Online-Journal für systemische Entwicklungen

Family Process 1969

Heft 1

Charny, Israel W. (1969): Marital Love and Hate. In: Family Process, 8 (1), S. 1–24. 

Abstract: For all practical purposes, the working theory of desirable marriage in our contemporary mental health literature speaks of marital communication, cooperation, and relatively little fighting; and if fighting, certainly not too intense or regressive. In marriage counseling or various individual or family psychotherapies, troubled couples in effect are invited to consider just what are the personal sources of immaturity that lead them to be too angry, or how they are failing to communicate their feelings in more respectful and mature ways; most treatment aims at eliminating fighting rather than helping and teaching people to experience the possible positive effects of fighting. Many other “patients” of the mental health professions who present themselves for help for any of a variety of other kinds of symptoms of emotional problem are also led to discover and acknowledge the destructive consequences of the marital fighting and/or dissension that are all-too-soon discovered in their live.

Ferber, Andrew & Marilyn Mendelsohn (1969): Training for Family Therapy. In: Family Process, 8 (1), S. 25–32. 

Abstract: In our program of training in Family Therapy in the clinical psychiatric units affiliated with Albert Einstein College of Medicine, our trainees come from almost all professional groups connected with the Psychiatry Department of the Medical Schoolresidents, fellows, child psychiatry fellows, social workers, psychologists and nurses. Some are trainees, others have staff positions. Our program has evolved over the past seven years and currently we offer three levels of training: Level I teaches concepts of family process and basic skills of family interviewing; Level II trains people to practice family therapy; and Level III trains teachers and supervisors of family therapy, with optional research experience. The main body of this paper is a detailed description of our Level II program and an elaboration of the basic assumptions underlying all of our training programs.

Levitt, Herbert & Ralph Baker (1969): Relative Psychopathology of Marital Partners. In: Family Process, 8 (1), S. 33–42. 

Abstract: The accumulating literature in the areas of family and couple therapy contains an impressive number of descriptive, anecdotal, and experienced based reports of selected cases and far too few research based reports. A reader of this literature recognizes, however, that with careful search and evaluation, a cache of research leads exists there which is awaiting discovery and development. The present study pursues one such lead which has attracted the attention of a number of authors but about which little evidence has been brought to bear. Briefly stated, it is the assumption that the member of a marriage who seeks treatment initially may not be the more disturbed member or the one who needs the most help. The derivation of this assumption is that “sickness” as inferred from the neurotic symptoms or emotional disability of one member of a family may be a cover for the “sickness” of another member or members of the whole family system. This assumption has provided an impetus to examine and counsel with whole families or couples (3). Vogel and Bell (7) were among the first to describe this phenomenon in their discussion of the scapegoat family member who has “assigned” to him the role of the disabled one in order to enable other members in the family to remain psychologically intact. Authors discuss the exact distribution of “sickness” in families in as many ways as probability allows. Whitaker (8) suggests that the degree of illness is approximately equal although the symptom presentation may be different. Martin and Bird (5) say that the “patient” is “sicker” than the spouse but projects problems onto the spouse in order to be regarded as the “healthy” one. After testing 40 married couples who were referred for psychological testing, Harrower (4) concluded that the least disturbed partner came into treatment first. Fry (1) reviewed seven cases of phobic-like symptoms of patients and discovered that their phobias fronted for a disturbed marriage and concealed phobias of the spouse. Numerous examples of how symptom formation relates to disturbed marriages are provided by Haley (2). At the least, this situation has raised questions as to who really is the patient, how family members get into treatment, and which one or group of members is the appropriate one or ones to treat. The present study dealt primarily with the first question. Accordingly, ratings were made of the relative order of intrapsychic emotional disturbance of married couples to know better whether the identified patient was, in fact, the “sicker” marital partner. The term “sicker” is tangentially of semantic interest. Perhaps, the concept of “sickness” will offend some readers in these times when the contemporary scene is oriented toward human potentiality and adaptive behavioral systems. Yet, there are those who say still that “sickness” is a shared set and has communication value. This idea will persist until the underpinnings of what is shared can be brought to the surface. Elaboration of this point will be made in later sections.

Mosher, Loren R. (1969): Schizophrenogenic Communication and Family Therapy. In: Family Process, 8 (1), S. 43–63. 

Abstract: A technique of family therapy the author has developed for families with a schizophrenic or borderline schizophrenic offspring is described here. Since it has as its theoretical basis the findings of research with such families, it is hoped the description of this technique will help bridge an apparent gap between the research with “schizogenic” families (i.e., families with a schizophrenic member) and the practice of conjoint family therapy with this type of family.

Willi, Jürg (1969): Joint Rorschach Testing of Partner Relationships. In: Family Process, 8 (1), S. 64–78. 

Abstract: The present Joint Rorschach Procedure is basically similar to that of Loveland (4), and Levy and Epstein (3). It differs, however, in its aims and especially in its interpretation. Loveland uses the Joint Rorschach to assess the specific disturbances in thinking and communication styles in the family. My test procedure is directed toward answering the following questions:

1. What is the relative strength of the partners taking the test, and how do they interact in their relationship?

2. How does the personality of one subject change in a discussion with the other? Do the pathological modes of conduct shift from one subject to the other?

My aim was to work out a test procedure for studying the relation between partners which would be so clear and simple that it would be suitable for use in the practice of marriage and family therapy. The test has been simplified to the point where it can be administered by a single examiner and the protocol evaluated by him with a moderate expenditure of time. For the performance of the test no special equipment such as one way screens and tape recorders is necessary. A single series of 10 Rorschach cards suffices. The interpretation is based on the collection of a small quantity of sharply defined data which, in their combinations, is able to yield diverse, comprehensive information about the relationship between partners. In the course of the test, these data accumulate in sufficient quantity to allow quantitative analysis. This makes it possible to compare the behavior and interaction within small groups (e.g., pairs or families) with one another, and to attach appropriate significance to the typical and specific.

In contrast to Loveland, and Levy and Epstein, I have evaluated the results of the Joint Rorschach Test in the traditional way. It has become evident that the response behavior in the joint test often deviates significantly from that in the individual test. This yields considerable insight into the way the subjects influence each other. With an average knowledge of the Rorschach technique it is easy to become thoroughly acquainted with the present procedure. The test was performed with 80 pairs. One member of most pairs was neurotic, psychotic, psychopathic, or addicted to drugs or alcohol. There was no overt psychiatric illness in 13 pairs.

Nakhla, Fayek, Lydia Folkart & Jan Webster (1969): Treatment of Families as In-patients. In: Family Process, 8 (1), S. 79–96. 

Abstract: Psychiatric hospitalization tends to occur, not because of the severity of the individual’s psychopathology or a dramatic change in symptoms, but because of intolerable interpersonal pressures within a family or social framework.

Wood and his colleagues (24), who investigated admission to a psychiatric hospital, using a family frame of reference, regarded it as an event taking place in an interpersonal setting, and frequently as a response to threatening demands for someone to change his behaviour: the demand being either for the patient to change his behaviour through hospitalization or a demand from the patient for someone else to change. Moreover, the family may also use hospitalization as an attempt to exclude one of its members from its midst as an effort to regain some equilibrium; or, conversely, the family may resist change because of its continuing need for its disturbed member, who plays an important balancing role in the family dynamics.

Recent emphasis on family life in psychiatry and psychology, and the study of object relationships, has alerted many workers (2, 4, 5, 6, 9, 18, 19, 20) to the significance of including the family in the work with the hospitalized patient. Their reports have emphasized that the success or failure of the treatment depends on the close assessment of the family situation, a continuing examination of the relationships between patient, hospital, and family, and the need to involve the family in the treatment process. With the exception of Bowen’s (2) research work on the treatment of adult schizophrenics and their families at the National Institute of Mental Health (Bethesda, Maryland), however, these reports are confined to settings in which only one member of the family was in the hospital.

This paper describes work at the Cassel Hospital, a National Health Service hospital for the treatment of neurosis by intensive analytically oriented psychotherapy against the background of a therapeutic community. Here, for three years since 1964, over thirty five families with children of early or pre-latency age were in hospital for a period of eight months on average.

Many years of experience in hospitalizing mothers and children together (13) and in treating disturbed mother-child couples (7) led to a growing awareness of the significance of other dynamic forces within the family; especially the importance of the father’s role, which had accounted for some of the difficulties we had met in our work. Stimulated by these experiences and by the emerging literature on family therapy, we decided to adopt a family-centered approach to treatment, and to see if this would further our understanding and prove helpful as a method of work. This paper gives an account of the value and special problems of our technical approach.

Miyoshi, Nobu & Ronald Liebman (1969): Training Psychiatric Residents in Family Therapy. In: Family Process, 8 (1), S. 97–105. 

Abstract: Modification in psychiatric residency training is taking place with the introduction of family treatment into the programs of a number of institutions. Yet there is a scarcity of articles in the literature on this subject. We are reporting on the experiences we have had in the psychiatric unit at the Mercy-Douglass Hospital in Philadelphia.

Forrest, Tess (1969): Treatment of the Father in Family Therapy. In: Family Process, 8 (1), S. 106–118. 

Abstract: A discussion of the treatment of the father in family therapy is an arbitrary and heuristic division. In practice, the treatment of the father is conducted as an integral part of the overall treatment of the interactional family system. The family unit is a homeostatic system, and the treatment of each member is inseparable from the treatment of the unit. The purpose of focusing on the treatment of the father in particular is to underscore how therapeutic intervention may be brought to bear on important facets of the family dynamics relevant to the father in order to change the family homeostasis.

For family therapy to be effective, it must reach the father as the person of prime importance for group functioning (3, 4, 5) because of the instrumental-leadership and authority role assigned to him (8, 13), and because of the identification model he is to his children. It is generally agreed that he is the most difficult family member to engage in the treatment process (6, 9, 10), but, as Fulweiler emphasizes (6), his participation is essential to equalize the family balance. In view of his pivotal position in the family homeostasis, it seems useful to concentrate on the problems pertinent to his treatment.

Coe, William C., Andrew E. Curry & David R. Kessler (1969): Family Interactions of Psychiatric Inpatients. In: Family Process, 8 (1), S. 119–130. 

Abstract: Because the patients’ environment is becoming an important point of focus in the mental health movement increasing efforts are being made to isolate and to remove sources of environmental stress (4, 10). Many investigators feel that the family environment is one of the important sources of stress that contributes to a breakdown in psychological adjustment.

An increased understanding of the family unit is needed in order to examine etiological implications and to guide therapeutic interventions. Several methods are being used to achieve this: analysis of interviews, hospital records, projective tests; analysis of family interactions in task situations, and structured questionnaires (7). Of these methods, the structured questionnaire has the advantage of increased standardization and reliability as well as being more efficient and practical for collecting data on large numbers of subjects. It would seem to be the ideal way of locating and isolating important variables in this early phase of family investigation. However, an inherent weakness in self-report questionnaires is the lack of direct observation, and consequently, the suspicion that the subject is reporting what he thinks the investigator wants, or what he would like the investigator to think of him. Psychiatric patients and members of their families may be particularly sensitive to these demands and the report of their behavior may not be the same as their actual behavior. Control groups, because of the difference in situational demands, provide only a partial answer. Interpreting the differences between a psychiatric sample’s reports and a control sample’s reports must be carried out with caution.

This study presents the initial results from a questionnaire that was constructed to examine family interaction patterns. The questionnaire is based on the “Day at Home Technique” (8) which samples patterns of family interactions in everyday activities. More specifically, the instrument samples the interactions of family members in child care and control duties, household duties, economic duties and social-recreational duties. A previous study using a different questionnaire indicated that these activities are important problem areas in both successful and unsuccessful marriages (9). The “Day at Home” has also been used to examine and to differentiate different cultural and sub-cultural family patterns (1, 3, 8, 11).

A brief description of the questionnaire will clarify the kinds of information derived from the subjects’ responses.

Wynne, Lyman C. (1969): Family Affairs. In: Family Process, 8 (1), S. 131–132. 

Glick, Ira (1969): Abstracts of Literature. In: Family Process, 8 (1), S. 133–137. 

Rabkin, Richard (1969): Book Reviews. In: Family Process, 8 (1), S. 138–139. 

Abstract: In the last issue I took the position that modern communication and systems theory supported the Leavis side of the Two Culture debate in asserting that a literary sensibility is probably a more fundamental judgment than anything that science can produce. If nothing else it acts as a gyroscope to keep scientific ventures on course. The most recent book to carry the late Don D. Jackson’s name (Lederer and Jackson, Mirages of Marriage reminds the reader of, perhaps, the most important case: romantic love. Although the book itself appears to be intended for the intelligent layman and is a nice addition to the biblio-therapy bookshelf, it is really the professional, particularly the family therapist or marriage counselor, who would benefit most from a thorough familiarity with the major critical point made in the book: that the notion of romantic love is the source of a great many of our most disastrous experiments in livingthe hippie movement notwithstanding.

Johnson, Lloyd A. (1969): Review – Families of the Slums, by Salvador Minuchin, Braulio Montalvo, Bernard G. Guerney, Jr., Bernice L. Rosman and Florence Schumer, New York, Basic Books, 1967; Black Families in White America, by Andrew Billingsley, Englewood Cliffs, New Jersey, Prentice Hall, 1968; Black Rage, by William H. Grier and Price M. Cobbs, New York, Basic Books, 1968; Marriage and Family Among Negroes, by Jessie Bernard, Englewood Cliffs, New Jersey, Prentice Hall, 1966. In: Family Process, 8 (1), S. 139–141. 

Hetrick, Emery S. (1969): Review – The Treatment of Families in Crisis, Donald G. Langsley, M.D. and David M. Kaplan, Ph.D., with the collaboration of Frank S. Dittman 3rd, M. D. Davel Machotka, PhD., Kalman Flomenhaft, M.S.W. A.C.S.W., and Carol D. DeYoung, R.N., M.S. New York, Grune and Stratton, 1968. In: Family Process, 8 (1), S. 141–142. 

Heft 2

Haley, Jay (1969): An Editor’s Farewell. In: Family Process, 8 (2), S. 149–158. 

Abstract: Since I am resigning as Editor of FAMILY PROCESS this will be my last issue. After eight years I think it is time someone with fresh enthusiasm took over the task. My wife, who has been the entire editorial staff of the journal over these years, looks forward to passing her duties on to others. The Editorial Board has selected Donald Bloch to succeed me, and he has my best wishes in the adventure ahead.

As the founding Editor of this journal, I have felt it necessary to help provide encouragement and guidance to the family field. It is with some relief that I give up that function, but there is also a certain nostalgia which leads me to make some comments about the journal and about the last two decades of family therapy and research.

Spitzer, Stephen P., Robert M. Swanson & Robert K. Lehr (1969): Audience Reactions and Careers of Psychiatric Patients. In: Family Process, 8 (2), S. 159–181. 

Abstract: The term “career” encompasses at least two notions. It refers to the sequence of movements from a position in any particular network of social relations to another position in the same or in a different social network, and to the individual adjustments accompanying the movement. The concept of career has received a wide variety of applications. Hughes (16) has applied it to the analysis of organizational adjustment, Hall (14) to medical education, and Becker (2) to marijuana users and jazz musicians.

Recently, the concept of career has been extended to the area of mental illness. According to Goffman (11), the career has three distinct phases: a prepatient phase, which describes the person in the community prior to hospitalization; an inpatient phase, which describes the person in the psychiatric treatment center; and a postpatient phase, which describes the person as he is back in the community after hospitalization. In describing the patient career, Goffman focuses on the consequences of being regarded as psychiatrically deviant, accommodating to institutional life, and forming alignments with persons in similar circumstances and hospital personnel. The purpose of this paper is to describe the careers of psychiatric patients as they are influenced, perhaps determined, by family reactions. Specifically, this paper identifies two dimensions of family reactions to deviancy and the relationship of each to the patient career.

Speck, Ross V. & Uri Rueveni (1969): Network Therapy-A Developing Concept. In: Family Process, 8 (2), S. 182–191. 

Abstract: A Social network is defined as that group of persons who maintain an ongoing significance in each other’s lives by fullfilling specific human needs (5). In working with the social network of a family containing a labelled schizophrenic person, we have sought to assemble all members of the kinship system, all friends of the family and wherever possible friends of kin of the family, plus the neighbors of the nuclear “schizophrenic” family. Experience with about a dozen such social networks would indicate that the typical lower middle class or middle class white urban “schizophrenic” family has the potential to assemble about 40 persons for network meetings.

Previous papers by Speck (1, 2, 3), Speck and Olans (4), Speck and Morong (5) have reported our experiences in treating the social networks of several schizophrenic families. The treatment of four additional social networks in the first six months of 1968 has added further experience particularly in supplying new concepts and methods.

Attneave, Carolyn L. (1969): Therapy in Tribal Settings and Urban Network Intervention. In: Family Process, 8 (2), S. 192–210. 

Abstract: Most professionals in therapy are aware of the importance of extended family and friends in the lives of their patients. In a growing wave of experimentation and innovation the walls of the one-to-one therapeutic model have been breached or rebuilt around new groupings. A variety of group process models, ranging from group therapy sessions, through sensitivity training and marathon week-ends, attempt to supply social settings artificially created. Family therapy has become established as one mode of incorporating an intimate social context into the consulting room. One of the newest groupings to be presented to the professional mental health community is Network Therapy.

Network Therapy seems to be based upon the concept of mobilizing the family, relatives and friends into a social force that counteracts the depersonalizing trend in contemporary life patterns. The concept appears particularly attractive to those attempting to counteract the isolation experienced by urban residents. Ross Speck refers to the networks as creating a “Clan” or “Tribal Unit” which can then support, oppose, expose and protect its members in effective ways (1, 2, 3, 4, 5). Such networks have been potent forces in breaking through the isolation of schizophrenic patients). Such networks have been potent forces in breaking through the isolation of schizophrenic patients, and Network Therapy in various forms could also be used in community psychiatry with other types of patient.

Hoffman, Lynn, Lorence Long & Edgar H. Auerswald (1969): A Systems Dilemma. In: Family Process, 8 (2), S. 211–234. 

Abstract: The current shift of interest, reflected in public policy, from the production of goods to the provision of services, has caused a major re-examination of the nature of the services the individual can expect from his society. This re-examination is producing a number of insights, some of them shocking. In particular, we are learning that many of the systems we have created to deliver services are, in the name of ‘progress’ and ‘civilization,’ contributing to the conditions of human distress they were designed to alleviate. Much has been written lately about how service systems of one kind or another subvert their announced goals-how a welfare system perpetuates poverty, or how the medical profession creates iatrogenic illness. There has not been very much written, however, about how several systems inadvertently combine in their day to day operations in such a way as to frustrate each others’ activities, and how, in so doing, they destroy in varying degrees the lives of people, or render it difficult for them to improve their lives. We have all been much too tightly locked in our own niches by training, experience, and various types of private interest to see this kind of interlock. It comes into sharp perspective only when one studies the problems of a single person in terms of his total life space, his ‘ecology.’ This paper represents an effort to describe one such situation in a family as viewed from a community health services program designed to approach human crises as ecological phenomena, and to explore and respond to them within this framework. We have found that the best way to organize our view of the environmental field people move in is according to the diverse systems which make it up, so we have labeled our theoretical base ‘ecological systems theory.’ (1) What is of particular interest to the behavioral scientist in the situation described is that neither individual nor family diagnosis, nor the contributions of the larger systems (in this case a housing system and a system of medical care) will, if viewed separately, explain the state of the man in question. Only when the contributions of all of these systems are made clear, and their interrelationships explored, do the origins of the phenomena described begin to emerge.

Sojit, Cloë M. (1969): Dyadic Interaction in a Doublebind Situation. In: Family Process, 8 (2), S. 235–259. 

Abstract: A Comparative study of parents of delinquents, ulcerative colitis patients and controls was done and the methodology and results of the investigation are reported here. Marital couples were exposed to a doublebind situation, a method of scoring their verbal transactions was developed, and significant relations between the communicational styles of these couples and the individual behavior or pathology in their children was found.

Fitzgera, R. V. (1969): Conjoint Marital Psychotherapy: Outcome and Follow-up Study. In: Family Process, 8 (2), S. 260–271. 

Abstract: This paper reports an outcome and follow-up study of conjoint marital psychotherapy conducted in a private-practice setting. The author’s approach is exclusively extramural, psychoanalytic in orientation and conservative in the use of sedatives and nepenthic drugs. These factors, no doubt, influenced both patients and referral sources and therefore acted as built-in selectors of the type of patients who came to him for therapy. No patients were rejected for any reason except genuine inability to afford private treatment.

Bodin, Arthur M. (1969): Family Therapy Training Literature: A Brief Guide. In: Family Process, 8 (2), S. 272–279. 

Abstract: Following in the footsteps of family therapy itself, the training literature is just emerging from its infancy. Some glaring gaps invite the attention of future authors. The relation of family therapy training to training in other forms of therapy is just one among the issues which, though not readily settled, might well be explored in future writings. Though much remains to be learned, codified, and eventually shared through writing in this field, the literature on family therapy has a promising start.

Beels, Christian & Andrew Ferber (1969): Family Therapy: A View. In: Family Process, 8 (2), S. 280–318. 

Abstract: This paper is a personal view of the literature of family therapy. It is written to inform those who, like ourselves, are second-generation family therapists, entering a field which began in the early 1950’s, and has since developed rapidly. The field has its journals, its books, its GAP committee, its training programs, its internal wars, its multiplying hundreds of practitioners, and, most important for us, its pioneering teachers. In an attempt to bring coherence out of the various teachings and practices of these leaders of the field, we try here to evaluate them by imposing upon them our own order, in the light of our own experience with teaching and practice.

Framo, James L., F. Gentry Harris, Lyman Wynne, Gerald H. Zuk, Christian Beels & Andrew Ferber (1969): Discussion of Beels & Ferber: „Family Therapy: A View“. In: Family Process, 8 (2), S. 319–331. 

Abstract: The preceding article was sent to the fifteen family therapists mentioned in it with an invitation to comment. Four therapists chose to respond, and their comments follow.

Wynne, Lyman C. (1969): Family Affairs. In: Family Process, 8 (2), S. 333–334. 

Abstracts Of Literature.  (1969): In: Family Process, 8 (2), S. 335–341. 

Rabkin, Richard (1969): Book Reviews. In: Family Process, 8 (2), S. 341–343. 

Abstract: The American Psychiatric Association (1) in collaboration with the U.S. Public Health Service (2) and the World Health Organization (3) has produced DSM-II (4), a diagnostic manual of mental disorders which fits into ICD-8 (5), the international diagnostic manual. Backed by international, national, and professional prestige of the highest caliber, it is specifically suggested for use in mental hospitals, clinics, offices, general hospitals, comprehensive community mental health centers, courts, textbooks, and industrial health services. In view of the organizations that stand behind it, it is virtually assured of use in all these systems as well as in schools and in research. It is therefore the most powerful and important publication in the behavioral sciences and of immediate concern to the family field. The problem is how we family-therapy-mice are going to bell the cat.

DSM-II, for all intents and purposes, is above criticismfor to criticize it would call into question organizations that are sacrosanct by their very nature. Yet it seems that such an achievement deserves notice, a thoughtful welcome. Possibly even some acknowledgment of fealty is due since, as the Foreword points out, there are three trends that this publication exemplifies: international unity, the rapid integration of psychiatry with the rest of medicine, and a clear statement of that which the “well informed psychiatrist” believes. It, therefore, is only fitting for the American Psychiatric Association like its brother association, the American College of Physicians, to direct the A.P.A. Office of Continuing Education to sponsor a self-administered, elective test in September, 1969, for its members, one in which only the participant will know his score. The psychiatrist will presumably be stimulated to keep up-to-date, and this will require intimate knowledge of DSM-II.

Long, Lorence (1969): Review – The Subversive Science: Essays Toward an Ecology of Man, Boston, Houghton, Mifflin Co., 1969. In: Family Process, 8 (2), S. 343–344. 

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