A case for family treatment

We cannot escape family. Their presence or absence will always impact us on some level because family is interconnected in a way that nothing else is. It’s foundational to who we are. A family can be composed in many ways – with blood being only one possible tie – and we will all have different “families” throughout our lifetimes. Sometimes we may be more alone than others, but we all started in a family and that is paramount to the people we become.

There’s an analogy that compares a family to a mobile or a wind chime. There are independent units, but you can’t move one without moving the others. Everything we do impacts our families – and everything they do impacts us. For instance, if a child graduates high school and moves out to go to college, the family has to readjust to the environment without that person. This can mean practical changes, such as redistributing chores, or emotional ones, like when the sibling closest to the one who moved feels left out and has to form new bonds with the remaining family.

  

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There’s a concept in psychology called the “identified patient” (IP). The IP is the family member who has a “problem.” This could be an alcoholic parent, a child failing out of school or someone struggling with physical or mental illness. Everyone else in the family can convince themselves that they are okay because they are not the IP. In this way, all the problems of the entire family get shifted on to one person. 

This isn’t done with bad intentions. Often, the family has benevolent or fond feelings for the IP. A wife will make excuses for her partner’s absences due to a drug problem in order to save face or get him off the hook. A parent gives a child lots of attention because she’s acting out at school. A teenager is happy to have an ill brother because he distracts the parents so she can rebel. This isn’t the family being mean. It’s the family adjusting.

These adjustments that are made for the IP do, however, have consequences. The wife is saving the husband from the repercussions of his drug problem, enabling him to continue to use. The siblings of the “problem child” feel like their parents don’t care about them. The sister gets in trouble because the parents were busy caring for the sick brother. Trying to cover up the problem is just creating more problems, but because they aren’t the IP, the other family members eschew their own troubles in favor of those of the IP.

Remember that mobile? One person “moves” by having a problem and everyone else shifts their problems somewhere else. 

This brings up the question of where the real problem lies. Is the identified patient of concern, or is it the family as a whole? What starts out as an obstacle for one family member can set off a chain reaction wherein everyone becomes involved.

So what happens when the IP gets better? First of all, the family often stands in the way of the IP improving. If her problems are resolved, then theirs become real again. While the family wants what’s best for the IP, they also want to retain the balance they have established. They might even fear becoming the next IP because the family doesn’t know how to function without one. 

This is why family treatment is so important. It allows all the cards to be put on the table, making it easier to notice connections between family members and their various problems. Sometimes, having a mental health professional take a look at your family unit as a whole can help all of the family better understand what is going on and how to make the family healthier. Everyone’s problems get a chance to be addressed, not just the IP. A good therapist will know not to blame the IP for everything.

   

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Family treatment can cause upset, though. It’s a time of change as new habits and coping skills need to be put in place. It will bring out all sorts of things that no one knew were there and things might even feel worse for a while. But having the family unit heal both individually and as a whole is worth it. There is no price for having stronger, healthier bonds and better problem management. 

When each family member learns to see what he contributes to the problem, he can learn valuable information about how he relates to others, which will be useful in any type of relationship. As she examines her real issues and how she displaces them, she can learn to take more responsibility and thereby have more control over her life. None of us exist in isolation and none of us can heal that way.
                                                                                                                   Individual and common concerns are intricately
                                                                                                                   interwoven.

Even if all the family members aren’t struggling, consider getting treatment together anyway. If nothing else, the love and support shown by joining the treatment is irreplaceable. There is work that simply cannot be done in individual therapy. Besides, by learning healthier patterns, you can improve the lives of the generations to come by having and teaching the skills necessary to have a healthy and happy family.

Have you had any experiences with family treatment? Post your experience in the comments.