Jackson, Don D. (1965): The Study of the Family. In: Family Process, 4 (1), S. 1–20.
Abstract: For the past six years, we at the Mental Research Institute in Palo Alto have been studying family interaction to see whether and how such interaction relates to psychopathology or deviant behavior in one or more family members. The “normal” as well as the “disturbed” family is studied in order to infer conditions conducive to mental health. Our approach has been interaction-oriented because we believe that individual personality, character and deviance are shaped by the individual’s relations with his fellows. As the sociologist Shibutani has stated:
Many of the things men do take a certain form not so much from instincts as from necessity of adjusting to their fellows… What characterizes the interactionist approach is the contention that human nature and the social order are products of communication … communication… The direction taken by a person’s conduct is seen as something that is constructed in the reciprocal give and take of interdependent men who are adjusting to one another. Further, a man’s personalitythose distinctive behavioral patterns that characterize a given individualis given regarded as developing and being reaffirmed from day to day in his interaction with his associates (14).
Thus, symptoms, defenses, character structure and personality can be seen as terms describing the individual’s typical interactions which occur in response to a particular interpersonal context. Since the family is the most influential learning context, surely a more detailed study of family process would yield valuable clues to the etiology of such typical modes of interaction.
Dwyer, John H., Mildred C. Menk & Houten Van (1965): The Caseworker’s Role in Family Therapy with Severely Disturbed Children. In: Family Process, 4 (1), S. 21–31.
Abstract: The American contribution of including parents in the treatment of disturbed children is unique and important. The clear insight that led William Healy to form the orthopsychiatric team (11) has placed American child psychiatry in advance of all others in this respect. The emphasis on including the parents, a basic goal of child guidance clinics by the mid-twenties, has resulted in the present child psychiatric patient’s receiving routinely what is perhaps the most complete and comprehensive treatment of any handicapped person.
Because it was recognized that parents must be included if the child is to be diagnosed accurately, treated successfully and kept healthy, those of us in the residential treatment field who have developed within such a child guidance framework find ourselves in a most advantageous position to use family treatment methods. However, just as it has been found inadequate simply to transplant child guidance practice directly to residential units without modification (6), we have found that the treatment of parents must be adapted to their special needs. It is the purpose of this paper to discuss the work we have begun withfamily treatment of the severely disturbed child, placing emphasis on the caseworker’s role in this evolving method. We have re-evaluated the role of the caseworker in light of the fact that the psychiatrist would be seeing the family and not just the child as before. In reviewing the literature, we found references to participation of caseworkers but little about what they did; therefore we assumed that they were doing family therapy along with the psychiatric staff. Presently the role of the caseworker within our unit is one which we believe to be an essential, organic part of the treatment process.With the activities of the psychiatrist and caseworker so interrelated, it is important to understand the theoretical background and rationale of the family treatment process.
Since the Children’s Residential Treatment Service began twelve years ago it has offered intensive, medically directed treatment to small numbers of severely and moderately disturbed children and their families. The typical family, such as the five routine, consecutive admissions with whom we have been using our method, includes a psychotic child-patient. Under our present plan, adapted from that of Richard Cohen and the staff of Oakbourne Hospital (7), each family unit is involved in a weekly two hour treatment session. This session starts with an hour of family therapy in which the parents and child are seen by the psychiatrist, followed by a period in which the caseworker sees the parents together while the psychiatrist sees the child. More about these details later.
In general our treatment plan is to offer services to the family which enable them to understand better the problems that the child represents for the family, so that they are then free to change their interaction if they wish. This understanding is achieved through talking about the problems in therapy. The explanation of the plan to the family at the beginning of treatment uses the analogy of “turning on the light” in the following manner: The responsibility of the therapist consists of “turning on a light” in a previously dark room so that those who have been in the room bumping into unseen objects can then see the obstacles and be better able to avoid them. This plan derives from a number of different sources in which the therapists rely on the healthy part of the individual ego (8, 9, 10, 17, 23) and the group ego (3, 16, 20) for improvement.
Zuk, Gerald H. (1965): On the Pathology of Silencing Strategies. In: Family Process, 4 (1), S. 32–49.
Abstract: In the limited literature dealing with silence in psychotherapy, emphasis is usually placed on the motivation of the silent patient (8). The patient is often said to be using his silence to defend against the intrusive efforts of the therapist. This paper suggests that there is a rich learning history determining a patient’s resort to silence in psychotherapy or in other human situations. Individuals are exposed early to a wide variety of silencing strategies which aim to impose silence on them. How can such silence be imposed? By means of a process so crude as a mother saying to her child, “Now shut up or you’ll get a beating!” to a process so subtle as one who says, “Do be quiet, child, for mother has such a headache”. It should be clear that in imposed silence the motive originally exists primarily outside of the person who actually engages in silencethat is, in another person or group who might be labelled the silencer(s).
A number of silencing strategies which have been observed in psychotherapy, primarily in family psychotherapy, will be illustrated here and an attempt made to assess some aspects of their structure and dynamics. It is hoped to provide evidence for a general theory that silencing strategies, in so far as they successfully accomplish their aim, are important determinants of thought and affect disturbances.
The definition of silencing strategies is as follows: those maneuvers designed to punish an individual for some transgression by isolating him in silence. The motivation for silencing strategies is complex, but an effort will be made to describe at least two levels. A number of descriptive statements and hypotheses have been deduced for which evidence will be presented. They are as follows:
1. Silencing strategies may be conducted primarily by verbal or nonverbal means;
2. They may be conducted by one person primarily or an alliance of persons;
3. They may be directed primarily at an area of communication or at a person;
4. A primary “public” level motive for them is to induce compliance or conformity;
5. A primary “private” level motive for them is to possess the victim as an object for the needed projection of feelings of being bad or inanimate;
6. There is a causal relation between silencing strategies and pathogenic silence and babbling which may themselves be used as powerful silencing strategies.
Zwerling, Israel & Marilyn Mendelsohn (1965): Initial Family Reactions to Day Hospitalization. In: Family Process, 4 (1), S. 50–63.
Abstract: Interest in the study of family processes, and specifically in how these relate to mental illness and recovery from illness in individual patients, has grown in recent years. Relationships have been postulated between communication patterns, role relationships, emotional atmosphere, etc., in the family and illness or symptom patterns in the individual. The approaches reported have been largely inductive, based on speculative psychodynamic or interactional formulations imposed on the observation of small numbers of families. Empirical data relating family processes and individual illness are as yet scanty. It is the purpose of the present report to present the findings of a study concerned with the relationship between the course of hospital treatment and certain family attitudes and reactions at the time of the hospital admission of a psychotic member.
Our setting provides us with a unique opportunity to observe what seems to us to be a critical moment in the family’s relationship with the patient, and to provide important clues to significant and as yet scantily reported processes. Psychotic patients are generally brought to the admitting room of a hospital with the expectation that they will be removed from the family. Events preceding the decision to bring the patient to the hospital are usually made in an atmosphere of great stress. The patient may have been threatening to harm himself or others, or may have behaved in a manner embarrassing to the family, or shown very bizarre symptoms. Family members may be frightened, ashamed, or angry with the patient member. The decision to bring the patient to the admitting room for hospitalization is usually a difficult one. It is often accompanied by guilt and is seen as a last resort, or as the only way out. The family fully expects that the patient will be admitted as a “full-time” patient. However, at the Bronx Municipal Hospital Center a certain number of such patients accepted for admission are, in fact, not admitted to the 24-hour service. Instead, on a purely random basis, they are designated as Day Hospital patients.1 The resident then confronts the family with the fact that the patient will not receive full-time hospital care, but that he will return to his home every evening and on week-ends. Also, the entire family, including the patient, is requested to meet once a week with the doctor for regularly scheduled family therapy.
Katz, Myer (1965): Agreement on Connotative Meaning in Marriage. In: Family Process, 4 (1), S. 64–74.
Abstract: An investigation of connotative or emotive meaning as a variable in interpersonal relations, the present study involves a comparison of indices of discrepant affect states associated by happily and unhappily married partners with concepts of considerable importance to marriage. Marriage is conceived as a particular class of interpersonal relations, and the investigation of connotative meaning is considered as an approach to the more general process of communication.
Meaning has long been considered a significant pivotal variable in human behaviour and interaction (6). When the literature on marital success and discord is examined, it becomes apparent that most investigators, both clinical and experimental, highlight in one way or another the importance of understanding and agreement between spouses as related to marital success. Ruesch (9) has argued that “to be understood is a pleasure; to reach an agreement is expedient and pleasant; to be understood and reach agreements is deeply satisfying.” It follows that mutual understanding and agreement are likely to be significantly related to the success of such close relationships as marriage entails. In fact, married couples frequently describe their marital problems by such phrases as, “we just don’t understand each other”; “we don’t see things eye to eye”; “love means something different to him than to me”; or “she says one thing and means something else.” Such phrases, heard frequently in the consultation offices of marriage counselors, may be figures of speech or clinically irrelevant verbalisms. On the other hand, it may well be that when maritally troubled couples complain of a mutual lack of understanding, they are referring to a dimension of affective disagreement upon issues of genuine importance to such intimate forms of interpersonal living as marriage represents.
The general hypothesis here is that happily married spouses, compared with unhappily married husbands and wives, show greater agreement in affective judgment or connotative meaning (are psychologically more similar) on issues of importance to marriage. More specifically, three assertions are tested: (1) Troubled married partners show greater connotative disagreement generally than untroubled couples. (2) Troubled partners show greater connotative disagreement than untroubled couples over concepts related to marriage. (3) Troubled partners are more discrepant over marriage-related concepts than over concepts unrelated to marriage.
Pattison, E. Mansell (1965): Treatment of Alcoholic Families with Nurse Home Visits. In: Family Process, 4 (1), S. 75–94.
Abstract: The use of Public Health Nurses (P.H.N.) for psychotherapeutic home visits with the families of alcoholic patients is described in this report. Our experience indicates that the P.H.N. can offer singular mental health aid to multiple-problem families during situations of acute crisis, ameliorating family conflict and supporting the family through to stable re-settlement.
Current studies of community mental health indicate that patterns of mental illness vary with socioeconomic class (37, 65). Although the lower classes present particular therapeutic problems (Hollingshead-Redlich class IV, V) (37), membership in the lower socioeconomic class does not intrinsically imply the presence of social or psychological dysfunction. Social agencies have found that a certain number of families contribute disproportionately to the social service requests to a community (18, 26). These “multiple problem” families come to the attention of multiple agencies for repeated crises involving legal, welfare, school, marital, health and psychiatric problems. Frequently alcoholism is a major problem in these families35% in one sample (21), 25% in another (70)which contributes to the development and perpetuation of family dysfunction.
When these families face crisis situations, their personal and social resources are often ill-suited to cope with the situation in an adaptive fashion. As Herzog (36) points out, the “needy poor” exist in a marginal sub-culture which lacks the necessary adaptive mechanisms of a true culture. The product of family crisis is the dissolution of family mechanisms, resulting in social problems which bring the family to community attention.
The “multiple problem” (Class IV, V) families need a unified approach rather than scattered aid to individuals by several agencies (26). There is a difference between the psychiatric problems and the mental health problems of this group, which suggests that agencies focus upon the psychosocial needs of these families (14).
Several programs have implemented such an approach through home visits by psychiatrists, psychologists, social workers, and public health nurses (29, 30, 31). The aim of such home therapy has been to deal with the basic social pathology of the family (e.g., alcoholism) which may be little helped by hospitalization or erratic clinic attendance. Such mental health programs anticipate that through home visits effective social prescriptions can be better correlated and more consistently achieved.
Beavers, W. R., Stanley Blumberg, Kenneth R. Timken & Myron F. Weiner (1965): Communication Patterns of Mothers of Schizophrenics. In: Family Process, 4 (1), S. 95–104.
Abstract: In recent years there has been an interest in the communication patterns, not only of schizophrenic patients, but of these patients’ families. In 1956, Bateson, Jackson, Haley and Weakland (1) first presented the concept of what was labeled “the double-bind” as an etiological factor in schizophrenia. The double-bind hypothesis suggests that meaningful figures in the schizophrenic’s early life frequently communicate puzzling, conflicting messages to the patient-to-be. These messages, impossible to integrate as transmitted, require clarification or revision before the communication is meaningful.
Wynne, et al. (11), reporting studies of families of schizophrenics, concluded that a simple shared meaning between the person speaking and the person receiving the message is absent in characteristic relationships of schizophrenics’ families. Contradictory expectations are communicated, and shared interpersonal mechanisms produce failures in selection of meaning.
Lidz and others (5, 6) reported meticulous investigation of families of schizophrenics and found serious distortions and absences of usual meaningful family interaction. Brodey (2) found similar communication difficulties in family members of schizophrenics who lived in a hospital setting and interacted in their daily living with staff members.
These studies indicate an increasing awareness by professional workers who deal with schizophrenia that the family is indeed involved in the illness and has a great deal to do with the onset and eventual outcome of this disease in one of its members. However, such studies have had serious handicaps in experimental design. As Wynne and Singer recently commented, “usually the investigators themselves have been quite convinced that the families of schizophrenics are indeed distinctive, but it must be granted that such an impression has remained less than convincing to others who have not engaged personally in intensive work with such families” (12).
It was the purpose of this study to investigate communication processes in family members of schizophrenics and non-schizophrenics, to work out means of scoring such communication objectively, and to diminish as much as possible the effects of investigator bias. To determine whether there were significant differences in the kinds of verbal communication seen in family members of schizophrenics as opposed to other emotionally ill persons, it was considered necessary to evaluate the communication patterns in an interview with a family member. In this study the natural mother of the patient was interviewed without prior knowledge of the patient’s diagnosis by the interviewer or by the individuals who scored the transcripts of these interviews.
Rabkin, Leslie Y. (1965): The Patient’s Family: Research Methods. In: Family Process, 4 (1), S. 105–132.
Abstract: The family, as the chief agent of socialization, exerts its influence in myriad ways to make the child an extension of itself and of its cultural mileu. The extraordinary complexity of this interaction of child with family leaves great room for role confusion and distortion. And it is these distortions which we label as signs of mental illness.
Within the purview of the concern with family processes and mental illness there have been attempts to simplify the interactional nature of the family relationships and focus on but a single aspect of the child’s inheritance. Researchers such as Kallman (52) and Slater (83), for example, have marshalled much evidence to bolster their belief that mental illness is primarily of biological origins, the genes transmitted through the parents being the cause of the child’s emotional difficulties. A combination of the geneticists’ intransigent theoretical views and Jackson’s (50) incisive and critical reassessment of their evidence, has temporarily at least lessened the force of their argument.
The psychogenic notion of emotional and mental disorder, that early pernicious home experiences have a deep and lasting effect on the individual’s psychological adjustment, postulates that there are family patterns of roles and behaviors which, presented by the parents and assimilated by the child, predispose him to one or another psychological disturbance. According to this point of view, it is the parents’ attitudes and modes of behavior which are “inherited” by the child.
Much of the thinking about psychogenic causation has continued in the tradition of the early Freudian notions. Freud emphasized the etiological importance of specific parental behaviors (e.g., seduction, frustration) and stressed the psychological effects of these activities when they occurred at the earliest stages of the child’s development. This “critical period” conception has led researchers to focus their attention on what will later be described as “trait” studies (87), attempts to correlate a specific parental attitude (e.g., overprotection, rejection) with a specific set of responses in the child (e.g., aggression, autism).
Sherman, Murray H., Nathan W. Ackerman, Sanford N. Sherman & Celia Mitchell (1965): Non-Verbal Cues and Reenactment of Conflict in Family Therapy. In: Family Process, 4 (1), S. 133–162.
Abstract: When an entire family is seen together in therapy, there is the opportunity to observe a reenactment of the specific conflict which has brought the family to treatment (1). This enactment of conflict is attributable to many factors, among which is the family’s need to demonstrate their emotional turmoil to the therapist in order to gain his help in resolving the family neurosis. However, the family conflict also has a static, perseverative quality which leads to its continuance in all sorts of situations in and out of treatment. One of the major advantages of family therapy is the opportunity afforded the therapist to observe and intervene in these perseverative enactments in situ, on the very scene of battle.
Within any given session it is often difficult to detect the specific origins of a particular conflict enactment at the very moment it is occurring. These origins are doubtless of a multidimensional sort, but among them the significance of non-verbal cues has been noted with increasing frequency (5, 9). As a matter of fact, the significance of such subtleties of non-verbal communication as tonal inflections and fleeting facial expressions has long been noted as characteristic of the psychoanalytic situation (8, 10, 11), but only now are these data being explored in a systematic, scientific fashion. The development of such scientific recording devices as the tape recorder and motion picture camera has undoubtedly been a major factor in the study of fleeting aspects of non-verbal expressions. The scientific description of the startle pattern (6) and its diagnostic significance was made possible by examination of individual frames of motion picture recording.
The traditional role of the psychotherapist has tended to include relatively less attention to these non-verbal behaviors than to the verbal content that is communicated. Moreover, the specific relationships between non-verbal cues and the psychodynamics of family conflict have not yet been demonstrated in detail with illustrative case material. The problems of this type of study have been explored from the standpoints of kinesics (4) and of paralinguistic analysis (7), but our intent here is to deal with more molar cues that could be detected in ordinary therapeutic interaction, were the therapist to pay particular heed to these minute behavioral expressions.
Jackson, Don D. (1965): Family Affairs. In: Family Process, 4 (1), S. 163–164.
Abstracts of Literature. (1965): In: Family Process, 4 (1), S. 165–171.
Daniels, Arlene K. (1965): Review – Schizophrenic Women: Studies in Marital Crisis, by Harold Sampson, Sheldon L. Messinger and Robert D. Towne, Atherton Press, 1963. In: Family Process, 4 (1), S. 172–173.
Paul, Norman L. (1965): Review – Conjoint Family Therapy by Science and Behavior Books, by Virginia Satir, Science and Behavior Books, Palo Alto, Calif., 1964. In: Family Process, 4 (1), S. 173–174.
Sonne, John C. & Geraldine Lincoln (1965): Heterosexual co-therapy team experiences during family therapy. In: Family Process, 4 (2), S. 177–197.
Abstract: This paper represents an attempt to make a contribution towards an appreciation of the problems of technique in family therapy, through an examination of the authors’ co-therapy relationship during treatment of a schizophrenogenic family, in order to delineate and conceptualize the interweaving of co-therapy experiences with family interaction and change. This account describes the working out of the authors’ particular relationship in working with a particular family, the Ichabod family, an upper middle class Jewish family of four, comprising a father, age 37, a passive, masochistic, lanky, under-achieving man; a mother, age 35, an isolated, intellectualizing, boyish looking, unexpressive woman, who had difficulty in resolving her conflict of working woman vs. mother; a 14 year old, sullen, sad, withdrawn son, clinically diagnosed as schizophrenic; and an overactive, enuretic, ten year old daughter. The family had been involved in constant bickering for years, and previous therapists had expressed a growing fear that the son might respond to his sister’s teasing by murdering her. The therapists met with this family for an hour and a half, once a week for a period of three and a half years. No meetings were held unless both therapists and all four family members were present. At the time of termination, all participants, and independent psychological testing gave evidence of marked improvement in total family and individual family member functioning.
We have chosen to present our concepts embodied in the description of our relationship with a specific family, feeling something would be lost in presenting the concepts without a setting. We anticipate the reader will be able to grasp the essence of the examination in this form and use the concepts more universally.
Berger, Andrew (1965): A Test of the Double Bind Hypothesis of Schizophrenia. In: Family Process, 4 (2), S. 198–205.
Abstract: Bateson, Jackson, Haley, and Weakland (2, 3) have provided a theoretical basis for the present study with their formulation of the double bind hypothesis. It proposes that when an individual is involved in an intense relationship with someone who repeatedly gives him messages which are in conflict with one another, symptoms of psychological disorganization may develop if the individual can not comment on the contradictions nor escape the conflict. In a situation of this type discrimination becomes difficult and no response will be correct. Although the double bind situation is always conflictual and the messages conveyed are contradictory, to say merely that it can be considered an insoluble conflict hypothesis would omit its most essential characteristic: that the “contradiction” is not at the level of the victim’s behavior but at the “set” level, within the context of a situation whose various isolated parts may be well understood by the victim but into whose essentially devastating gestalt he lacks insight. The conflicting situation is therefore quite subtle and frequently, at least in part, non verbal; i.e., a castigated action today may be mildly encouraged tomorrow; a rejecting phrase may deny the affect of an embrace.
Bursten, Ben (1965): Family Dynamics, the Sick Role, and Medical Hospital Admissions. In: Family Process, 4 (2), S. 206–216.
Abstract: Investigation of family life has made an increasingly important contribution, in recent years, to the understanding of psychosocial phenomena. Psychiatrists have become aware that the family “is not simply a collection of individuals; it constitutes a true small group, a dynamic entity with a life structure and institutions of its own. Within the family, the action of any member affects all, producing reactions and counter reactions and shifts in the family’s equilibrium.” (1) Similar views have been expressed by many other authors (2, 3, 4, 5, 6). Thus, the psychosocial events which come to the attention of us, as psychiatrists, reflect, not only the psychodynamics of the individual, but also his responses within a family and social framework.
With the family frame of references, Wood et al (7) investigated some of the relationships involved in the process of a patient’s seeking admission to the psychiatric hospital. They have referred to the admission “as an event taking place in an interpersonal setting…” They have demonstrated that in addition to the psychopathology of the individual, hospitalization is often dependent on family pressures. These interpersonal pressures can also precipitate hospitalization for psychosomatic illnesses, as Titchener et al (8) have illustrated in their discussion of the relation between family dynamics and ulcerative colitis. It is the purpose of this paper to illustrate that, in addition to hospitalization for classical “psychiatric” or “psychosomatic” illnesses, the family has available to it general medical and surgical hospitalization as a means of resolving a psychosocial crisis. We shall analyze one aspect of the family dynamicsthe interaction between husband and wifeto demonstrate how the medical hospital may be used in the service of evolving family patterns and to show how an analysis of these patterns can broaden our understanding of the psychosocial situation of some medical patients.
Rautman, Arthur L. (1965): Meeting a Need in Child Guidance. In: Family Process, 4 (2), S. 217–227.
Abstract: A somewhat unorthodox method which has often proven effective in interpreting child behavior, diagnostic evaluations, and treatment recommendations to “problem parents” of exceptional and handicapped children will be described in this paper. Parents who have taken their deviant children to diagnostic centers or guidance clinics all too often return to their homes with emotional indigestion and with only a vague idea as to how the clinic’s recommendations can be implemented. Sometimes this difficulty seems to arise because the parents themselves are unusually obtuse, at least as far as this particular child is concerned; sometimes, however, these recommendations themselves are unrealisticeither because they are contrary to the parents’ conception of the problem or because they are beyond their means to provide (financially or otherwise). Whatever the cause, the result of such consultation frequently is that the original difficulty with the child is thereby compounded by the parents’ now desperate feelings of utter frustration and helplessness. The technique which I shall describe is often successful in enabling such parents both to comprehend and accept the professional interpretations and to carry out effectively this recommended treatment which their exceptional child needs.
The function of the child guidance clinic, viewed in its historical setting, has been to observe, evaluate, and interpret child behavior to the parents, teachers, or other individuals directly interested in and concerned with the care and welfare of the child. Because of the growth and development of modern clinics, be they diagnostic or therapeutic, many have come to view their main function as consultants to other agencies, so that the diagnosis and evaluations are sometimes made without an adequate interpretation being given directly to the parents. Many times formal recommendations are made directly only to the referring agency or to the referring physician, rather than to the individual parents themselves. Thus there may be recommendations of treatment or care outside the family without specific instructions or assistance as to where this care is available or how to go about securing it. Recommendations for hospitalization or residential training are sometimes made without these institutions being available, or at least with their being unavailable to this particular parent because of distance and money, to say nothing of emotional hesitations.
Hader, Marvin (1965): The Importance of Grandparents in Family Life. In: Family Process, 4 (2), S. 228–240.
Abstract: A fantasy of Little Hans at the termination of his analysis with Freud concerned his use of his grandmother as a convenient object on which to relegate his father (1). The significance and value of this grandparent for Little Hans was evident to Freud. Unfortunately, the importance of grandparents in family life and psychopathology is often as unrecognized today as it was prior to 1909. The tenuous bond that ties generation to generation is often stronger than we think, and the direct impact of that alternate older generation on development is usually not recognized as being of significance. Grandparents are often considered just a substitute or their role is recognized as only subsidiary, and the family constellation is considered as father, mother and children only. The assigned role of the grandparents is often that of being a surrogate. In many instances the influence of the grandparents is unique and different as well as important. This paper purports to help show that the absence of grandparental influence can be deleterious to grandchild development. It will point out the important pressures our senior citizens may bring to bear on family unity and stability and it will emphasize the tendency for a correlation between the presence of healthful elderly and freedom from mental illness in the younger relatives. It will point out the importance of being aware of the influence of older people both for their own benefit and for others close to them.
We are all aware of the dignity and respect awarded older people in other societies (2). We are also aware of the possible correlation of designated roles for oldsters with mental illness of old age (3). What is often not recognized is that the elderly can play a positive, effective, supportive, and worthwhile role in the development of the grandchildren. The softening of the intensity of the parental-child relationship can be associated with beneficial understanding and less immature attitudes on the part of the grandchildren. An interested, caring, thoughtful and mature person who is directly involved in the family has a positive potential of significance. The learned intervention of a party who has a degree of objectivity and distance can afford the mutuality necessary for a consistent, warm, and balanced interdependent family environment.
Kaffman, Mordecai (1965): Family Diagnosis and Therapy in Child Emotional Pathology. In: Family Process, 4 (2), S. 241–258.
Abstract: In this paper, we want to limit ourselves to the formulation of our theoretical and clinical model of family psychotherapy as it is being applied by us at two outpatient Israeli clinics. The detailed analysis of the data, clinical histories, comparative psychopathological findings and analysis of parental attitudes of Kibbutz and urban families, and evaluation of clinical results will be reported in subsequent articles. It may be well to state at the start that even for our own particular method of treatment the use of the plural term family therapies instead of the singular represents the reality of everyday clinical practice. There are no two families to which the same therapeutic plan can be applied. Family therapy as we practice it in Israel requires substantial variability in the therapist’s ways of activity according to the patient’s ethnic and cultural background, social values, level of sophistication, age, etc. It also demands a high degree of plasticity regarding length, frequency and distribution of the therapeutic interviews.
Terrill, James M. & Ruth E. Terrill (1965): A Method For Studying Family Communication. In: Family Process, 4 (2), S. 259–290.
Abstract: During the past few years there has been an increasing shift away from the individual and toward the family group as an object of both therapeutic and diagnostic efforts. Much of the current literature on the family is based on the assumption that the family is a system in which the personality and behavior of each family member is dynamically related to that of every other family member. While numerous case studies and descriptive reports tend to support such an assumption, there is an obvious need for studies of family interaction which employ a theoretically consistent set of categories of interpersonal behavior that can be handled quantitatively. As has been suggested by Guerney and Guerney (6), the theory and techniques of Leary and his co-workers in the Kaiser Foundation Research project (10, 11, 12), appear to offer considerable promise for the study of interpersonal relations within the family group.
Hoover, Carol F. (1965): The Embroiled Family: a Blueprint for Schizophrenia. In: Family Process, 4 (2), S. 291–310.
Abstract: To isolate a family type of observed character and interaction, and then to analyze the process through which schizophrenia may develop in such a group, will supply no comprehensive view of schizophrenia. But an approach of this nature can suggest questions to be applied, on a consistency basis, to schizophrenia as it appears in other human settings. This paper will describe a family gestalt rather commonly seen and attempt to show how schizophrenia emerges from it.
Every mental hospital staff tears its collective hair over the families of schizophrenic patients. But there is one type of family which has a particularly grievous effect on staff hair. This sort of family is always around. Concern with every aspect of the patient’s treatment is high. There seems to be an excessive closeness and at the same time an antagonism between the patient and at least one other member of the family, and this person is forever visiting and getting him upset, reiterating love and anxiety, suggesting plans, having arguments with him.
It may not immediately be clear that the rest of the family is also involved (though sometimes two or more are equally “active”) because the more visible member serves as the family stalking horse. But closer acquaintance nearly always reveals that both parents, and frequently one or more siblings, are entangled with the patient in some peculiar, difficult-to-identify, complex and paradoxical relation.
Kessler, David R. & Andrew E. Curry (1965): A Preliminary Report on Multiple Conjoint Family Therapy. In: Family Process, 4 (2), S. 311–313.
Abstract: The term “multiple conjoint family therapy” is used descriptively for a type of group meeting of six to eight total family units currently in use at the Langley Porter Neuropsychiatric Institute, San Francisco, California (4). As a result of our conjoint family therapy focus on a 28 bed (14 male and 14 female) unit, 70% of all admissions are involved in some type of therapy sessions involving the nuclear family or the family of procreation.
The common predicament of having a family member hospitalized, the similar problems and family stresses, and the fact that each family unit was in conjoint family therapy, served to stimulate a kind of “groupiness” among the families. Whether or not some type of therapeutic management (1) of these large groups could be developed offered a challenge and an opportunitya challenge because the situation presented another opportunity to develop therapeutic experiences for families; an opportunity because theory and technique would have to be developed. Although we relied heavily on techniques of conjoint family therapy (2, 5), they could not be transposed in toto to the large group setting. A search of the literature (3) offered few guide posts, consequently treatment goals and evaluation of results would have to be based on empirical, clinical opinion and guesswork. This brief communication is a preliminary report of the clinical work done over a two year period on a ward of the Adult In-Patient Service.