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When Events Cause Crises Family Therapy has Much to Offer – Part One

by Dr Leonie White trainer for Key Skills in Family Therapy                                                                                         

I love a sunburnt country,
A land of sweeping plains,
Of ragged mountain ranges,
Of droughts and flooding rains.
I love her far horizons,
I love her jewel-sea,
Her beauty and her terror -
The wide brown land for me!

From My Country by Dorothea Mackellar

As Australians we are used to dealing with a lot!  Living in a ‘sunburnt country’ means some of us will likely have experienced drought, damaging storms, floods, cyclones, or bushfires more than once in our lifetime – and sometimes regularly or ongoingly …and as a country we frequently face multiple events at one time!  We have relatives who faced large scale financial crises that changed lives (The Great Depression), and we have faced financial crisis ourselves (The Global Financial Crisis).  Currently we are in the midst of a Pandemic. Some of these events are short lived but have long lasting consequences (e.g. cyclones), and some of these events last months or years in themselves (e.g., COVID-19 and drought), and can create multi-generational legacies - if you have a grandparent who grew up in the Great Depression, you might have parents who insisted you “eat everything on your plate because there are people starving in the world”, and you might have learned to keep some money “tucked away for a rainy day”.  

Events bringing severe pressure are called a social crisis and they impact us all – perhaps directly, indirectly, or vicariously.  A direct impact would be loss of employment and the associated stress and pressure.  Alternatively we might find ourselves experiencing more stress and anxiety as we are indirectly exposed to trauma talking to a friend who lost their property to a bushfire, or scrolling through our Social Media and seeing multiple posts of the devastating impact of a cyclone.  We might have trouble sleeping, headaches, tension, experience increased anxiety or distress, or increased relationship conflict.  

Yes that’s right – relationships can come under strain too.  The impact doesn’t stop with the individual – there will be ripple effects spreading through relationships, families, workplaces, sporting clubs, and communities etc e.g., what will the ripple effect be when the main ‘breadwinner’ loses their job and is highly stressed about making ends meet?  How will the person’s stress response ripple out to effect family and friends?  For some, these societal crises and associated pressures will happen when individual, couple or family stress is already high, making adjusting, coping, getting through and growing following the crisis even more challenging.

So how to do we cope?  What makes us live, love and thrive in “a sunburnt country…a land of drought and flooding rain”?  As Australians how do we get through tough times?  Steve Waugh, one of our famous Cricketers described being Australian as “looking after your mates, taking care of the less fortunate, supporting the underdog, and enhancing the Spirit that makes all Australian’s unique”.  Australian’s have a reputation as ‘battlers’ and ‘adventures’ who value mateship, but sometimes we need a little help to look after our mates, and to look after ourselves. Sometimes we need to reach out and seek support from a Helping Professional.  

Family Therapists as Helping Professionals are uniquely positioned to understand the complex impact of societal crises and the way the effects ripple outwards from the individual to relationships with partners and children, the family system as a whole and even more broadly.

Let me explain how - As a Psychologist and Systemic Family Therapist my primary framework involves thinking and working in ways that consider the individual experience (yes – what’s happening inside your head, heart and body matters!), and also the relational and contextual factors around the individual (the important people in your life, and all the other parts of your life outside ‘the problem’ matter too!).  And I’m interested in how these individual, relational and contextual factors influence the meaning people make of the things that happen in life e.g., do family stories feature what’s going wrong (“bad things always happen to me”), or resilience and courage (“Grandpa was a battler and so am I”, “Dad would have wanted me to keep trying”).  

As a Family Therapist I think big picture.  This means I am interested in understanding the person or family I am working with holistically – Who is in their life?  Family of Origin? Family of Choice? Friends? Colleagues? What are their values, strengths and capacities? Community? Culture? Religion? Gender? What era in time did they grow up in? Hobbies and interests? What challenges are they facing (e.g., managing important life transitions such as getting married, starting a family, relationship conflict, experiencing anxiety or depression, remaining single, grief and loss, parenting challenges - biological, step or foster children, divorce, remarriage, experiences of trauma etc)?  What are the historical issues that have been passed down through family, community or culture? What is happening right now to bring them to see me?

If this sounds like a lot of information to consider and hold in mind you are right! That’s where a Systemic Family Therapy framework comes in handy – it provides a way to gather and organise information, map out a person’s broader life context and work collaboratively to develop a shared understanding of what is going on, what might be helpful, and who in the family system it would be most useful to work with to get the biggest ‘bang for buck’.  That’s right – sometimes I work with the whole family, and sometimes I work with subsystems or individuals - another handy aspect of a Systemic framework is the considered flexibility of who best to work with…or how to work with the person in the family who is a ‘customer’ for therapeutic interventions. 

Rather than focus purely on the individual, this broad understanding opens up possibilities to assist in coping, healing and thriving in life.  People don’t exist in a vacuum and a consideration of relationships, context and meaning making can identify not just opportunities and possibilities for change, but also what is currently working well, so that we can identify and amplify existing strengths and resources (problems have a way of tricking people into forgetting or not noticing what is going well in life!).  

Think of this as taking a helicopter up to sky to look down on the big picture of a person’s life context with ‘the problem’ as a part of the bigger, more holistic picture.  

A big picture view opens up our perception of ‘the problem’ and also ‘the solution’ and we can then think more expansively and creatively about where we might bring the helicopter back down to ‘land’ that will be most helpful, most likely to be valued by our client….or at least get us unstuck.

So what is this ‘relationship perspective’ or ‘systems thinking’ that informs Family Therapy? This way of thinking and working comes from Systems Theory and started to develop in the 1940s as a revolution in thinking that placed a spotlight on the importance of social context and interaction in understanding human behaviour – instead of an individual focus.  This was a major shift from the dominant approaches to Psychotherapy at the time.  Systems Theory is an exciting combination of ideas from diverse fields that might not typically be associated with Helping Professions (engineering, physical and biological systems), and also ideas now taken for granted in Helping Professions (consideration of larger social systems).  

This approach is exciting because it offers a great sense of possibility and manoeuvrability in understanding and helping others, no matter what the presenting issue is, and especially in times of crisis when Anxiety might invite us to narrow our focus.  And after 20 years of working to help others with Mental Health, and working with the effects of trauma, one thing I know for sure is that possibility and manoeuvrability really help balance out the cost of caring and enhance sustainability to keep doing what I love to do.

So now that you are starting to understand big picture ‘systems thinking’ - what does Contemporary Family Therapy actually look like?  And how can this approach be of assistance in societal crises, like the current challenge we are facing with COVID-19?  Family Therapy has a lot to offer because multiple ‘schools’ of Family Therapy, or if you like ‘different Family Therapy approaches’ have developed over time providing multiple ways of intervening, supporting and achieving change – think of this like a smorgasbord of ideas and interventions that gives you options and choice.  While each school differs in the application of knowledge gained from Family Systems Theory, all accept the family as a system, and different approaches to Family Therapy can be integrated to provide an individualised approach for each person/family….like making up an individual plate from different parts of the smorgasbord buffet.  

In order to make this a bit clearer let me describe some aspects of Family Therapy that are cornerstones of my practice, and particularly pertinent in societal crises.   In a follow up blog, I will elaborate on the contributions from different Family Therapy approaches, and highlight how Psychotherapeutic approaches outside of Family Therapy can be integrated into a Systemic Framework in contemporary practice.  But for now let’s consider some Family Therapy ideas that stand out as helpful guides to understanding, mapping and supporting people.

Family Structure and Organisation 

Family Roles

Has self-isolating or job loss led to a change of roles? Is there a sense of loss from the change e.g., feeling lost no longer being the ‘breadwinner’? Has one parent taken on multiple roles of care giver, facilitator of home-learning, emotional support, negotiator, coordinator, work from home…and possibly heading towards fatigue?  How can the family flexibly adapt to what is happening so that no one person is overburdened?

Parenting Teamwork

Are both parents on the same page understanding what the children are experiencing, what they need, and how to support the children’s behaviour…which might be a difficult during a societal crisis given children communicate with their behaviour (remember the saying ‘your child is not being bad, they are having a bad time’).  Are the parents working together to provide leadership and ‘steer the ship’?  Are parents finding ways to make time for themselves as a couple?

Who is in Charge?

Are the adults running the show together as a Parenting Team, or are children moving up into the adult subsystem?  Has an adult moved down the hierarchy out of the adult subsystem? Consider a Dad who has lost his job, is feeling stressed and down… and his teenager tries to help by getting together with Mum to ‘motivate’ him to get a job “Come on Dad – why haven’t you been down to Centrelink yet?!”

Managing Anxiety in the Family System

The Family Emotional System

How much stress and tension were there before the crisis and how did family members manage? Has the added pressure of, e.g., COVID-19, impacted the family emotional system?  Does stress drive the family apart or bring them together?   How does tension influence communication and interactions? 

Healthy Coping

Do family members manage anxiety with health coping, or turn towards something like alcohol or overuse of Social Media? Can family members notice how they are impacted by stress and tension?  Can they become aware of their triggers, ‘hot spots’, and stress responses, and implement coping and self care strategies?  

Family Legacies

Can family members reflect on what their family of origin has taught them about managing stress and challenges?  What is helpful? And what would they like to do differently?

Family Patterns

How is everyone in the ‘family system’ responding to, or ‘dancing around’, the anxiety the crisis has created?  When one family member displays stress or anxiety how do others respond?  And does this soothe the tension or not?  Do family members get trapped in unhelpful patterns or vicious cycles when stress rises?  How can patterns be transformed?  Who can play a role in the change?

Strengths, Coping and Solutions 

Problems are Normal

‘Problems happen’…as we know and are currently experiencing with COVID-19.  If people believe it’s not normal to have a problem, this thinking actually causes further problems.  How is the person/family making sense of their response to the crisis?  Do they realise it’s perfectly normal to be having a hard time in a flood, bushfire or pandemic?  Or e.g., do they put pressure on themselves to be a ‘Super-Mum’ and ‘keep it all together’ whilst also keeping the family together….and working more hours….

What’s Working Well? 

Is the person/family mostly focused on what is going wrong, or what is working well? What helps them cope?  How can Therapists provide validation and also ensure we don’t inadvertently give messages people are ‘damaged’ by a trauma or crisis, instead fostering positive development (AKA post traumatic growth)?  How can we balance teaching skills and coping strategies with eliciting our clients’ own capacities and resources?

Identifying the ‘Real Problem’

What does the person/family see as ‘the problem’?  Is someone in the family identified as having or being a problem (e.g., “She’s just so anxious”)?  Or can they see the problem as separate from the person (e.g., “The Anxiety really tries to take hold of him”)?  Can the family develop a shared language (e.g., “I’m so mad at the darn COVID and how it’s stopped me seeing my friends” – “Yep I’m really mad at it to!”), and discuss the problem in ways that separate the problem from the person.  Can the family unite again ‘the problem’?   

Contemporary Family Therapy and Integration amongst Family Therapy Approaches

I hope that in providing a brief overview of some of the different aspects of Family Therapy I have shown some practical ideas, and inspired you to continue on your journey learning about Systems Theory and Family Therapy.  As you think about these different ideas, it‘s important to keep in mind that Contemporary Family Therapy involves Integration in Therapy Practice, and what’s important is how we do this in collaboration with those we work with, in ways that are respectful, acceptable to them and experienced as helpful.  

Remember “Finding what works for this client at this moment in this context” (Bannink, 2015: 19) is at the crux of collaborative, integrative practice.

Stay tuned for future blogs by Dr Leonie White.

Bannink, F. (2015).  101 Solution-Focused Questions for Help with Trauma.  Norton: New York.

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