoldrick– Thomas Fogarty– Edwin Friedman– Philip Guerin– Michael Kerr– Daniel Papero

Background

• Bowen

– College & medical school at University of Tennessee

– Five years as army surgeon in WWII

– Pursued psychiatric specialization upon his return

– Worked at the Menninger Clinic

– Became a researcher at NIMH & Georgetown University

• Theory based on his work with schizophrenics

Theoretical Assumptions

• Evolutionary theory

• Three systems– Emotional system– Feeling system– Intellectual system

• Two life forces– Individuality– Togetherness

Multigenerational Therapy: Eight

Interlocking Core Concepts

Eight Interlocking Core Concepts

1. Differentiation of self

2. Triangles

3. Nuclear family emotional process

4. Family projection process

5. Multigenerational transmission process

6. Sibling position

7. Emotional cutoff

8. Societal emotional process

1. Differentiation of Self

• Intrapsychic – ability to separate feeling from thinking

• Interpersonal – ability to separate one’s own thoughts/feelings/behaviors from the thoughts/feelings/behaviors of others

1. Differentiation of Self

• Balance between dependence and independence

• Ability to cope with the anxiety present in all human relationships

• Ability to remain in relationship with those with whom you disagree

• Decisions & behavior based on personally-held principles

• “Wanting” instead of “needing” to be in relationship with others

1. Differentiation of Self• Low levels

– Talk about feelings more than thoughts– Struggle to keep relationship systems in

balance– Try to achieve comfort & freedom from

anxiety– Incapable of making long-term goals except

in vague terms– Grow up being highly dependent on parents– Seek adult relationships in which they can

borrow enough strength to function

1. Differentiation of Self

• Moderate levels– Functioning resembles good levels of

differentiation when anxiety is low– Functioning resembles low levels of

differentiation when anxiety is high– Relationship-oriented– Energy goes into loving & being loved– Seek approval from others– Concerned more with what others think & to

winning friends & approval than to goal-directed activity

– Self-esteem dependent on others

1. Differentiation of Self

• High levels– Enough basic differentiation between emotional & intellectual

systems for the two to function alongside each other as a cooperative team

– Intellectual system functions autonomously without being dominated by the emotional system when anxiety increases

– Ability to live more freely & to have more satisfying emotional lives within the emotional system

– Can participate fully in emotional events but can be logical when the need arises

– Life course is determined more from within than from what others think

– Marriage = functioning partnership– Function well alone or with other people as the situation

requires– Lives are more orderly, able to cope successfully with a

broad range of problems

2. Triangles

• Most stable relational unit consists of at least three people

• A way for two people to avoid resolving conflict by focusing on a 3rd party

• Freeze conflict in place by becoming chronic diversions that undermine family relationships

3. Nuclear Family Emotional Process

• Emotional forces in families that operate over the years in recurrent patterns

• Lack of differentiation in FOO leads to fusion in marriage, thereby producing:– Reactive emotional distance between

spouses

– Physical/emotional dysfunction in one spouse

– Overt marital conflict

– Projection of problem onto children

4. Family Projection Process

• Process by which parents transmit immaturity & lack of differentiation to children

• Child who is object of projection process becomes most attached to parents (either positively or negatively)

5. Multigenerational Transmission Process

• The transmission of the family emotional process through multiple generations– Child most involved in family’s fusion

becomes less differentiated– Child least involved becomes more

differentiated

• All family members are actors & reactors

6. Sibling Position

• Children develop certain fixed personality characteristics based on sibling position– 1st borns – identify more strongly with

power & authority– Later borns – more inclined to identify

with the oppressed & question the status quo; open to experience

• Family is multiplicity of micro-environments

7. Emotional Cutoff

• A technique for managing undifferentiation & the emotional intensity associated with it

• Greater fusion = greater likelihood of emotional cutoff

8. Societal Emotional Process

• The emotional process in society influences the emotional processes in families

• A prolonged increase in social anxiety can result in a gradual lowering of the functional level of differentiation in families

Break

2:15-2:30

Family of Origin Case Study

Discussion Questions

• Who is this story really about?

• What principles/concepts from multigenerational therapy do you seeing playing out in this family’s story?

Dyads

Peer Evaluation Groups• Group 1 – Control

room (main)– Kelsey– Ashley– Tommy– Amie

• Group 2 – Control room– Tyson– Tara– Emily– Elizabeth

• Group 3 – Resource room– Blake– Sybil– Sarah– Morgan

• Group 4 – Workroom– Jacqueline– Dean– Kevin

• Group 5 – Intern room– Scott– Kent– Sabrina

Instructions

• Watch everyone’s tape for 5-10 minutes

• Use the evaluation sheets & evaluate according to the Truax & Carkhuff scales

• Each person should write down at least one suggestion for the person being evaluated

• Share evaluative comments with one another

• Place evaluation sheets in my box

For Next Week…

• Dyad #2 due - meet in Control Room in MFI

• Finding Our Way Home (ch. 1-3) reflections due

• Reading– Gilbert, 7-13– Kerr & Bowen, 6