Milan Systemic Family Therapy: Conversations in Theory and Practice Hardcover – 30 Nov 1987
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About the Author
Lugi Boscolo is co-director of the Centro Milanese di Terapia della Famiglia. Gianfranco Cecchin is co-director of the Centro Milanese di Terapia della Famiglia. Lynn Hoffman is the author of Foundations of Family Therapy (Basic Books, 1981) and, with Jay Haley, of Techniques of Family Therapy (Basic Books, 1967). Peggy Penn is director of training at the Ackerman Institute of Family Therapy.
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Let's say that food unconsciously represents love, comfort and nurturing/soothing to a person. He emotionally overeats on a regular basis. He could then say to himself, "You unconsciously feel lonely so you eat to feel less alone, to meet your social needs, even if in fantasy. You do this to maintain a certain homeostasis, to protect yourself from the feelings that could come up were you to fully remember how you were once abandoned. Emotionally eat as needed." He may then discover emotional eating to be not as necessary as before.
The example given in the book is about a child who forms an attachment to a family member and then fears what would happen to his family without that member. "Since his grandfather's death the boy had stopped doing well in school and was talking and acting like [him] ... The message the therapists gave to the boy went as follows: '... You're doing a good thing. We understand that you considered your grandfather to be the central pillar of your family; he kept it together, maintaining a certain balance. Without your grandfather's presence you were afraid something would change, so you thought of assuming his role, perhaps because of this fear that the balance in the family would change. For now you should continue in this role that you've assumed spontaneously. ...'
At the end of the message, the boy jumped up and began to complain about the fact that he might be left back at school. He immediately started to do better at this studies and ... the little-old-man behavior ... stopped. One can see that the positive connotation does not address itself to particular persons so much as to the self-maintaining tendencies of the system as a whole. The therapists prescribe the symptom not in a vacuum, or with a persuasive rationale, as a strategic therapist might do, but in relation to its social context - in the service of the family's 'homeostasis' or some aspect thereof. In so doing, the family's need to protect its equilibrium is respected and the risk of increasing the family's resistance to change is thereby reduced." pg 8 Perhaps also the child just needed some time to process the loss.
Another example comes from the book, Intimate Worlds, by Maggie Scarf. "What ['prescibing the symptom'] involves is ... telling him to go on doing exactly what he is doing because it is so helpful to those around him. Thus rather than suggesting that Dave work harder to control his defiant, oppositional behavior, I urged him to continue making trouble, because his doing so was clearly of vital importance to others in the family. His rebellious acting out was actually, as I remarked, in the nature of a loving gift that he was giving to his mother - a caring son's way of protecting his parent from pain. For, I observed thoughtfully, as long as his mother remained riveted upon all of the bad things he was doing, she could avoid ever having to deal with the losses and injuries she had suffered. His mom need never focus upon herself, or upon the tragic events of her girlhood, or upon the betrayals that transpired later on in her lifetime." pg 89 It seems as if the boy said to himself, "Mom doesn't want to face her stuff. It seems she needs a constant distraction. I can help her by creating lots of drama."
In many cases,"prescribing the symptom" doesn't work but as noted in both books, when the focus is on how interactions and symptoms serve a family system rather than on labeling individuals, one is able to see things more clearly. Instead of saying one child is bad while the other is good, one can look for closeness and distance between family members.
Although the book provides an introduction to family systems theory and offers a few interesting ideas related to it, I found the book's format (four lengthy transcripts between family members and their therapists) a bit unfocused.
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