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Tuesday, May 7, 2013

Strategies for Initiating Discussions of Family Dysfunction




In several previous posts (The series Ve have Vays of Making You Talk, and How to Disarm a Borderline), I have discussed ways in which individuals who experience ongoing and repetitive family discord can overcome the defenses and sensitivities of other targeted family members in order to change these patterns.

I have neglected one important consideration, however.  How on earth can a person get such a conversation started? For discussions of these patterns (metacommunication) to be successful, it is vitally important to get off on the right foot.  Otherwise, metacommunication can quickly provoke fight, fight, or freeze reactions in everyone concerned.  

Metacommunication will end as quickly as it started, and family behavior may actually deteriorate even further.  One’s initial approach to the targeted other is usually critical in determining one’s ultimate success or failure at any given attempt at metacommunication.

A successful start may allow ideas about the family dynamics to be discussed without encountering undue defensiveness or invalidation from the target. In turn, the discussion of family dynamics allows an individual to empathically discuss the nature and origins of difficulties in his or her own relationship with the target, and potential ways to improve it.

Unfortunately, a strategy that works wonderfully in one family may lead to disaster in another family that may superficially appear quite similar. Every family has its own unique set of variables to which they over-react! There is usually no way to know in advance what the best opening will be. Figuring out the best approach usually requires the assistance of a therapist. Nonetheless, in Part I and Part II of this post, I will discuss five possible initiating approaches.


In doing psychotherapy with patients, when I start to help them shape an initial approach, I usually try one or another of the five potential strategies in a role playing exercise to see what my patient is up against. I generally stick with a given strategy even if the target’s initial response is a negative one - such as evasive maneuver or a verbal invalidation of the patient. Such maneuvers can often be countered with specific responses that are employed as the conversation progresses. 

However, if I seem to get in trouble with escalating negativity from the patient playing the targeted other even while employing the usual countermeasures, I know that I should stop, and try a different initial approach. 


Of course, all the usual approaches may not work, so ingenuity is required. Every time I am foolish enough to think that I have heard every possible negative response, I am surprised.  But where there is a will, there is definitely a way.        


What follows are the first two of the five suggested initial strategies:

1.  The first option is to begin with a discussion of family history, using the core relationship problems as they were manifested in past generations as a metaphor for current interactional difficulties. To use this option, a potential metacommunicator should have already done a bit of research about the history of the family emotional process and the family history by constructing a genogram.  

I will not go into the complex subject of genograms here; an example of the kind of information needed can be found here.  Of crucial importance is the relationships parental figures had with their own parents, as they were affected by such historical events as ethnic and cultural values, changing circumstances, illnesses and premature deaths, immigration, mental illnesses, child abuse, and emotional cut-offs.

The metacommunicator starts with non-threatening questions about family history and then goes on to discuss more emotionally charged past family interactions that parallel the current problem. Next, the metacommicator slowly traces with the target the history of the family problem all the way into the present day, as it has come to affect the individual's current relationship with the target. 

This strategy was the first one I devised and is discussed in more detail in my first book (Allen, 1988). Current problematic roles being played out by family members stem from issues that develop over at least three generations. Therefore, any problem in the present or in one’s childhood has precedents in the interactions of the members of earlier generations. 

For families that do not produce individuals with borderline personality disorder (BPD), strategy number one is often the least threatening option. It tends to be much less threatening for parents to discuss long past relationship problems with their own parents, with their siblings (the metacommunicator’s aunts and uncles), or even with the other parent than it is to discuss those very same problems as they exist with the metacommunicator in the here and now. 

The negative impact of the issues seems muted when viewed from the distant perspective of the past. However, once the analogous issues have been brought up for discussion, one can gradually demonstrate how the earlier difficulties have led to problems and miscommunication in the present. The metacommunicator can then say something like, “No wonder you reacted so strongly when I did [such and such]! I wish I had known that before.  I always thought you reacted because [whatever explanation one had thought to be true previously].” 

During this process, one receives confirmation or clarification about the family dynamics. In this scenario, the parents should feel that their adult child is really trying to understand them and not attack them.

Unfortunately, I have found that in families that produce offspring with BPD, strategy number one is often the worst option. In these families, the parents usually do not want to touch their feelings about their own families of origin with a ten foot pole. There is so much repressed rage and anguish from the past that it is in fact easier for an adult child and his or her parents to talk about the here and now first. Rather than seeming distant, the past seems more alive in the present than it ever has.  

Even getting the target to describe interactions in previous generations for purposes of gathering genogram data can be extremely difficult. The parents do not want to even think about their relationships in the past for fear of triggering an all-consuming emotional reaction. This leads us to strategy number two.

2.  The second option is the most direct of all. Metacommunicators cut to the chase and move directly into a tactful confrontation about how the target's current behavior affects them adversely.  The term “confrontation” as I am using it here means bringing up a problem for discussion, not picking a fight.  

If a direct confrontation is to succeed, there can be no sense whatever that the conversation is an adversarial proceeding. Adult children must remain absolutely empathic and say nothing that clearly suggests that their parents are to blame for their own problems, even if they had been severely abused. The best way to start such a confrontation is to employ disclaimers. The use of disclaimers was discussed in a previous post.

The opening gambit in this strategy is a statement such as “Dad, I know you always wanted me to succeed in my career, but when you did not come to my graduation, I began to wonder if somehow you might be threatened by my success.” The metacommunicator then say nothing further and awaits some kind of response by the parent.  Depending on how the target responds, the metacommunicator and the target should then go on to discuss how they have been misreading one another’s intentions because of behavior they have both manifested that was due to each person’s own internal conflicts. 

The metacommunicator must be careful to acknowledge his or her own contribution to any misunderstanding while explaining that his or her behavior was due to a misreading of the target’s motives. Such a conversation can lead to discussions of the past family history that has lead to the conflicts. If the target has a high level of emotionality about past interactions as mentioned previously, however, that part of the conversation must be approached with exceptional delicacy and tact.

In the next post of this series, I will describe three more possible strategies for initiating family metacommunication.


2 comments:

  1. I just had some interaction with my family along these lines and it was a disaster. At this point, and to my great disappointment, I've realized my family's emotional life is a minefield that I am more or less content to steer clear from. It stinks because experience has taught me that where the greatest threat to ego lies is where the greatest gifts may lie. As an aside, would you have a referral for a therapist in northeastern Ohio?

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    1. Hi anonymous,

      Sorry, but I don't know any therapists in Ohio. You might try Googling for a "schema therapist," since that is the most common type of therapy available that I would recommend for these issues.

      For general advice on what to look for in a therapist: http://www.psychologytoday.com/blog/matter-personality/201205/finding-good-psychotherapist

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