Urban

Wednesday, March 11, 2015

 

Resilience in the Individual and in the Family System

Webster's Dictionary (1974) defines resilience as "an ability to recover from or adjust easily to change or misfortune" (p. 596). Although this definition is widely accepted, resilience may be conceptualized as being more than merely bouncing back from setbacks. Resilience may also be the ability to bounce forward in the face of an uncertain future (Walsh, 2004). Resilience has been conceptualized as the forging of strengths through adversity (Wolin & Wolin, 1993). Like the willow tree, people thrive if they have a strong, healthy root system. With branches flexible enough to bend with the storm and firm enough to weather strong winds without breaking, the willow tree can continue to grow despite being twisted into differing shapes. The willow tree may be a metaphor for the resilient individual and resilient family system. Resiliency is critical to mental health and healthy aging.

Bonanno (2004) defined adult resilience as a person's capacity to resist maladaptation in the face of risky experiences. Bonanno's individually-based definition of adult resilience assumes that resilience resides in the person, an observation supported by the list of individual attributes that covary with resilient outcomes in Bonanno's work (hardiness, self-enhancement, repressive coping, and positive emotion.). Importantly, this definition of resilience does not identify the positive outcomes that can result from adversity in the hardy individual. Despite Bonanno's (2004) narrow definition, his analysis includes an interesting finding that loss and brief traumatic experiences, despite being aversive and difficult to accept, are normatively not sufficient to overwhelm the adaptive resources of ordinary adults. Bonanno's research calls into question the research of Sameroff, Bartko, Baldwin, Baldwin, and Seifer (1998), which demonstrated in longitudinal analyses that as levels of adversity rise, and as resources fall, resilience becomes less tenable.

Rutter (1985) observed that strong self-esteem and self-efficacy make successful coping more likely, whereas a sense of helplessness increases the likelihood that one crisis will lead to another. In a similar vein, Kobasa's (1985) research findings supported his hypothesis that people with resilience possess three general traits: (1.) the belief that they can influence or control events in their lives; (2.) an ability to feel deeply committed and involved in activities in their lives; and (3.) a tendency to embrace change as an opportunity to grow and develop more fully. Thus, resilient children are more likely to have an inner locus of control (Seligman, 1990), or an optimistic belief that they can positively impact their fate.

Dugan and Coles (1989) suggest that individuals prevail over adversity more effectively if they have moral and spiritual resources. In a phenomenological study of nine subjects who had experienced such traumas as life in a concentration camp, disability, breast cancer, massive head injury, a life of violence and abuse, and loss of a child, Rose (1997) identified similar themes of resilience which emerged from individual interviews: the role of supportive others, empathy, self-care, faith, action orientation, moving on, positive outlook, and persistence. Rose identifies the foundational structure of resilience as faith, self-respect, striving, supportive others, coping, empathy, self-reliance, and moving on.

Closer scrutiny of children and families that are at risk reveals many exceptions to the "damage model" of development, which considers stress or disadvantage as predictive of dysfunction. For example, Werner and Smith (1992) conducted an extensive longitudinal study of almost a half a century of children from Kuai. The researchers found that in spite of early medical distress, poverty, school difficulties, teen pregnancy, or arrest, children were able to learn and persevere through difficulty, given adequate supports. In their analysis of how these impoverished children matured successfully, Vaillant (2002) notes that Werner and Smith emphasized, ". . . the importance of being a 'cuddly' child and of being a child who elicits predominantly positive responses from the environment and who manifests great skill at recruiting substitute parents" (p. 285). Werner and Smith point out that key turning points for most of these troubled individuals were meeting a caring friend and marrying an accepting spouse. It is also salient that Werner and Smith found that more girls than boys overcame adversity at all age levels. Walsh (2004) speculates that this finding reflects the notion that ". . . girls are raised to be both more easygoing and more relationally-oriented, whereas boys are taught to be tough and self-reliant through life. . . [and] often because of troubled family lives, competencies were built when early responsibilities were assumed for household tasks and care of younger siblings" (pp. 13-14). Werner and Smith's study is especially important in reminding clinicians that early life experiences do not necessarily guarantee significant problems in later life. Walsh (2004) suggests that their most significant finding is that resilience can be developed at any point over the course of the life cycle. Walsh extrapolates from Werner and Smith's research that ". . . unexpected events and new relationships can disrupt a negative chain and catalyze new growth" (p. 14). Favorable interactions with individuals, families and their environments have a systemic effect of moving resilience in upward spirals, and a downward spiral can be reversed at any time in life (Walsh, 2004).

Felsman and Vaillant (1987) followed the lives of 75 males living in impoverished, socially disadvantaged families. People who suffered from substance abuse, mental illness, crime and violence parented these men. Several of these men, although scarred by their childhoods, lived brave lives and became high functioning adults. Felsman and Vaillant concluded, "The events that go wrong in our lives do not forever damn us" (1987, p. 298).

Another study refuting the accuracy of the "damage model" is Kaufman and Zigler's (1987) finding that most survivors of childhood abuse do not go on to abuse their own children. Similarly, other research found that children of mentally ill parents or dysfunctional families have been able to prevail over early experiences of abuse or neglect to lead productive lives (Anthony, 1987; Cohler, 1987; Garmezy, 1987).

Werner (1995) identified clusters of protective factors that have emerged as recurrent themes in the lives of children who overcame great odds. The protective factors that were characteristic of the individual were myriad. Resilient youngsters are engaging to other people. Additionally, they excel in problem-solving skills and display effective communication skills. Problem solving skills included the ability to recruit substitute caregivers. Moreover, they have a talent or hobby valued by their elders or peers. Finally, they have faith that their own actions can make a positive difference in their lives.
From a developmental perspective, Werner (1995) emphasizes that having affectional ties that encourage trust, autonomy, and initiative enhances resilience. Members of the extended family or support systems in the community frequently provide these ties. These support systems reinforce and reward the competencies of resilient children and provide them with positive role models. Such supports may include caring neighbors, clergy, teachers, and peers.

In Vaillant's (2002) Study of Adult Development at Harvard University, arguably the longest longitudinal study on aging in the world, it is suggested that resiliency researchers who focus on risk factors and pathology are mistaken in believing that misfortune condemns disadvantaged children to bleak futures. Instead, Vaillant calls upon clinicians to count up the positive and the protective factors when conducting assessments. Vaillant cites Sir Michael Rutter (1985), who reminds clinicians, "The notion that adverse experiences lead to lasting damage to personality 'structure' has very little empirical support" (p. 598).

Vaillant (2002) identifies four protective factors in the individual's potential to age well. A future orientation, a capacity for gratitude and forgiveness, a capacity to love and to hold the other empathically, and the desire do things with people instead of to people are personal qualities identified as resiliency factors. He posits that ". . . marriage is not only important to healthy aging, it is often the cornerstone of adult resilience" (p. 291).

Furthermore, Vaillant (2002) describes resilience as being a combination of nature and nurture. Both genes and environment play crucial roles. He explains, "On one hand, our ability to feel safe enough to deploy adaptive defenses like humor and altruism is facilitated by our being among loving friends. On the other hand, our ability to appear so attractive to others that they will love us is very much dependent upon the genetic capacity that made some of us 'easy' attractive babies" (p. 285).

An essential part of resilience is ". . . the ability to find the loving and health-giving individuals within one's social matrix wherever they may be" (Vaillant, 2002, p. 286). Thus, like Werner and Smith (1992), Vaillant's research identified extended families and friendship networks as key foundations to resilience in the individual and the family system.

American culture glorifies the "rugged individual." John Wayne, the personification of masculinity and strength, has been adored by generations of Americans as a hero. However, there is an inherent danger in the myth of rugged individualism, which implies that vulnerability and emotional interdependence are weak and dysfunctional (Walsh, 2004). As Felsman and Vaillant (1987) note, "The term 'invulnerability' is antithetical to the human condition. . . In bearing witness to the resilient behavior of high-risk children everywhere, a truer effort would be to understand, in form and by degree, the shared human qualities at work" (p. 304). Avoidance of personal suffering and the glorification of stoicism are hallmarks of American culture. Such cultural attitudes are typified by the call to "move on," to "cheer up," to get over catastrophic events, to put national and global tragedies behind us, or to rebound (Walsh, 2004). Higgins (1994) notes that struggling well involves experiencing both suffering and courage, effectively processing and working through challenges from intrapersonal and interpersonal perspectives. In Higgin's study of resilient adults, it became clear that they became stronger because they were severely tested, endured suffering, and developed new strengths as a result of their trials. These adults experienced their lives more deeply and passionately. Walsh (2004) observes that over fifty per cent of the resilient individuals studied by Higgins were therapists. Egeland, B. R., Carlson, E. and Sroufe (1993) offer an alternative approach to thinking about resilience as ". . . a family of processes that scaffold successful adaptation in the context of adversity" (p. 517).

Important research conducted by Wolin and Wolin (1993) points toward the notion that although some children are born with innate resiliencies, resiliency can be modeled, taught, and increased. They emphasize that persons tend to seek healing from pain instead of holding on to bitterness. The researchers note that the resilient person draws lessons from experience instead of repeating mistakes, and that they maintain openness and spontaneity in their relationships rather than becoming rigid or bitter in interaction. Wolin and Wolin also found that resiliency in individuals is strongly correlated with humor and creativity, as well as mental and physical health. The Wolins identify seven traits of adults who survived a troubled childhood: insight (awareness of dysfunction), independence (distancing self from troubles), relationships (supportive connections with others), initiative (self/other-help actions), creativity (self-expression, transformation), humor (reframing in a less threatening way), and morality (justice and compassion rather than revenge). Traits are viewed as dynamic processes by which resilient individuals adapt to and grow through challenge, rather than static properties that automatically protect the invulnerable. These observations are correlated with empirical studies of resilient children (Baldwin, Baldwin, & Cole, 1990; Bernard, 1991; Garbarino, 1992; Masten, Best, & Garmezy, 1990; Werner & Smith, 1992) and adults (Klohnen, Vandewater, and Young, 1996, Vaillant, 2002).

Walsh (2004) asserts, "In the field of mental health, most clinical theory, training, practice, and research have been overwhelmingly deficit-focused, implicating the family in the cause or maintenance of nearly all problems in individual functioning. Under early psychoanalytic assumptions of destructive maternal bonds, the family came to be seen as a noxious influence. Even the early family systems formulations focused on dysfunctional family processes well in the mid-1980's" (p. 15).

The popularity of the Adult Children of Alcoholics Movement surged in the late twentieth century and encouraged people to blame their families for their problems. This movement tempted the individual to make excuses for his behavior in terms of his dysfunctional family history instead of looking for family strengths that might help him/her overcome challenge and become stronger. Adult Children of Alcoholics ". . . spend much of their time other-focused, and it is easy for them to become preoccupied with another group member's problem, take responsibility for it, and avoid the painful job of self-examination and taking responsibility for their own behavior" (Lawson & Lawson, 1998, p. 263).

In contrast to this damage model, the Wolins offered an alternative way to view challenging family backgrounds: a Challenge Model to build resilience, stating that ". . . the capacity for self-repair in adult children of alcoholics taught [them] that strength can emerge from adversity" (p. 15). The Wolins reflect a paradigm shift in recent years, as family systems therapists have started to focus upon a competence-based, strength-oriented approach (Barnard, 1994; Walsh, 1993, 1995a). A family resilience approach builds on recent research, empowering therapists to move away from deficit and focus upon ways that families can be challenged to grow stronger from adversity (Walsh, 2004). From the perspective of the Challenge Model, stressors can become potential springboards for increased competence, as long as the level of stress is not too high (Wolin & Wolin, 1993). Walsh notes, "The Chinese symbol for the word 'crisis' is a composite of two pictographs: the symbols for 'danger' and 'opportunity'" (p. 7). Wolin and Wolin (1993) observe that we may not wish for adversity, but the paradox of resilience is that our worst times can also become our best.

It is clear that the extensive research on resilient individuals largely points toward the social nature of resilience. However, most resiliency theory has approached the systemic context of resilience tangentially, in terms of the influence of a single, important person, such as a parent or caregiver (Bowlby, 1988). Looking at resilient family functioning through a systemic lens calls upon the clinician to view individual resilience as being embedded in family process and mutual influence (Walsh, 2004). Walsh suggests that if ". . . researchers and clinicians adopt a broader perspective beyond a dyadic bond and early relationships, [they] become aware that resilience is woven in a web of relationships and experiences over the course of the life cycle and across the generations" (p. 12).

It has only been in the last twenty five years or so that families that cope well under stress have been the subject of research (Stinnet & DeFrain, 1985; Stinnett, Knorr, DeFrain, & Rowe, 1981). A growing body of knowledge has pointed toward the multidimensional nature of family processes that distinguish adaptive family systems from maladaptive family systems (Walsh, 2004). Walsh (2004) defines "family resilience" as ". . . the coping and adaptational processes in the family as a functional unit," [and adds that]. . . a systems perspective enables us to understand how family processes mediate stress and enable families to surmount crisis and weather prolonged hardship" (p. 14). Strong families create a climate of optimism, resourcefulness, and nurturance which mirrors the traits of resilient individuals (Walsh, 2004). In fact, research on family adaptation and on family strengths suggests the following traits of resilient families: commitment, cohesion, adaptability, communication, spirituality, effective resource management, and coherence (Abbott, et al., 1990; Antonovsky, 1987; Beavers & Hampson, 1990; Moos & Moos, 1976; Olson, Russell, & Sprenkle, 1989; Reiss, 1981; Stinnett, et al., 1982). Walsh observes, ". . . a family resilience lens fundamentally alters our perspective by enabling us to recognize, affirm, and build upon family resources" (Walsh, 2004, p. viii). Rutter's (1987) research added further confirmation that resilience is fostered in family interactions through a chain of indirect influences that inoculate family members against long-term damage from stressful events. It is essential to consider family resilience as a major variable in a family's ability to cope and adapt in the face of stress (McCubbin, McCubbin, McCubbin, & Futrell, 1995).

Bennett, Wolin, and Reiss (1988) concluded from their research that children who grew up in alcoholic families that deliberately planned and executed family rituals, valued relationships, and preferred roles were less likely to exhibit behavior or emotional problems. They argue that families with serious problems, such as parental alcoholism, which can still impose control over those parts of family life that are central to the family's identity, communicate important messages to their children regarding their ability to take control of present and future life events. These messages can determine the extent to which the children are protected from developing future problems, including alcoholism in adolescence and adulthood.

Patterson (1983) asserts that it is only to the extent that stressors interrupt important family processes that children are impacted. However, from a systemic perspective, it is not only the child who is vulnerable or resilient; most salient is how the family system influences eventual adjustment (Walsh, 2004). Even those family members who are not directly touched by a crisis are profoundly affected by the family response, with reverberations for all other relationships (Bowen, 1978). Following from these ideas, it is clear that "Slings and arrows of misfortune strike us all, in varying ways and times over each family's life course. What distinguishes healthy families is not the absence of problems, but rather their coping and problem-solving abilities" (Walsh, 2004, p. 15).
From an ecological perspective, Rutter (1987) suggests that it is not enough to take into account the sphere of the family as influencing risk and resilience in the individual and family life cycles. He emphasizes that it is also incumbent upon therapists to assess the interplay between families and the political, social, economic, and social climates in which people either thrive or perish. Rutter's findings suggest that it is insufficient to focus exclusively on bolstering at-risk individuals and families, but there must also be public policy efforts to change the odds against them.
In the twenty first century, it is apparent that the configuration of the family is shifting. Diverse forms of family systems do not inherently damage children (Walsh, 2004). Walsh emphasizes, "It is not family form, but rather family processes, that matter most for healthy functioning and resilience" (p. 16).

One family process that governs how a family responds to a new situation is the way in which shared beliefs shape and reinforce communication patterns (Reiss, 1981). Hadley and his colleagues (1974) found that a disruptive transition or crisis could potentiate a major shift in the family belief system, with both immediate and long-term effects on reorganization and adaptation. Additionally, Carter and McGoldrick (1999) suggest that how a family perceives a stressful situation intersects with legacies of previous crises in the multigenerational system to influence the meaning the family makes of the adversity and its response to it.

Walsh (2004) asserts, "A cluster of two or more concurrent stresses complicates adaptation as family members struggle with competing demands, and emotions can easily spill over into conflict. . . . Over time, a pileup of stressors, losses, and dislocations can overwhelm a family's coping efforts, contributing to family strife, substance abuse, and emotional or behavioral symptoms of distress (often expressed by children in the family)" (p. 21). Figley (1989) noted that catastrophic events that occur suddenly and without warning can be particularly traumatic. Bowen (1978) suggested that shock wave effects of a trauma might reverberate through the system and extend forward into multiple generations. Thus, Walsh (2004) calls upon therapists to take a systemic approach to intervention in the face of crisis, with interventions that ". . . strengthen key interactional processes that foster healing, recovery, and resilience, enabling the family and its members to integrate the experience and move on with life" (p. 22).

To understand resilience, one must also look through a developmental lens (Carter & McGoldrick, 1999). Neugarten (1976) found that stressful life events are more apt to cause maladaptive functioning when they are unexpected. Also, multiple stressors create cumulative effects, and chronic severe conditions are more likely to affect functioning adversely. However, Cohler (1987) and Vaillant's (1995) research found that the role of early life experience in determining adult capacity to overcome adversity is less important than was previously believed. Thus, discontinuity and long-term perspectives on the individual and family life cycle point toward the idea that people are constantly "becoming" and have life courses that are flexible and multidetermined (Falicov, 1988). Furthermore, Walsh (2004) suggests that ". . . an adaptation that serves well at one point in development may later not be useful in meeting other challenges" (p. 13). Research has pointed toward a greater risk in vulnerability for boys in childhood and for girls in adolescence (Elder, Caspi, & Nguyen, 1985; Werner & Smith, 1982). All these variables highlight the dynamic nature of resilience over time.

In the field of family therapy, it is incumbent upon researchers and practitioners to recognize that successful treatment depends as much on the resources of the family as on the resources of the individual or the skills of the clinician (Karpel, 1986; Minuchin, 1992). Family processes can influence the aftermath of many traumatic events, reverberating into the course of the lives of people in future generations. Individual resilience must be understood and nurtured in the context of the family and vice-versa. Both immediate crisis and chronic stressors affect the entire family and all its members, posing threats not only to the individual, but also for relational conflict and family breakdown in current and future generations. Family processes may mediate the impact of crisis on all members and their relationships. Protective processes build resilience by promoting recovery and buffering stress. Indeed, healthy family processes influence the effects of present and future crises far into the future (Bowen, 1978; Kerr & Bowen, 1988). Since all families and their members have the potential to become more resilient, family therapists should work to maximize that potential by strengthening key processes within the individual and within the system.

References Abbott, D. A., & Meredith, W. (1988). Characteristics of strong families: Perceptions of ethnic parents. Home Economics Research Journal, 17, 140-147.

Anthony, E. J. (1987). Risk, vulnerability, and resilience: An overview. In E. J. Anthony & B. Cohler (Eds.), The invulnerable child. New York: Guilford Press.

Anatovsky, A. (1987). Unraveling the mystery of health: How people manage stress and stay well. San Francisco: Jossey-Bass.

Baldwin, A. L., Baldwin, C., & Cole, R. E. (1990). Stress-resistant families and stress-resistant children. In J. Rolf, A. S. Mastern, D. Chichetti, K. H. Neuchterlein, and S. Weintraub (Eds.), Risk and protective factors in the development of psychopathology (pp. 257-280). New York: Cambridge University Press.

Beavers, W. R., & Hampson, R. B. (1990). Successful families: Assessment and intervention. New York: Norton.

Bennett, L. A., Wolin, S. J., & Reiss, D. (1988). Deliberate family process: A strategy for protecting children of alcoholics. British Journal of Addiction, 83, 821-829.

Bernard, B. (1991). Fostering resiliency in kids: Protective factors in the family, school, and Community. Western Regional Center for Drug-free Schools and Communities.

Bonanno, G. A. (2004). Loss, trauma, and human resilience: Have we underestimated the human capacity to thrive after extremely aversive events? American Psychologist, 59, 20-28.

Bowen, M. (1978). Family therapy in clinical practice. New York: Jason Aronson.

Bowlby, J. (1988). A secure base: Parent-child attachment and healthy human development. New York: Basic Books.

Carter, B., & McGoldrick, M. (Eds.). (1999). The expanded family life cycle: Individual, family, and social perspectives (3rd ed.). Boston, MA: Allyn and Bacon.

Cohler, B. (1987). Adversity, resilience, and the study of lives. In E. J. Anthony & B. Cohler (Eds.), The invulnerable child. New York: Guilford Press.

Dugan, T., & Coles, R. (Eds.). (1989). The child in our times: Studies in the development of resiliency. New York: Brunner/Mazel.

Elder, G., Caspi, A., & Nguyen, T. V. (1985). Resourceful and vulnerable children: Family influences in hard times. In R. K. Silbereisen & K. Eyferth (Eds.), Development in context. New York: Springer.

Egeland, B. R., Carlson, E., & Stroufe, L. A. (1993). Resilience as process. Development and Psychopathology, 5, 517-528.

Falicov, C. J. (Ed.). (1988). Family transitions: Continuity and change over the life cycle. New York: Guilford Press.

Felsman, J. K., & Vaillant, G. (1987). Resilient children as adults: A 40-year study. In E. J. Anthony & B. Cohler (Eds.), The invulnerable child. New York: Guilford Press.

Figley, C. (1989). Helping traumatized families. San Francisco: Jossey-Bass.

Garbarino, J. (1992). Children and families in the social environment. New York: Aldine deGruyter.

Garmezy, N. (1987). Stress, competence, and development: Continuities in the study of schizophrenic adults, children vulnerable to psychopathology, and the search for stress-resistant children. American Journal of Orthopsychiatry, 57, 159-174.

Hadley, T., Jacob, T., Miliones, J., Caplan, J., & Spitz, D. (1974). The relationship between family developmental crises and the appearance of symptoms in a family member. Family Process, 13, 207-214.

Higgins, G. O. (1994). Resilient adults: Overcoming a cruel past. San Francisco: Jossey-Bass. Karpel, M. (1986). Family resources: The hidden partner in family therapy. New York: Guilford Press.

Kaufman, J., & Zigler, E. (1987). Do abused children become abusive parents? American Journal of Orthopsychiatry, 57, 186-192.

Kerr, M. E., & Bowen, M. (1988). Family evaluation: An approach based on Bowen theory. New York: W. W. Norton & Company.

Klohnen, E. C., Vandewater, E. A., & Young, A. (1996). Negotiating the middle years: Ego-resiliency and successful midlife adjustment in women. Psychology and Aging, 11, 431-442.

Kobasa, S. (1985). Stressful life events, personality, and health: An inquiry into hardiness. In A. Monat & R. Lazarus (Eds.), Stress and coping (2nd ed.). New York: Columbia University Press.

Lawson, A., & Lawson, G. (1998). Alcoholism and the family: A guide to treatment and prevention (2nd ed.). Gaithersburg, Maryland: Aspen Publishers.

Masten, A. S., Best, K. M., & Garmezy, N. (1990). Resilience and development: Contributions from the study of children who overcome adversity. Development and Psychopathology, 2, 425-444.

McCubbin, H., McCubbin, M., McCubbin, A., & Futrell, J. (Eds.). (1995). Resiliency in ethnic minority families: Vol. 1. Native and immigrant families. Madison: Center for Excellence in Family Studies, University of Wisconsin.

Minuchin, S. (1992). Family healing: Strategies for hope and understanding. New York: Macmillan.

Moos, R., & Moos, B. S. (1976). A typology of family social environments. Family Process, 15, 357-371.

Neugarten, B. (1976). Adaptation and the life cycle. The Counseling Psychologist, 6, 16-20. Olson, D. H., Russell, C. S., & Sprenkle, D. H. (Eds.). (1989). Circumplex model of marital and family systems. In F. Walsh (Ed.), Normal family processes (2nd ed.). New York: Guilford Press.

Patterson, G. (1983). Stress: A change agent for family process. In N. Garmezy & M. Rutter (Eds.), Stress, coping, and development in children. New York: McGraw-Hill.

Reiss, D. (1981). The family's construction of reality. Cambridge, MA: Harvard University Press.

Rose, J. M. (1997). Footprints on the soul: Journeys from trauma to resilience (Doctoral Dissertation, The Fielding Institute, 1997). Dissertation Abstracts International, 57, 7227.

Rutter, M. (1985). Resilience in the face of adversity: Protective factors and resistance to psychiatric disorder. British Journal of Psychiatry, 147, 598-611.

Rutter, M. (1987). Psychosocial resilience and protective mechanisms. American Journal of Orthopsychiatry, 57, 316-331.

Sameroff, A. J., Bartko, W. T., Baldwin, A., Baldwin, C., & Seifer, R. (1998). Family and social influences on the development of child competence. In M. Lewis & C. Feiring (Eds.), Families, risk, and competence (pp. 161-185). Mahwah, NJ: Erlbaum.

Seligman, M. (1990). Learned optimism. New York: Random House.

Stinnett, N., & DeFrain, J. (1985). Secrets of strong families. Boston: Little, Brown.

Stinnett, N., Knorr, B., DeFrain, J., & Rowe, G. (1981). How strong families cope with crises. Family Perspective, 15, 159-166.

Stinnett, N., Sander, G., DeFrain, J., & Parhhurst, A. (1982). A nationwide perspective of families who perceive themselves as strong. Family Perspective, 16, 15-22.

Vaillant, G. (1995). Adaptation to life. Cambridge, MA: Harvard University Press.

Vaillant, G. E. (2002). Aging well. New York: Little, Brown and Company.

Walsh, F. (1998). Strengthening family resilience. New York: The Guilford Press.

Werner, E. E. (1995). Resilience in development. Current Directions in Psychological Science, 4, 81-85.

Werner, E. E., & Smith, R. S. (1982). Vulnerable, but invincible: A study of resilient children. New York: McGraw-Hill.

Werner, E. E., & Smith, R. S. (1992). Overcoming the odds: High risk children from birth to adulthood. Ithica, NY: Cornell University Press.

Wolin, S. J., & Wolin, S. (1993). The resilient self: How survivors of troubled families rise above adversity. New York: Villard.

Dr. Barbara Cunningham, MFT

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Tuesday, June 01, 2010

 

A Review of The Family Crucible

The Family Crucible, by Napier and Whitaker (1978), reads like a novel while at the same time laying down some of the fundamental concepts of family systems therapy. It is a case study of one family's experience in family therapy. While the therapy shifts from daughter to son and then to parent interaction to daughters and son, it is finally the couple's marriage that must be treated if issues are to be resolved. Even the grandparents are brought into therapy to get at the family of origin issues.

The book opens with a quote from James Agee and Walker Evans: "The family must take care of itself; it has no mother or father; there is no shelter, nor resource, nor any love, interest, sustaining strength or comfort, so near, nor can anything happy or sorrowful that comes to anyone in this family possibly mean to those outside it what it means to those within it; but it is, as I have told, inconceivably lonely, drawn upon itself as tramps are drawn round a fire in the cruelest weather; and thus and in such loneliness it exists among other families, each of which is no less lonely, nor any less without help or comfort, and is likewise drawn in upon itself."

Through the telling of the Brice family's story, Napier and Whitaker illustrate underlying dynamics such as structural imbalances in the system and how child focus is a typical method used by unhappy couples to avoid dealing with their own marital and family of origin issues. Fusion, triangles, individual and family life cycle stages, family-of-origin themes, polarization, reciprocity, blaming, and the hierarchy and characteristics of living systems are among the concepts that are explained and illustrated through this family's therapy experience. David and Carolyn, an unhappily married couple, are the parents of Claudia (the IP), Laura, and Don. The book is well written and hard to put down once you start reading it.

Whitaker has been criticized in the field, because many people believe that he does not really have a theory. It is believed that it is only his charismatic personality that drives his treatment. I disagree. I believe that one has only to read his chapter in The Handbook of Family Therapy (1981) and see these concepts illustrated in The Family Crucible to realize the depth and breadth of his theory.

In the service of reviewing the book, it is useful to consider Whitaker's background and key theoretical concepts. He began as an OB/GYN and had no formal psychiatric training. He became involved in treating schizophrenics after World War II. Whitaker was interested in understanding disturbed relationships in a familial context and in determining whether serious symptoms such as those in psychotics might be reinforced by dysfunctional family patterns and beliefs.

From 1946 to 1955, Whitaker (1981) became involved in treating schizophrenia with a type of aggressive play therapy. In fact, Whitaker's most formative training was in a child guidance clinic where he learned play therapy (Whitaker, 1981). Whitaker used some outrageous methods, including learning to talk "crazy," arm wrestling, use of a baby bottle, and rocking, all of which were rooted in his training experience.

At the same time that he developed these techniques, he developed a kind of pyknolepsy, wherein he would fall asleep in the middle of a session. He would dream about his relationship with the patient being treated, and then make his associations to the dream a part of the therapy session (Whitaker, 1981). In justifying his unique techniques, Whitaker emphasized that "Each technique is a process whereby the therapist is developing himself and using the patient as an intermediary, that is the therapist is interacting in a primary process model" (p. 188).

In 1946, Whitaker (1981) moved to Emory, where he became chair of the Department of Psychiatry. It was here that he developed dual co-therapy with Dr. Thomas Malone. In 1964, Whitaker worked with David Keith to develop a postgraduate specialty in MFT at the University of Wisconsin School of Medicine. The development of symbolic-experiential methodology required students to ". . . take everything said by the patient as symbolically important as well as realistically factual" (Whitaker, 1981, p. 189).

Whitaker (1981) defined health as ". . . a process of perpetual becoming" (p. 190). He emphasized that what is most important in a healthy family is ". . . the sense of an integrated whole. . . The healthy family is not a fragmented group nor a congealed group. . . The healthy family will utilize constructive input and handle negative feedback with power and comfort. The group is also therapist to the individuals" (p. 190). Whitaker also defines the healthy family as ". . . a three to four generational whole that is longitudinally integrated. . . maintaining a separation of the generations. Mother and father are not children and the children are not parents" (p. 190). Whitaker also looked at the degree of volitional access parents and children have to outside support and interests. The families of origin in healthy families are on friendly terms.

Importantly, Whitaker looked to spontaneity as a marker of healthy communication in families. The healthy family allows each member to admit to problems and to identify competencies. Thus, it is emphasized that healthy families allow great freedom for the individual to be himself. Whitaker (1981) states that ". . . normal families do no reify stress" (p. 190).

Whitaker (1981) emphasized that a basic characteristic of all healthy families is the availability of an "as if" structure, which permits different family members to take on different roles at different times. Roles result from interaction instead of being rigidly defined. They are defined by various conditions, including the past, present, future, culture, and demands of the family at a given time. On the other hand, Whitaker defined the dysfunctional family as ". . . characterized by a very limited sense of the whole" (p. 194). Lack of flexibility at times of change, covert communication, intolerance of conflict, lack of spontaneity, lack of empathy, blaming and scapegoating, a lack of playfulness, and little sense of humor are all markers of unhealthy families from Whitaker's perspective.

Whitaker placed heavy emphasis on the technique of co-therapy. In The Family Crucible, for example, the reader constantly witnesses Whitaker and Napier turn up the power. Whitaker and Napier's process techniques illustrated in the book are designed to disorganize rigid patterns of behavior directly in session. The exposure of covert behaviors is considered to be the family's misguided effort to stay in tact by submerging real feelings. There is a decisive here-and-now quality to symbolic-experiential interventions used in The Family Crucible, with a focus upon creating and then addressing en vivo emotional dynamics in therapy session.

Napier and Whitaker insisted that the entire Brice family be present in therapy. Indeed, Whitaker's symbolic-experiential treatment model considered it crucial to begin the treatment process with the entire family (Napier and Whitaker, 1978). Whitaker (1981) has emphasized that "Our demand to have the whole family in is the beginning of our 'battle for structure.' It begins with the first phone call" (p. 204). He asserts that it is ". . . difficult to do process-focused family therapy without the children" and the ". . . experiential quality of family therapy requires the children's presence" (p. 205). In the book, Napier and Whitaker (1978) frequently attempt change through playing and teasing, especially with Laura, Don, and Claudia. Members from David and Carolyn's families of origin are invited to session. Whitaker (1981) states that in arranging for four generations to come to interviews as consultants that he is ". . . helping to evolve a large system anxiety" (p. 204). Experience is privileged over cognitive engagement throughout the treatment with the Brice family, as it is conceptualized that experience trumps cognitive growth in this theory.

Napier and Whitaker (1978) describe their co-therapy as symbolic of a professional marriage. Early treatment of the Brice family involved the co-therapists making decisions. Symbolically, they viewed the family as a baby taking its first steps. As such, the family required structure, so it follows that the therapists made unilateral decisions. Once Napier and Whitaker had won the battle for control, the therapists, like parents raising children, soften considerably. In the middle phase of the Brice family's treatment, decisions about treatment were made more collaboratively. Again, the model for this process is increasing differentiation of the family. As therapy proceeded, the therapists took increasingly smaller roles, watching like proud parents as the Brice family became more integrated into changing themselves independent of the therapists. Whitaker (1981) clarifies that the therapy process ". . . begins with infancy and goes to late adolescence, where the initiative is with the kids, who then bear responsibility for their own living" (p. 107).

Throughout the book, it is implicitly and explicitly emphasized that the self-development of the therapists is the most important variable in the success of therapy. Napier and Whitaker (1978) acted as coaches or surrogate grandparents to the Brice family as therapy progressed. They were active and considered themselves to be the forces for change. Rather than a blank screen, they acted as allies of the family system. Especially in the beginning, Napier and Whitaker were directive. They used silence, confrontation and other anxiety-building techniques to unbalance the system. They acted as catalysts, who picked up on the unspoken and discovered the undercurrents represented by the family's symbolic communication patterns. The co-therapists privileged their subjective impressions.

More than anything else, Napier and Whitaker (1978) had the courage to be themselves. They knew how to meet the absurdities of life and how to bring out people's primary impulses. They believed strongly in the healing power of the human being, and, even more, of the family. They insisted that the family be in contact with its own craziness, play, and honor the spontaneous through their own modeling and directing.

The reader could observe how this symbolic-experiential therapy team moved through several stages. In the early part of treatment, the co-therapists battle for structure and they are all-powerful. In the mid-phase, the parental team functioned as stress activators, growth expanders, and creativity stimulators. Late in treatment, the co-therapists sat back and watched, respecting the independent functioning of the family. Whitaker (1981) holds that the "The sequence of joining and distancing is important. It is a lot like being with children. A father can get furious with his kids one minute, then be loving the next. We take the same stance with families" (p. 205). Thus, the role of the co-therapists was dynamic over the course of treatment with the Brice family.

Whether as a training therapist or a lay reader, it is inspirational to study the therapy offered by Napier and Whitaker (1978) in The Family Crucible. Self-disclosure, creative play, teaching stories, spontaneous interpersonal messages, the use of metaphor, and the sharing of parts of the therapists' lives that reflect a working through in their own living are used generously. Process techniques intended to activate confusion around Claudia, the identified patient, unbalance the system, and open up authentic dialogue between marital partners and between the generations of extended families are used. It is emphasized, however, that it is not technique, but personal involvement that enabled Whitaker and Napier (1978) to do their best. It is continually illustrated how symbolic (emotional) experiences are fundamentally formative in the treatment of families, illustrated poignantly with the Brice family. Therefore, such experience should be created in session. To expose the covert world beneath the surface world is the most curative factor for the Brice family, is it is for all families. By getting inside the Brice family's unique language and symbolic system, the therapists were able to move the family's awareness from the content level to the symbolic level.

In THE FAMILY CRUCIBLE, Napier (1978) describes the curative process of Whitaker's family therapy from the perspective of the co-therapist. The courage to embrace life's absurdities involves the courage to be oneself, to the point of even sharing your free associations and thoughts with families. Daring to participate in the lives of the families, or even inviting them to share in your own life in order to get them in contact with submerged associations, helps families to get to the primary process level. In fact, the book underlines that the force of the therapist is central to treatment, so that the family's encounter with the therapists is the primary curative agent. The goal of psychotherapy with the Brice family, as with all families, is to provide therapeutic experiences, and questions should be fired off in ways to unbalance the family. When Whitaker asks Carolyn, "When did you divorce your husband and marry the children?" he acts as an agent of change. He does not care whether the client likes him. And it is here that one realizes that the success of the psychotherapy depends on the emotional maturity of the therapist. The person of the therapist is at the heart of what good psychotherapy is all about. Since Whitaker states that therapy for the therapist is crucial, experiential training is essential for the therapist who would provide his/her clients with experiential treatment. In conclusion, this highly readable, inspirational, and useful book deserves a central place on every therapist's bookshelf.

References
Whitaker, C. A. (1981). Symbolic-experiential family therapy. In A. S. Gurman & D. P.
Knistern (Eds.), Handbook of family therapy (pp. 187-225). New York: Brunner/Mazel.
Napier, A. Y., & Whitaker, C. (1978). The family crucible: The intense experience of
therapy. New York: HarperCollins.

Dr. Barbara Cunningham, MFT

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Thursday, February 17, 2005

 

i've got a dilemma

Ok - blogger is really slow. I work on a few Blogger blogs, and all are ok in speed save for this urban onramps blog. I'm not sure exactly what it is, but my hunch is that it's because this blog is so, well, big. I've not only had it for three years, but I've made thousands of posts (it quit counting in the fall at 2,700 posts). So if it's slow because of size, and it will continue to be slow, maybe I should:

(a) switch over to a new Blogger blog, or
(b) take the opportunity to jump to TypePad

Your thoughts, experiences with other blog engines are appreciated.

Wednesday, February 16, 2005

 

jobs at bresee, faith-based nonprofit in LA

Our friends at the Bresee Foundation, a faith-based nonprofit located in Central Los Angeles, have the following job openings:
CAREER COUNSELOR. Full-time position. Work with local employers to place youth and young adults in internships and unsubsidized employment. Along with other staff ensure that clients are adequately prepared for the workplace.

INTEGRATED TRAINING INSTRUCTOR. Full-time position. Develop and implement curriculum for established GED preparation and workplace readiness program for young adults 17-21. Also, teach workplace readiness and basic academic skills development to youth during after-school hours.

IN-SCHOOL EMPLOYMENT CASE MANAGER. Part-time (30 hrs/week) position. Provide documentation processing and counseling support for youth 14-18. Assess needs for supportive services, maintain accurate files.

TO APPLY FOR any of these positions, please your fax resume AND cover letter to Cathy Trout at 213.385.8482, or email them to ctrout@bresee.org. Indicate position for which you are applying in the subject.

 

paid summer internships...

...for African American and Latino college students to work in the Bayshore Christian Ministries summer program. More info here. Bayshore is good people, Andy Hartwell, John Liotti and them.
 

search term mania!

the latest ways people found themselves to UO:
urban church commute (stuck in heavy traffic on the 10 freeway on Sunday morning, eh?)
todd minturn (I know him)
latino church youth groups mission trips (send 'em to harambee)
delaying adulthood (you've come to the right place)
latino church minneapolis (they exist)
free video of wtc jumpers (never forget

 

Center for Youth and Family Ministry

It's a new think tank based out of Fuller Seminary (Kara Powell and them) that's got a strong emphasis on urban youth ministry. Check it out http://www.cyfm.net/.
 

right-winger smackdown

Want to see right-wingers lob grenades at each other under the big tent? Track the back and forth over the blogosphere's role in Eason Jordan's resignation. None other than the Wall Street Journal opinion page (which is generally regarded as the conservative counter-balance to the WSJ's more centrist news side) called out and (attempted) to take to task the Big Bloggers. Dumb move, WSJ. This blog post will catch you up to speed on the "kerfuffle," including the general Professional Journalist lament over the rise of the citizen reporters, i.e., the bloggers.
 

Is this good financial advice?

David Batstone, executive editor of Sojourners and author of Saving the Corporate Soul--and (Who Knows?) Maybe Your Own: Eight Principles for Creating and Preserving Wealth and Well-Being for You and Your Company Without Selling Out, writes the following in his weekly WAG:
Reduce - and then eliminate - your personal debt.

I'll be even more to the point: If you have credit card debts, use every bit of your savings to pay down your principle. Unless you have investments that are earning you over 18 percent return - and doing so on a consistent basis (just shy of winning the lottery) - then you're better off draining your bank account to pay off your loans. As Benjamin Franklin advised, "Rather to go to bed supperless than rise in debt."

 

the ongoing Wal-Mart debate, entry #41,667

(or whatever number we are on, I've lost count...)

Many say that when Wal-Mart enters a community, bad things happen, like jobs being lost, small businesses put out, etc. So you would think that when Wal-Mart decides to close a store and leave a community, that would be good for said community, no? Well, according to a union fighting a Wal-Mart in Canada, that's not quite the case:
"Fair-minded people who respect the rights of workers call on Wal-Mart to abandon plans to close its Jonqueiere, Quebec, store," the union urges Wal-Mart's chief executive, Lee Scott, in an electronic petition. It says the store's closing would "displace an entire community."
So they are urging the store to stay open:
The union has gone further than the petition, also filing a complaint with the Quebec Labor Relations Commission in an attempt to force Wal-Mart to return to the bargaining table and remain open. The store plans to close in May.
And can this be true? In a $285 billion a year company, leaders act like this?
Unions complaining about Wal-Mart's stinginess might have a better case if Wal-Mart's top brass were living lavishly. But the retailer's commitment to controlling costs can be seen from the top down. Wal-Mart CEO Lee Scott has a tiny office in the company's corporate headquarters in Bentonville, Arkansas. Along with other executives, Scott flies coach and shares budget hotel rooms when traveling.
Inquiring minds would like to know.
 

Sam is better

We are out of the hospital, Sam's fever came down, today they gave him his final dose (this week) of Ara-C, and he's running around strong. Thanks for your prayers.

Monday, February 14, 2005

 

50 gmail invites

Well, I don't know what gives, but now I've got 50 (fifty) gmail invites to give out. Doesn't everyone in the world who wants one have one by now? Last time I offered gmail accounts they were not all snapped up. But here goes: if you want one, leave a message in the comments below, telling me so, with an email address where I can send your invite - or you can just email me directly and I'll make the connect for you.

UPDATE 830 PM -- 2/14: Six down, 44 to go!

UPDATE 1030pm -- 2/15: 11 down, 39 to go!
 

9/11: Debunking the Myths

Popular Mechanics examines the evidence and consults the experts to refute the most persistent conspiracy theories of September 11

I'm trying to pick a good example of the type of rumor/myth this article dispells. Let's see -- how about the mysterious plane seen in the vicinity of the Flight 93 as it went down in Pennsylvania?
 

The Cheerful Oncologist

Another wonder of the blogosphere - a real live, cancer-treating oncologist blogs about what he sees, hears and feels as he makes the rounds. If you've ever been in my position, with a loved one being treated for cancer, you've probably wanted to know what was really rattling around in the doctor's brain. Wonder no more. Go lose yourself at the good doctor's blog.

 

Hard to disagree with this Valentine's Day observation

From Dawn Eden(http://www.dawneden.com/):
The mainstream media forces Valentine's Day down our throats, stating quite clearly that unless a single woman has a hot date on this very day of the calendar, she is a pathetic, unattractive git.

In truth, anyone who knows anything about love knows that there is no guarantee that one will meet the right person at any given point in one's life. One may wish to just fool around in the meantime, but Page Six itself shows on a daily basis the toll of such hedonism, spelled out in bitchiness, superficiality, and backbiting, not to mention abortion and sexually transmitted disease.

Thankfully, there is another way, andÑunless your name is Richard JohnsonÑchances are I don't have to tell you what it is. There are men and women reading this who are dateless today not because they're undesirable, but because they are too wise, deep, and principled to settle for something superficial. Here's to you this Valentine's Day. My heart goes out to you.

Paul writes in Romans 12:2, "And be not conformed to this world: but be ye transformed by the renewing of your mind, that ye may prove what is that good, and acceptable, and perfect, will of God."

I may be in the Page Six universe. But I'll be damnedÑliterallyÑif I'm of it.

 

Sam is better

We should go home in an hour or two. Thanks for your prayers.

Friday, February 11, 2005

 

Eason Jordan: What in the world just happened?

Michelle Malkin knows:
For those of us in the information business, this is truly an earth-shaking time. Who would have imagined that the downfall of one of the world's most powerful news executives would be precipated by an ordinary citizen blogging his eyewitness report at Davos in the wee hours of the morning on Jan. 27?
What happened is that CNN's Chief News Executive, Eason Jordan, just resigned a few hours ago after being held accountable by the blogosphere for devastating comments he made recently at Davos. Malkin's roundup will catch you up, in case you hadn't been following the affair.

I think back to my post below about Blogs: The Pressure of Instant Accountability...

Thursday, February 10, 2005

 

The Cops...

...came to Harambee tonight. Last week there was a disturbing incident that took place on the street in front of the center, most definitely a case of mistaken identity involving one of our top young people. All the officers involved plus their departmental higher ups were present, speaking to a number of parents and staff who witnessed the incident. We had almost two hours of vigorous dialogue, and things ended pretty well.
 

it's a page-turner

Just got the latest issue of The Journal of Morality and Markets. Hint: it's not oxymoronic; these folks are serious. Articles include:
Is There Only Secular Democracy? Imagining Other Possibilities for the Third Millenium

The Secret, Natural Theological Foundation of Adam Smith's Work

The Concept of Social Sin in Its Thomistic Roots

Justice: The Most Terrible of the Virtues

From Cracks in the Liberal Edifice to the Rediscovery of the Common Good

A Biblical Precedent for the Coase Theorom?
I'm interested to see what's in the Adam Smith piece.
 

I like Steven Seagal movies

There. I said it. I'm watching Out for a Kill right now. Actually, when I'm up at 4am with baby Micah (taking my turn) I often turn to the action movie channel. Almost invariably, it's a Steven Seagal flick. Or Bad Boys. No luck getting a Charles Bronson, Chuck Norris, or even a Jean-Claude Van Damme, though.
Italian charms / Google News / Jupiter Phone Card / Bizon Phone Card / Champion Phone Card / Mozart Phone Card / Saturn Phone Card / Continental Phone Card / Zen and the Art of Digression / Patriot Blog / Are We Still A Democracy? /

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