Minuchin- Outline

1. Minuchin- Outline View of human nature Source of motivation Development of pathology Nature of change Therapeutic relationship

2. 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.

3. 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.

4. 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

5. 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

6. 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.

7. 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

8. 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.

9. 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.

10. 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.)

11. Minuchin- Development of pathology • Hierarchies are 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.

12. 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.

13. 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.

14. 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.

15. 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.

16. 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)

17. 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

18. Minuchin- Techniques • Restructuring Symptom focusing- Re label symptom Alter effect Expand symptom Exaggerate symptom Deemphasize symptom

19. 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

20. Techniques • Highlighting and Modifying Interactions • Shaping Competence

21. Assessment • Using the symbols in the book, diagram your partner’s family –Structural Mapping, then change and have your partner diagram your family.