Family Process 1963

Heft 1

Bell, John Elderkin (1963): A Theoretical Position for Family Group Therapy. In: Family Process, 2 (1), S. 1–14.

Abstract: I want to take this opportunity to talk about my work and the evolution of my thoughts on family group therapy over the past eleven years. There is an immense gap between that which I believed when I first began and that to which I hold at this point. I recognize this transition in myself and know that others who start from the orientation I once held must make a big leap, a radical shift, if they are immediately to understand my present position. I cannot expect others to achieve in an hour, or a few days or months, what I have had the privilege of reaching gradually and progressively over a decade. This creates its own difficulties in our talking together about family group therapy.

Goodrich, D. Wells & Donald S. Boomer (1963): Experimental Assessment of Modes of Conflict Resolution. In: Family Process, 2 (1), S. 15–24.

Abstract: This paper describes a brief experimental technique for studying the coping behavior of husband and wife when they attempt to resolve a marital conflict. The specific conflict to be resolved is standardized, consisting of an apparent difference in perception of a set of colors. The interpersonal difference arises because the stimuli presented to husband and wife, while apparently identical, actually differ in a manner which is not readily discernible.

On the basis of experience with 50 marital pairs, we wish to report that this technique evokes meaningful differences in styles of interpersonal conflict resolution. While quantitative aspects of the behavior profiles obtained will not be reported here, certain qualitative dimensions will be described. This method of assessing interpersonal conflict we refer to as the color matching technique.

The technique was devised for a longitudinal pilot study of the initial stages of family formation (3, 4). It is used in conjunction with joint interviews with husband and wife, individual interviews with each spouse, questionnaires, home observations, role-playing and experimental observations. A major focus of the study is the nature of the initial marital bond in couples married for the first time. The subjects are a group of middle class paid volunteers aged 18 to 27 years. The project follows changes in this marital bond from the fourth month after the date of marriage, through the first pregnancy to the three month period immediately following the birth of the first infant. The research explores patterns of husband-wife behavior which are relevant to the mastery of these developmental stages. A major interest is the formulation of a meaningful typology of coping behavior patterns. The stability of these patterns from the newlywed stage to the first neonatal stage is of particular interest to us. Our hope is that stable coping patternsif they can be identifiedmay serve as a basis in future research for predictions of marital adjustment from the time of marriage to the first neonatal phase.

Differences in perception and evaluation tend to occur naturally when any two people are faced with a new or strange situation; the first pregnancy or the first-born infant present a number of such new and ambiguous situations. The style of coping observed in an experimental situation may be characteristic and hence may have predictive power for the couple’s adequacy or inadequacy when confronted with other puzzling or ambiguous natural situations. Thus by means of such techniques it may become feasible to predict a couple’s ability to cope with ambiguous situations which occur naturally with developmental changes.

The task1 belongs to a class of experimental problem-solving situations which have been investigated by those interested in cognitive processes, personality, and group problem-solving. In many such situations the task is deliberately left unstructured in order to evoke the subject’s characteristic mode of resolving ambiguity. There is evidence from these studies that individuals often have rather stable and somewhat predictable tendencies in their manner of evaluating ambiguous stimuli and of approaching a solution.

An important characteristic of the color matching technique is that it taps dimensions of dyadic relationships; it is not designed for studying individuals or small groups. In this situation any bit of behavior by a single person is considered as one step in an interactive sequence of communication and decision-making. Thus in reporting on various styles of conflict resolution shown by various couples, we do not refer to individual capacities or inadequacies but rather to the adequacies or incapacities of the two persons working together. The adequacy of the marital relationship itself is considered a better predictor of stability or change in family interaction patterns than would be an assessment of the husband or wife separately.

Carroll, Edward J., C. Glenn Cambor, Jay V. Leopold, Miles D. Miller & Walter J. Reis (1963): Psychotherapy of Marital Couples. In: Family Process, 2 (1), S. 25–33.

Abstract: Increasing experimentation in recent years with psychotherapeutic techniques which differ from standard one-to-one relationships (1, 2, 3, 4) has led to techniques of family therapy. Defined as psychotherapy of two or more members of the same family unit at the same time and place by one therapist, family therapy has as its central idea the application of group therapy to the natural group rather than to the artificial group. It is well known that individual therapy not infrequently results in failure, stalemate, or very slow progress, and some investigators question whether the problems in these cases don’t transcend the individual because they are an inseparable part of the group in which the individual is involved. This paper is a discussion of some factors in family therapy and presents two cases in which the technique of psychotherapy of marital couples was used.

Becker, Joseph (1963): ‚Good Premorbid‘ Schizophrenic Wives and Their Husbands. In: Family Process, 2 (1), S. 34–51.

Abstract: A number of experimental studies comparing the parental relationships, prognosis and differential reaction sensitivities of those schizophrenics with good, as well as those with poor psychosexual-social histories suggest that important differences exist between these similarly diagnosed groups (14, 6, 2). Recent clinical research studies have investigated the inter- and intra-personal dynamics of members of the primary families of schizophrenics with poor premorbid psycho-sexual-social histories (11, 18, 4, 1). Thus far, however, the literature on the primary and conjugal family dynamics of female schizophrenics with relatively good premorbid histories is very limited (7, 16, 9).

Shellow, Robert S., Bertram S. Brown & James W. Osberg (1963): Family Group Therapy in Retrospect: Four Years and Sixty Families. In: Family Process, 2 (1), S. 52–67.

Abstract: The route by which we have arrived at the frequent use of the family group arrangement as a setting for therapy has its origins as far back as the passage of the National Mental Health Act in 1946, and the birth of a federal demonstration clinic in Prince George’s County, Maryland. The Mental Health Study Center,1 as it is now called, set about „investigating the best ways of incorporating mental health services into the total community public health program“; and subsequently found itself focusing on the settings in which deviant behavior occurred almost as intensively as the deviant behavior itself.

Like many other clinics in the child guidance tradition, we recognized the crucial effect of family climate upon our therapeutic efforts with children. Collateral work with parents, relatives, teachers, and other key adults in the child’s life followed naturally.

However, our effect on the entire family was blocked within the limits of our understanding of a given family’s style of interacting with one another. Our data rarely was first-hand but was continually subject to the significant distortions implicit in the mother’s, the child’s and less often, the father’s view of family life. It becomes evident that even all of these edited descriptions of family life when pieced together, still fall short of the reality of everyday family interactions.

Seeing parents in joint conferences taught us that at least part of this distortion may be corrected by observing the parents together. The transition to observing parents and child, or children, in action in the same room at the same time was not a difficult one to make. This arrangement is what is referred to as „Family Group Therapy.“ It is a special form within the broader framework of „Family Therapy,“ which signifies a departure from „patient or individual oriented treatment“ in the direction of conceptualizing the social unit, the family, as malfunctioning. Currently the most vocal spokesmen for this viewpoint include: Ackerman (1, 2), Bowen (6, 7), Grotjahn (10, 11), Brodey (8, 9), and Bell (4, 5). Unfortunately, several patterns of seeing family members have emerged, presenting a confusing picture in that all are termed „Family Therapy.“ This may include the separate psychoanalysis of husband and wife, seeing husband and wife conjointly (we call this „marital therapy“), collateral treatment of a child and his parents, as well as the „Family Group arrangement“ referred to above.

Before turning to a review of our clinical experience with Family Group Therapy, let us mention briefly the central notions underlying our decision to treat families as a unit. The search for treatment and prevention techniques allowing for the most effective use of trained professionals leads naturally towards the use of a „Family Therapy“ approach. It, in turn, is predicated on the belief that improved communication among family members fosters clarification of member roles and assists the family in employing its own resources, as opposed to that of specialists, for problem solving in their present life situation.

The following analysis does not attempt to systematically evaulate the effectiveness of Family Group Therapy as a therapy. Evaluation requires a careful sampling of families as well as detailed and continuous observation of the technique in action. This is more than we have been able to achieve. Nor is it our intention to lay before the reader a chain of enthusiastic testimonials intended to proselytize the skeptical, the traditional, and the meek. Rather, in this paper,2 we have set for ourselves the limited objective of systematically reviewing the most visible characteristics of some sixty families seen in Family Group Therapy at the Mental Health Study Center over the past four years.3

We will address ourselves to the following questions: Which families are selected for Family Group Therapy? Do these people differ from those receiving other services currently offered at the Center? And, is it possible to isolate characteristics of families which do not seem to take to this form of treatment? Despite the relatively large number of families reviewed, we prefer to be tough minded and caution the reader, as well as ourselves, that the relationships to be reported are only tentative and to a great extent represent a group of families seen in a special therapeutic fashion where comparable data on all families coming to the Study Center is incomplete.

Rapoport, Rhona (1963): Normal Crises, Family Structure and Mental Health. In: Family Process, 2 (1), S. 68–80.

Abstract: There is a growing body of work in the social-psychiatric field known as „crisis“ studies. Although these studies have been conducted by people with different approaches and different topics, with no single set of theoretical and clinical interests, there is a common factor among them in that the crises being considered are viewed as turning pointsas points of no return (1, 2, 3, 4, 5, 6). If the „crisis“ is handled advantageously, it is assumed the result for the individual is some kind of maturation or development. If the stresses engendered by the „crises“ are not well coped with, it is assumed that old psychological conflicts may be evoked or new conflicts may arise and a state of poorer mental health may be the result. Further, it is suggested that persons undergoing the crisis are amenable to influence when skilled intervention techniques of relatively brief duration are applied.

In a program of Family Research recently initiated in the Community Mental Health Program at the Harvard School of Public Health, there is an attempt to focus on the application of some of these ideas to a more prevalent type of crisis than in the studies referred to above. Our concern is with the critical transition points in the normal, expectable development of the family life cycle: getting married, birth of the first child, children going to school, death of a spouse, or children leaving home. These, too, are seen as points of no return. While both normal and expectable, these standard status transition points in the life cycle of the family always have elements attached to them that are novel for the individuals experiencing them. This is perhaps especially true in our society where rites de passage are limited, where anticipatory socialization for new familial roles tends to be minimal, and where the prescriptions for behavior expected in the new roles may be highly variable. Thus these critical turning points often provoke disequilibria both in the individuals concerned and in the family system. It is postulated that the way these normal „crises“ or status transitions are handled or coped with, will affect outcomeboth in terms of the mental health of the individuals and in terms of the ensuing family relationships. It is also assumed, in line with Lindemann’s (2) and Caplan’s (1) assumptions that, to the extent that these critical periods have a limited time of „acute“ disequilibria, it may be possible to do preventive intervention in a limited time so as to improve outcome levels.

Davis, Derek Russell (1963): A Re-Appraisal of Ibsen’s ‚Ghosts‘. In: Family Process, 2 (1), S. 81–94.

Abstract: To the psychopathologist, Ibsen’s plays are of great interest because they portray conflicts between members of familieshusband, wife and childand because Ibsen provides sufficient details of the history of the families to show how the conflicts have arisen. These things are especially true of the play, „Ghosts: A Domestic Drama.“

This play, written and published in 1881, is an epiloguelike several of Ibsen’s plays (14), the action in it being the culmination in a progress of events extending back to before the birth of its central character, Oswald Alving. In this respect it is like a case history. The case it describes is an epitome of what was then and is still one of the cardinal problems of psychopathology, namely, dementia, i.e., loss of mental powers, in a man in the middle twenties, in the absence of signs of physical illness.

Much that Ibsen wrote about Oswald’s illness reflected the attitudes of physicians of his day. Thus he suggested that its cause lay in the degenerationor softeningof the brain as a result of the inheritance of disease from a profligate parent, and that its course would inevitably be a progressive decline to idiocy. Yet the essence of the play lies in the dramatic representation of the conflicts in the family triangle formed by Oswald and his mother and father.

The pattern of relationships in Oswald’s family is one now regarded as typical, in general and in detail, of the families of young male schizophrenic patients. Re-appraisal along these lines, and in the light of modern psychopathology, meets some of the criticisms made of the play and shows that Ibsen was astonishingly accurate and pertinent in the observations he reported of human behaviour. The play is indeed „like an image of life.“

The disaster that befell Oswald, it may be argued, was not due to infection by syphilis, transmitted to him by his father, which might have been treated by Penicillin, or for that matter Salvarsan or malaria, had they then been available. On the contrary, it was the consequence of the psychological circumstances in which he grew up, which also led Captain Alving to disgrace and death, and Helene Alving to disillusionment and despair. They and Oswald were haunted and destroyed by ghosts, not just by what they inherited, but by „all kinds of old defunct theories, all sorts of old defunct beliefs, and things like that,“ which they could not get rid of.

Titchener, James L., Thomas D’zmura, Myra Golden & Richard Emerson (1963): Family Transaction and Derivation of Individuality. In: Family Process, 2 (1), S. 95–120.

Abstract: ndividual’s way of life and the way of life of the family in which he develops. We have found it possible to obtain relatively fresh and untampered samples of family transaction which seem representative of the ways a family behaves when it is not in a clinic or laboratory. Our experimental procedure permits observation of whole family transaction with the communicative interplay recorded on tape for later exhaustive analysis. The experiment presents us with samples of natural family interchange. These complex phenomena are dismantled into more simple components for comparison with individual personality traits.

Systemic concepts of personality and family are essential parts of the theoretical background of our work (1). Systemic concepts assume an organization of purpose and motive plus the means for accomplishing purposes or satisfying motivation. An organization of the adjustive and regulatory functions is assumed for both personality and family. Further, these systems, personality and family, are transactionally related in that each is part of the other. They share functions, and the adjustive processes of the individual and his family are interdependent.

The basic aim of our research1 is to increase understanding of the links between the systemic organization of the family and that of personality.

We will present our procedure, our experimental findings with illustrative data from two of the thirteen families for which we have experimental data, and then our categories and hypotheses.

Ehrenwald, Jan (1963): Family Diagnosis and Mechanisms of Psychosocial Defense. In: Family Process, 2 (1), S. 121–131.

Abstract: Family diagnosis, in order to be brought up to the standards currently applied to psychiatric diagnosis in the individual, has to proceed in two major steps. First, it must aim at a descriptive, taxonomic delineation of patterns characteristic of a given family constellation. Secondly, it must seek to arrive at a deeper, dynamic, psychosocial understanding of such patterns. In a previous study (1), I have tried to outline the guiding principles of the first step in such a venture. It is based on an Inventory of Thirty Traits and Attitudes contained in a broad spectrum of more or less habitual ways of relating which can be observed in members of a given family group (Table I). They range from „giving-supportive-affectionate“ on the „socially desirable, well-adjusted“ end of the scale, to „erratic-eccentric-defec-tive“ on the other side. The 30 traits and attitudes, grouped in 10 clusters or triads, are presented to a clinical observer or judge who is asked to state which cluster or triad of interactions is, in his opinion, „most outstanding“ or „most characteristic“ of the interpersonal relationships, say, between husband and wife, mother and son, father and daughter, sibling and sibling, etc. A simple method of preferential rating or ranking makes the diagrammatic representation of the diverse combinations and permutations of patterns of interaction possible. At the same time it permits a quasi-mathematical treatment of the data arrived at in this way. Two charts drawn along these lines suffice for the diagnostic representation of the interpersonal relationships of one family pair, while according to the formula n(n  1) six charts are needed to do justice to a family of three, 12 charts to a family of four, etc. It should be noted, furthermore, that by averaging the scores obtained in two or eight or 12 interaction charts, diagrammatic Family Profiles can be arrived at characteristic of an existing family constellation in terms laid down in the Inventory of Traits and Attitudes (Figs. 1 and 2).

Watzlawick, Paul (1963): A Review of the Double Bind Theory. In: Family Process, 2 (1), S. 132–153.

Abstract: In 1956, Bateson, Jackson, Haley, and Weakland reported on a research project which they had undertaken to formulate and test a new view on the nature of schizophrenic communication. This report was entitled „Toward a Theory of Schizophrenia“ (97), and postulates the concept of the double bind.

The present paper has the purpose of reviewing the literature of the last five years (1957-1961 inclusive) and assessing the attention the concept has found in psychiatric thinking.

This review is based on a search of 37 American and European periodicals and of other pertinent publications in the field of psychiatry and of the behavioral sciences in general. It should, therefore, be reasonably comprehensive.

Bateson, Gregory, Don D. Jackson, Jay Haley & John H. Weakland (1963): A Note on the Double Bind – 1962. In: Family Process, 2 (1), S. 154–161.

Abstract: Because of the reaction in the literature to the concept of the double bind as presented in our joint article „Toward a Theory of Schizophrenia,“ it seems appropriate to state briefly the research context of that article, to clarify what we consider most significant about our work generally, and to describe the further developments in our research since 1956.

Prior to the 1956 paper the research project had investigated a variety of phenomena from the communication point of viewthe nature of metaphor, humor, popular films, ventriloquism, training of guide dogs for the blind, the nature of play, animal behavior, the formal nature of psychotherapy and the communicative behavior of individual schizophrenics (1, 2, 30). All communication involves the use of categories and classes, and our focus of interest was on the occurrence in classification systems of combinations which generate paradox; a particular interest was in the ways two or more messagesmeta-messages in relation to each othermay qualify each other to produce paradoxes of Russellian type.

Originally the idea of the double bind was arrived at largely deductively: given the characteristics of schizophrenic communicationa confusion of message and meta-message in the patient’s discoursethe patient must have been reared in a learning context which included formal sequences where he was forced to respond to messages which generated paradox of this type. In this sense the double bind hypothesis was initially a conjecture about what must have happened granted the premises of the theoretical approach and the observations of the schizophrenic individual’s way of communicating. By 1956 this conjecture was beginning to be supported by empirical observation of mothers and their disturbed children.

However, although our investigations thus involved various fields of phenomena, and the particular concept of the double bind was a striking oneas attested by the specific attention that both we and others have given itneither these specific subject-matters nor this specific concept has been the real core of our work as we see it. This point needs special attention, as it seems that a number of existing criticisms or misunderstandings of our statements rest on a lack of clarity at just this level.

Family Affairs. (1963): In: Family Process, 2 (1), S. 162–164.

Abstracts of Literature. (1963): In: Family Process, 2 (1), S. 165–174.

Daniels, Arlene (1963): Review – Family Worlds, A Psychosocial Approach to Family Life, by Robert D. Hess and Gerald Handel, University of Chicago Press, Chicago. In: Family Process, 2 (1), S. 175–176.

Terrill, James (1963): Review – Families in Treatment, by Erika Chance, Basic Books, New York, 1959. In: Family Process, 2 (1), S. 176–178.

Peters, Carl (1963): Review – Mental Health Book Review Index, American Foundation for Mental Hygiene, New York. Volume II, 1962. In: Family Process, 2 (1), S. 178–178.

Heft 2

Jackson, Don D. (1963): Comment. In: Family Process, 2 (1), S. 182–184.

Abstract: Already family therapy has reached an age where in some quarters it is regarded as a noisy, rebellious adolescent. Certainly, enthusiastic and uncritical remarks about the blessings of family therapy justify such an attitude on the part of non-believers. However, I feel that skepticism and criticism stem also from another source. Some critics probably sense that family therapy, especially when it has a better theoretical base, will necessitate a different language from the common tongue in American psychiatry, namely, psychoanalytic terminology. Any change in the status quo will be regarded as disturbing, if not downright dangerous by these individuals seriously dedicated to their own psychiatric beliefs and style of practice.

At this stage of the game, it might be most sensible for interested parties to regard an individual-oriented framework like psychoanalysis, and a group interactional framework as required by family therapists as essentially discontinuous systems. That is, the language of one will not be appropriate for the other. The creation of a new language is hazardous and is tiresome to readers. It is also apt to raise questions about which is better than which, even though the two systems are not strictly comparable and one cannot be better than another. Despite these obstacles, it would appear worthwhile for those interested in family therapy to struggle to create their own framework.

Loveland, Nathene T., Lyman C. Wynne & Margaret Thaler Singer (1963): The Family Rorschach: A New Method for Studying Family Interaction. In: Family Process, 2 (2), S. 187–215.

Abstract: The Family Rorschach was developed to utilize the special advantages of the relatively unstructured and unfamiliar Rorschach technique in the direct study of interaction within families. In contrast to the dyadic nature of the classically administered Rorschach test, the family members, without the examiner present, interpret the inkblots to each other and attempt to reach consensus in their responses.

Our preliminary experience has supported our expectations for this procedure: It provides a relatively standardized task in which the impact of family members upon one another can be sampled; the task is sufficiently interesting and emotionally stimulating to a variety of families so that intervention of a tester or therapist is not required to elicit and sustain the interaction; the individual perceptual starting points from which family members begin communication are relatively accessible; and finally, the Family Rorschach procedure is an interpretative transaction in which meanings are attributed to the „reality“ of the Rorschach cards. Styles of communicating and relating in this test situation appear to parallel those found in the highly influential interpretative transactions of parents with their children during their formative years.

The rationale of this procedure is conceptually linked to previous family studies at the National Institute of Mental Health which have indicated that the thought and communication disorders found in individual psychiatric patients can be related to the forms or styles of communicating seen in their families (1, 2, 3, 4, 5, 6). The ways parents focus attention, communicate and relate to others are especially good predictors of stylistic disorders in their offspring. Excerpts from family psychotherapy sessions (6) and projective tests from individual family members (3, 5) have been used on a blind basis to predict which families contained neurotic or schizophrenic members. It has also been possible to match blindly tests from young adult patients with projective tests from their families (3, 4).

These research studies, as well as the family therapy conducted in the same over-all program, have been based to a considerable extent upon the premise that families constitute social subsystems which are maintained through reciprocal expectations and interactional processes. To be sure, certain inferences can be made about over-all family patterns of patients from the nature of the individual’s dyadic relation to a psychotherapist; similarly, inferences about family organization can be drawn from projective tests individually administered to family members (3). Nevertheless, conjoint family therapy does add significantly to the kind of family data obtained from individual therapy (1), and similarly, we felt a Family Rorschach, in which the family members would directly interact and not be studied in parallel, would be a logical and useful addition to individual Rorschach testing.

In this paper, we shall present the methods used thus far in developing the Family Rorschach and discuss some of its merits, shortcomings, and possible future variations. We shall include an excerpt from one Family Rorschach, with comments on it and what it added to the body of learning from individually administered tests.

Kaffman, Mordecai (1963): Short Term Family Therapy. In: Family Process, 2 (2), S. 216–234.

Abstract: Freud, in an often quoted paper published in 1919 (1), dealt with the impact of psychoanalysis on psychiatric needs of society and stressed the fact „that the therapeutic effects we can achieve are very inconsiderable in number…. Against the vast amount of neurotic misery which is in the world, and perhaps need not be, the quantity we can do away with is almost negligible…. At present we can do nothing in the crowded ranks of the people, who suffer exceedingly from neurosis.“ Freud raised the possibility that new simpler forms of psychotherapy based on psychoanalytic principle might be found. Almost half a century later, we still are searching for new psychotherapeutic tools allowing treatment of large masses of people.

Present methods of psychotherapy seem to be suitable to a limited group of people within our society. This is not only from an economic standpoint but also in view of their intrinsic content, which is connected with values and characteristics of the middle and upper class of our culture (2). Generally speaking, psychotherapy has remained an expensive, time consuming, and highly restricted therapy out of accord with the pressing needs of the community in the Mental Health Field. Israel by no means constitutes an exception. Practical shortcomings determine that only a negligible minority out of a large number in need of psychotherapy can get the necessary help. This is true, too, of the Israeli Workers Sick Fund, which maintains an efficient, low cost and modern provision of medical service covering all aspects of curative medicine for 70% of the total population. The search for a brief form of psychotherapy continues to be an urgent pragmatic problem, not only because of the scarcity and high cost of the present facilities for prolonged psychotherapy but also because of intrinsic advantages to be found in an available service of short term psychotherapy.

Ferreira, Antonio J. (1963): Rejection and Expectancy of Rejection in Families. In: Family Process, 2 (2), S. 235–244.

Abstract: The attitude of overt non-acceptance or rejection has been regarded as of central importance to most interpretations of behavior and to the etiology of psychopathology. The present study grew out of an increasing interest in seeking and studying some behavior variables in the context of the living relationship to which they belong. The research tools and design were determined by the wish to investigate the factors here to be called „overt rejection“ (R), and „expectancy of overt rejection“ (E), as if they were basic factors and of a sort that could be isolated and measured, pure and uncontaminated by other factors. Towards this unreachable goal, the present design seemed to provide an opportunity to „measure“ the rejecting behavior of a family member towards another, as well as the degree of his expectancy of being rejected. The primary aim of the project was to test the general hypothesis that in regard to operationally defined manifestations of these two factors there would be measurable differences among family members which could ultimately help us in the task of clarifying what distinguishes normal from pathologic families. The only specific hypothesis made was that, in the light of clinical experience, pathologic families would have a greater amount of „rejection“ and „expectancy of rejection“ than normal families.

Glasser, Paul H. (1963): Changes in Family Equilibrium During Psychotherapy. In: Family Process, 2 (2), S. 245–264.

Abstract: This report summarizes one section of a larger study of the ways in which role changes occur in a family when a parent is mentally ill and undergoes psychotherapy.1 A large number of case records from the Psychiatric Clinic at North Carolina

Memorial Hospital were examined following a review of the literature on family crisis studies (1, 2, 3, 4, 5, 6, 7, 8, 9), marital adjustment studies (10, 11, 12, 13, 14), family development theory (15), role theory (16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26), and social psychiatry (27, 28, 29, 30, 31, 32, 33, 34, 35, 36, 37, 38, 39, 40). Out of this survey and from beginning contacts with study families, an investigation emerged which focused upon the equilibrium of the family as a small group2 in the following areas: how internal stresses within the family arise; what changes take place in the behavior of family members, and what changes take place in group methods for handling problems. This paper discusses primarily the intrafamilial processes which accompany the psychotherapy of one member of the family group.

During the psychotherapeutic process, three stages of family equilibrium were delineated: (a) re-equilibrium following the patient’s initial improvement, (b) disequilibrium (family crisis) during intensive psychoanalytically oriented treatment, and (c) the emergence of a new equilibrium prior to termination of treatment. Each stage is associated with a series of factors related to (a) the therapeutic techniques used and the depth of the transference relationship at different periods in the treatment process, (b) the reactions of family members to the patient’s new behavior patterns, his changing symptom picture, and his treatment, and (c) other situational factors (hospitalization, loss of income, etc.). At the second stage, these elements lead to inconsistent expectations between the patient and other members of the family; that is, a serious crisis. Changes in the patient’s behavior and expectations require other members of the family to change also. This change process in the family group is described in detail in the body of the paper. A final section of the report discusses implications for social work practice, emphasizing particularly the need for family diagnosis even when the patient is receiving individual psychotherapy and the important part the worker can play in facilitating treatment and in keeping the group together by seeing other members of the patient’s family.

Mitchell, Howard E. (1963): Application of the Kaiser Method to Marital Pairs. In: Family Process, 2 (2), S. 265–279.

Abstract: In the past few years a number of pioneering investigators have taken a step forward and proposed classifatory and family diagnostic systems to account for the multiplicity of personal and interpersonal factors involved in working with families. Interestingly, most of this work has been done by those doing therapy with family units which include a schizophrenic member. A number of individuals engaged in these treatment programs have stated that an adequate conceptualization of the sometimes confusing human phenomena being worked with in such families must take into account the interplay of intrapersonal and interpersonal factors within the family social system. Moreover, a number of the early family therapists of schizophrenics have developed specific interactional theories which they feel at least partially explain, if not the etiology of schizophrenia within the familial environment, at least the function of its maintenance. Here we refer to the Palo Alto group’s concept of the „double-bind“ and „family homeo-stasis“ (2), Wynne’s theory of „pseudomutality“ (3), and the concept of „marital schism and skew“ developed by Lidz and his associates at Yale University (4). Little empirical data has appeared in the literature, however, to test these specific theories or to demonstrate the utility of the conceptual systems. Indeed, little has been said about the availability or the need to develop measurement methods.

This paper concerns the application of a method whose properties lend themselves to the nature of the personal and interpersonal phenomena inherent in the study of the intrafamilial environment. Although the method is applicable to the study of entire family units, this paper is delimited to an application of the technique to a sample of distinctive marital pairs. Before extending use of the method to a larger unit, we have focused upon better understanding its merits and limitations when applied to a less complex dimension of family interaction.

In 1954, the Division of Family Study of the Department of Psychiatry, School of Medicine, University of Pennsylvania, embarked on an intensified study of a group of maritally conflicted couples in which the husband was alcoholic and the wife is not.1 The paper reports and discusses the findings obtained from a population of 21 alcoholic husbands and their nonalcoholic wives who were tested by the Kaiser technique independently as an adjunct to a joint counseling effort in which both participated. The mean age of these white, American-born spouses was 35.2 years for the wives and 38.3 years for the husbands. Educationally both sexes ranged from having completed two years of high school through postgraduate college. The mean duration of the marital union was 11.2 years.

One of the major research interests of this project was to study the nature of marital transactions between the alcoholic and his nonalcoholic spouse along a number of significant interpersonal dimensions. It was agreed by the project team that a method of interpersonal measurement would have to meet the following conditions:

1. The continua selected must be relevant to some theoretical system in order to avoid essential identities being concealed behind semantic differences and so that the dimensions selected would include all significant factors.

2. The terms in the system must be specifically (and preferably operationally) defined.

3. The system must not only include the intrapersonal traits that define the continuum, but also the interpersonal

behaviors that these traits support. Stated differently, we must be prepared to define the same continuum at various levels.

Brodey, Warren M. (1963): On Family Therapy. In: Family Process, 2 (2), S. 280–287.

Friedman, Alfred S. (1963): The Incomplete Family in Family Therapy. In: Family Process, 2 (2), S. 288–301.

Abstract: One of the most important problems encountered in the practice of family therapy is the therapeutic problem resulting from composing a treatment unit of an incomplete family. Failure to include all members of the operational family organization in the composition of the treatment unit will later result in serious obstacles to progress in therapy.

The question of who constitutes the family and what persons are to be included in the unit of treatment makes it necessary to define what we mean here by the terms „family therapy“ and „the family as a unit of treatment,“ since these terms have been used loosely in the literature to connote a variety of therapy approaches. We mean specifically a therapy procedure in which all members of a nuclear family of procreation, as a minimum, are seen together and at the same time by two co-therapists, and in which neither the primary patient nor any other family member is seen in any concurrent individual therapy sessions.

We do not however restrict the therapy unit membership to the nuclear family of procreation. We now regard the optimal family therapy unit as including all those who share a living experience together under one roof. We had previously accepted for therapy some nuclear family units consisting only of the parental pair and their schizophrenic offspring. No longer do we accept such partial therapy units, but require as a beginning minimum the participation of all unmarried siblings living under the parental roof. Out of our experience with conducting family therapy on the spot, in the home, we furthermore learned the importance of including, as an integral part of the therapy unit, not only all siblings, but grandparents, close relatives, and others who shared the twenty-four hour living experience under one roof. These individuals are inevitably a part of the emotionally meaningful organization of family relationships, though they may believe themselves to have separated emotionally and to have broken the familial ties. We found that certain family members would stay aloof from the family therapy from the beginning, pretending to have no vested interest in what might be discussed. Actually, they did not want their motives uncovered. When the family therapy then began to have an effect, they would openly criticize it and actively attempt to break it up. When care is taken to include these members in the therapy group from the outset, there is more opportunity to control this acting out by observing the family cliques and splits in operation, and by bringing them into the open and analyzing them.

Zuk, Gerald H., Ivan Boszormenyi-Nagy & Elliot Heiman (1963): Some Dynamics of Laughter During Family Therapy. In: Family Process, 2 (2), S. 302–314.

Abstract: Laughter, a behavior that conceals as much as it reveals, has deep meaning in human affairs. One of its important functions is to disguise feelings such as anger, love, hostility, joy, shame; or it may reflect some general tension or anxiety. As a socially acceptable cloak for feelings which may be socially unacceptable, laughter warrants close psychological study.

A peculiar psychodynamic characteristic of laughter as a defensive maneuver is that it need not totally conceal underlying motivation or affect. „Smile when you say that,“ the maxim of the Old West, is a good example of this feature of laughter (or in this case its variant, smiling) as a socially acceptable device to check a direct hostile reaction to hostility. Laughing or smiling when expressing criticism with underlying anger often spares a critic a direct angry response in return. In the term made popular by Bateson, Jackson, Haley and Weakland (3), the critic thus „double-binds“ the one criticized. The one criticized is put under a social obligation to play by the rule of the game and also cloak his feelings with laughs, smiles or jokes. In this situation, laughter tempers feeling which if expressed directly might lead to an undesired outburst of anger or hostility.

An important function of laughter is to serve as a socially acceptable means of probing the motivations or feelings of various parties in communication with each other. This function is greatly exercised in sophisticated society. That laughter is a powerful device to probe, modulate or inhibit motivation and affect is confirmed not only in everyday observation and clinical experience, but also in psychological theory (see, for example, the work of Freud (8) on wit and humor).

The present study attempts to define a relationship in the laughter behavior of various members of a family, one of whom is a schizophrenic young woman. A symptom of the girl’s illness is her bizarre laughter, which may be defined as laughter which appears unrelated in meaning to the social situation, and the question is raised whether the girl’s laughter was really as inappropriate as it appeared on gross observation. This study asks the specific question: Is there a factor in the immediate, ongoing family psychotherapy situation which influences her seemingly bizarre laughter, or is the behavior strictly determined by her intrapersonal fantasies? „Embarrassed“ laughter, which was frequently employed by the parents, particularly the mother, especially when a point was made or subject raised which was sensitive, was inferred to be a significant signal to others present. Some current thinking about the etiology of schizophrenia (6, 13, 5) suggested the idea that the laughter of both parents might be a device they regularly employed to avoid certain kinds of communication; thus, by implication, that laughter was a symptom not only of the psychopathology of the schizophrenic daughter but to some extent also of her overtly non-schizophrenic parents. Thus the study also examines the question whether there may have been a kind of cooperation or complementarity in the transmission of tension or anxiety underlying the laughter of the parents and the daughter.

The findings of the study, finally, will bear on an important issue in personality theory originally championed by Lewin (10) and taken up recently in the monograph of Tyler, Tyler and Rafferty (12). The issue has been examined in a prior monograph by one of the present writers (14) and by others (2, 7, 11). Lewin said that every behavior is a product jointly of intrapersonal characteristics and characteristics in the immediate, ongoing social situation. But it has been pointed out that psychological studies, for the most part, have considered the impact of only one of these sets at a time. It will be suggested that the findings lend support to the demand in personality research not to discount the joint impact on behavior of intrapersonal and situational variables, even in instances in which it seems most unlikely that more than one set of these variables is operating. The special relevance of the findings in increasing understanding about the range of situational determinants of apparently bizarre symptoms in psychosis should also be noted.

Green, Kenneth A. (1963): The Echo of Marital Conflict. In: Family Process, 2 (2), S. 315–328.

Abstract: For years, the Superior Court of Los Angeles County has maintained a Conciliation Court which offers professional marriage counseling, without fee, to any married couple when both are residents of Los Angeles County. One-third of the couples requesting help are not involved in a divorce proceeding. The remaining two-thirds are referred, in the main, from the Domestic Relations Department of the Court and other legal sources.

The staff is comprised of a Supervising Conciliation Counselor and ten other Counselors. Staff personnel hold master’s degrees in one of the behavioral sciences, and are further qualified by at least ten years prior counseling experience in the field. The confidentiality of the counseling and the Conciliation Court record is rigidly observed.

When the Conciliation Court was first created by the State Legislature in 1939, it operated with intermittent success and lukewarm support from the bench, bar and general public. It was not until the enactment of additional legislation and the employment of trained marriage counselors in 1955, that the Conciliation Court has steadily evidenced new gains. In 1961 for example, an average of 360 new applications were filed monthly, while during the early period the average was only 100 cases a month.

The program is based upon intensive short term counseling, but when it seems advisable, as it often does, couples are encouraged to seek further therapy from other approved community counseling resources.1

Because of the uniqueness of the service, the setting within which the counseling is offered, the wide range of problems encountered and the large volume of cases processed, the Counselors have an unprecedented opportunity to study the factors involved in marital discord.

The success of the program is measured by various criteria. When both husband and wife appear together for their conciliation conferences, between 50 and 60 per cent agree to attempt a trial reconciliation. Some couples continue short term counseling with the Conciliation Court; others accept referral to community services for counseling of an ongoing nature, and others do not wish further help. One year following the decision of a couple to reconcile, the Conciliation Court makes a follow-up contact. Of those couples, 75 per cent report that they are still reconciled.

For couples who are unable or unwilling to accept a trial reconciliation, the Conciliation Court conferences have other functions as follows: (a) The opportunity to discuss objectively the ongoing responsibility to their children during and after divorce. (b) Acceptance of the decision to divorce and constructive planning relative to divorce proceedings. (c) Reduction of hostility generated by the separation. (d) Acceptance of, and planning for, a separation as a prerequisite to reconciliation.

Otto, Herbert A. (1963): Criteria for Assessing Family Strength. In: Family Process, 2 (2), S. 329–338.

Abstract: Although the professional literature is replete with criteria for identifying „problem families“ and criteria useful in the diagnosis of family problems or family disorganization, little is known about how we might identify a „strong family.“ Sound research into the dynamics of the so-called healthy or normal family is minimal. Studies focusing on the production of criteria for assessing family strengths have, to the writer’s knowledge, not been undertaken to date. Yet research in this area is an imperative if we are to have a clearer understanding of how we can strengthen family life for children. Defining, analyzing and establishing the nature of family strengths can make a major contribution to the development of effective programs which will strengthen family life.

Professional people as well as lay persons often describe a family as being a „strong family“ or refer to „family strengths.“ Closer examination, however, reveals considerable confusion and lack of clarity about the meaning of family strengths, and we have found that most families are themselves not too clear about what they consider to be their own strengths.

A search of the literature reveals that family strengths are more often implied than defined or described. For example, in an article entitled „Design of a Model of Healthy Family Relationships as a Basis for Evaluative Research,“ (1) Pollak discusses family relationships. Although not referring to the following as family strengths, the implication is clear:

1) Spouses have willingness to give up satisfaction of their own needs for the satisfaction of the needs of the other;

2) interdependency and a certain amount of independency between the marriage partners;

3) positive feelings of the spouses for one another gain ascendency over their negative feelings for one another;

4) parents and children are involved in a „give-and-take“ relationship;

5) parents help the child to emancipation when the child is ready;

6) the existence of healthy sibling relationships, which include:

a) helping develop individual differences by providing objects of identification and differentiations on a peer level;

b) giving support in claims of one generation against another;

c) providing the opportunity for competitive strivings;

d) providing the opportunity for seeing similarities and differences in the sexes;

e) offering one another the strength that comes of participating in peer groups.

Kimball Young in a discussion of „What Strong Family Life Means to Our Society“ (2), lists five items that contribute to a successful marriage in our culture. In a later paper (3), Young states that „Today the most important single need for the modern family is that of adaptability; this is, it must develop new resources to meet recurrent crises in order to survive.“ Although not explicitly referring to family strengths, a round table discussion conducted in 1942 (4) developed the following definition: „Family resources include the personal factors of mental and physical health, abilities, relationships, and morale of the familyas well as time, energy, money, equipment, and housing.“

To date, the writer has been unable to find a cohesive and detailed frame of reference of family strengths in the professional literature.

Currently, a series of research projects have been conducted at the Graduate School of Social Work, University of Utah, to explore this area. These projects are entitled, „The Family Resource Development Program“ (5), and „The Personal Resource Development Program“ (6). It has been the purpose of these studies to seek answers to some of the following questions: What are individual and family strengths? How do we help individuals and families recognize and utilize their strengths and resources more fully? How do we work with strengths?

This paper will be confined to a discussion of the first of these questions, specifically with reference to the production of criteria which can be useful in assessing family strengths. The findings of the research project will be presented and application of these findings to programs concerned with strengthening family life will be discussed.

Caputo, Daniel V. (1963): The Parents of the Schizophrenic. In: Family Process, 2 (2), S. 339–356.

Abstract: THE PRESENT STUDY is concerned with the interaction between the parents of male chronic schizophrenics and the role these parents may play in the development of such psychotic reactions. Specifically, the dominant-mother passive-father notion, frequently reported to be present in the backgrounds of chronic schizophrenics, is empirically evaluated.

Descriptions of the interaction between parents of schizophrenics which supply the empirical foundation for the dominant-mother, passive-father notion have been derived largely from more or less unstructured interviews, objectivity probably suffering from the interviewer’s being aware that he is dealing with the parents of schizophrenics (4, 8, 10, 13, 22). Many of these earlier investigators have so concentrated on the mothers of schizophrenics that they have neglected the role of the father of the schizophrenic, stressing, by this exclusion, the presumed pathogenic „schizophrenogenic“) talents of the mother (2, 4, 8, 18, 22).

Historically, the male pre-schizophrenic has been characterized as inadequate and anxious in many aspects of life, e.g., Boisen (3). It may be that the quality of early training by the parents results in the induction of this extreme anxiety in the child, which in turn results in the production of a psychotogenic agent as a physiological concomitant of anxiety (9) in the hereditarily prone individual, resulting in schizophrenia. On the other hand, it may be that the parents are not at all involved in the sequence of events leading to schizophrenia.

In the present paper, the author has attempted to explore further the pathogenic role of parents and to obviate theoretically derived biases by employing objective measures which tap both „attitudinal“ variables (obtained from paper and pencil measures) and the quality of ongoing interaction. The use of these two types of objective measures (paper and pencil, and interactional) represents a set of converging operations (7) whereby some of the findings obtained through the use of one measure may be checked by the use of another.

Three hypotheses describe the conditions of family interaction that were considered by early researchers to be of significance for the production of schizophrenia. These hypotheses, which are tested in this study, derive largely from Levy’s (12) concept of maternal domination and overprotection.

Levinger, George (1963): Supplementary Methods in Family Research. In: Family Process, 2 (2), S. 357–366.

Abstract: Progress in both theoretical and empirical understanding of family relationships will be speeded through the use of a combination of research methods in the same studyspecifically, direct behavioral observation together with indirect report by family members or other respondents. This thesis will be presented by reviewing the use of these kinds of techniques in family research, discussing the advantages and limitations of each used singly, and illustrating their combined use in a recently completed study.

What are the various techniques that students of the family have used in the past? In Hill’s bibliography and review of the literature on Marriage and Family Behavior, 1945-56 (1), numerous techniques are cited. Whether European or American, they ranged from the impressionistic, the philosophical, and the library method, to the use of structured interviews, questionnaires, or personality tests. Also mentioned were the use of statistical records, case studies, ethnographic data, and controlled behavioral observation.

Hill’s review summarized the methodology for the annotated items in his bibliography. Almost half these 422 studies had employed „interviews, questionnaires, or tests“; one fifth had used „literary, legal, or historical documents“; one tenth were based on statistical summaries; another tenth were studies with „impressionistic“ or unspecified methods; and the remaining tenth were based on behavioral observation. This last group were described as „largely ethnographic“ in nature.

Taking a 10% random sample of the entire 908 items in Hill’s bibliography, the writer found a fairly similar distribution of methods used, but with a larger proportion of articles based on speculation or on secondary sources and a smaller proportion of systematic empirical studies. In this sample, only one reference pertained to the controlled use of behavioral observation; this was an article by Vidich (2) which criticized such a standardized technique, arguing that it is subject to severe misinterpretation. Thus, Hill reported few instances of successful applications of rigorous objective methods to family study.

It must be noted that the field of family research is becoming increasingly concerned with improving the objectivity, the precision, and the generalizability of its findings. Hill’s review, for example, points out that the testing of theory, the drawing of generalizations, and the attention to scientific methods is more common in today’s than in yesterday’s publications. In this phase of the field’s development, it would be natural to see an increasing consideration of methodological as well as theoretical issues. Researchers will probably agree that family research is a most difficult area in which to apply strictly the canons of scientific inquiry. The sanctity of the home, the seeming uniqueness of the constellations we wish to represent, and the multiplicity of variables which affect family transactions would lead to such a statement. Nevertheless, one should not forget that such opinions have not been unusual in the development of other, now more advanced fields of disciplined knowledge.)1 In this perspective, one may find no ceiling to the degree of scientific precision with which family interaction can be studied.

Drechsler, Robert J. & Marvin I. Shapiro (1963): Two Methods of Analysis of Family Diagnostic Data. In: Family Process, 2 (2), S. 367–379.

Abstract: IN PSYCHIATRIC CLINICS there is often an uneasy alliance between clinical practitioners and research methodologists. Researchers promise to test clinical speculations against objective criteria and thus to establish a scientific basis for clinical practice. But many clinicians believe that researchers, in their zeal to achieve objectivity and scientific respectability, are blind to the essential clinical realities. This paper is an attempt to illustrate how statistical analysis may supplement and enrich clinical observations and contribute to their reliability.

For the past two years we have been studying total families diagnostically in a child guidance clinic, using a systematic procedure developed specifically for that purpose. Because the data for the present paper comes from this project we will summarize the procedure, which was described in detail in an earlier paper (6).

Each family was seen as a unit for a session which lasted from eighty to ninety minutes. The sessions were tape-recorded and observed through a one-way screen. Each session was divided between an interview with the family and a standard family task performed by the family alone. The interview probed the family’s view of the problem and the understanding of it by the various family members. The family task comprised a twenty-item questionnaire which the family members were asked to discuss together. Families were selected from the Child Guidance Center’s waiting list. The only criteria for selection were that the families should be intact and should contain no more than two children. Thirteen families were studied in this way.

We had observed from these data that families in their interactions, demonstrated behavior which seemed to contribute directly to the child’s problem for which they sought help. Now we will consider the methods by which we sampled and analyzed the data. These methods were made possible by two essential characteristics of the data-gathering process: It was systematic and standard, so that families could be compared on their performance of the same task; and it regularly elicited rich clinical material.

Jackson, Don D. (1963): Family Affairs. In: Family Process, 2 (2), S. 380–381.

Abstracts of Literature. (1963): In: Family Process, 2 (2), S. 383–392.

Fisch, Richard (1963): Review – Psychoanalysis and the Family Neurosis, by Martin Grotjahn, M.D., W. W. Norton and Co., 1960. In: Family Process, 2 (2), S. 393–396.

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