Minuchin- Outline
View of human nature
Source of motivation
Development of pathology
Nature of change
Therapeutic relationship
Successes
► Family problems with children that are in
control, and parents are not being effective.
► Drug and Alcohol problems – inclusion of
spouse/partner and family, both extended
and immediate members.
► Working with subsystems where the
problem has been identified as something
else.
Minuchin- View of human nature
► Families and members exist within a structure.
Structures are built through repetitive family
interactions.
► There is a natural order to life, and generational
roles include grandparents, extended family,
parents, children, etc.
► Hierarchy is made up of both a hard side and a
soft side. Usually, problems are created when the
parental subsystem is inconsistent in its use of
both sides, i.e., one parent is hard the other is
soft, and they undercut each others positions.
Minuchin-Source of motivation
► Structure- organized patterns and
predictable sequences. These become
family rules that exist in unmentioned,
covert family operating principles. (What are
some of the covert rules in your family)
► subsystems- joining of members in small
groups for the performance of functions,
i.e., Child/mother Father/son
mother/father Grandmother/teen
Minuchin-Source of motivation
► Structure- exists for a reason (function of
the symptom) most often in complement
with others.
► Flexibility – permeable boundaries and roles
► Complementary vs. parallel relationships
► Competition – ganging up on each other to
win.
► Hierarchy – hard side / soft side
► Chaos – lack of observable structure
Minuchin-Source of motivation
► Boundaries - Range from rigid to diffuse
► Rigid - rules are set in stone
► Disengaged – member of family that is not
involved with others.
► Diffuse – boundaries are not well defined.
► Enmeshment - over involvement with family
or member of family, at the expense of
growth and change. Over doing support.
Minuchin-Source of motivation
► Couples subsystem – partnership vs. over and
under. Covert or overt rules that are agreed upon
either tacitly or otherwise keep them stable in the
face of potential change.
► Accommodate – process of reciprocal agreements.
Complementary patterns
Boundaries from children – (I want my wife back)
MF
CC
Minuchin- Development of pathology
► Inflexible structures
► Stress
► Attention is paid to proximity and distance
between family members and subsystems
and these are defined through boundaries,
or rules which determine who participates
and how.
Minuchin- Development of pathology
► The extremes of the proximity and distance
continuum are enmeshment and
disengagement, with most (i.e. “normal”)
families and subsystems lying at
intermediate points between two poles.
► A family is described or schematized
spatially in terms of its hierarchies and
alliances or coalitions.
Minuchin- Development of pathology
► Problems result from a rigid, dysfunctional family
structure.
► (Note that the use of the term dysfunctional is
meant to get away from the pathologizing frame
of diagnosis, and focuses on patterns or
sequences of behavior, rather than on people.
The term dysfunctional family inadvertently
became a name used to pathologizing whole
family systems, rather than describe patterns.)
Minuchin- Development of pathology
► Hierarchiesare weak and ineffective
► Boundaries and assumptions are rigid and
arbitrary.
C/M C/F G/F/C G/M/C C G
FC MC CM CF MF C
P
► Men don’t cry; women belong in the home;
children should be seen and not heard, etc.
Minuchin- Nature of change
► Alter structure
► Alter boundaries
► Realign subsystems
► Establish healthy hierarchy and leadership.
► Reframe definitions of problems, and/or
assumptions of life: Johnnie needs his space
and parents should not check up on him.
Yet, Johnnie has been busted for pot 3Xs.
Minuchin- Therapeutic relationship
► Joining – meeting all family members where
they are, and making them feel welcome.
Language- (Mimesis) using the language of
the family.
► Behavior- Tracking, and accommodation to
family’s present views of the problem and
family life.
► Attempts to project all the problem on the
I.P. are met with, “yes, but we need your
help; if one member of the family is having a
problem it effects everyone; we can’t change
Johnnie without your help.
Minuchin- Techniques
► The basic goal is to induce a “more adequate
family organization” of the sort that will maximize
growth and potential in each of its members.
► The thrust of the therapy is toward “restructuring”
the system, such as establishing or loosening
boundaries, differentiating enmeshed members
and increasing the involvement of disengaged
members.
► The therapeutic plan is gauged against knowledge
of what is “normal” for a family at a given stage in
its development, with due consideration of its
cultural and socioeconomic context.
Minuchin- Techniques
► Techniques such as unbalancing a system and
intensifying an interaction are part of the therapy.
► The therapist “joins” and accommodates to the
system in a sort of blending experience, but
retains enough independence both to resist the
family's pull and to challenge (restructure) it at
various points. He thus actively uses himself as a
boundary-maker, intensifier and general change
agent in the session.
Minuchin- Techniques
► Treatment is limited to include those
members of a family who live within a
household or have regular contact with the
immediate family. However, this might
involve grandparents living nearby, or even
an employer, if the problem is work related.
► The practice is to bring a family to a level of
“health” or complexity” and then stand
ready to be called in the future, if
necessary. Such a model is seen to combine
the advantages of short and long-term
therapy. (Stanton, M.D., 1981 JMFT)
Minuchin- Techniques
► Notice problematic behavior sequence. This can
also be done by asking: “What happens then, and
then what happens,” etc. to get cycle or pattern.
► Initiate an enactment. “So how does that
work...can you show me?” Or, “Mom and Dad, can
you discuss this now, please?”
► Ask family to discuss issue
Therapist defines a sequence
Ask family to discuss sequence
Guide family to modify sequence
Tracking
Minuchin- Techniques
► Restructuring
Symptom focusing-
Re label symptom
Alter effect
Expand symptom
Exaggerate symptom
Deemphasize symptom
Minuchin- Techniques
► Work for structural modifications (usually,
working to reestablish corrected
hierarchies).
► Challenge and correct faulty realities.
► Create new subsystems.
► Block dysfunctional transaction patterns
Reinforce new family structures
Education family about change
Techniques
and Modifying Interactions
► Highlighting
► Shaping Competence
Assessment
► Usingthe symbols in the book, diagram
your partner’s family –Structural Mapping,
then change and have your partner diagram
your family.