Structural Family Therapy | Part 1

[Music] okay so welcome to the structural family therapy um lecture um and so structural family therapy is really um it is one of just the cornerstones of the whole field of mental health now if you're in Family Therapy or you specialize in family counseling and working with couples families and children you probably use this Theory quite a bit you've heard a lot about it but even if you work primarily with individuals you will find the concepts in this super super helpful because typically individuals will be talking about their experiences as a child in a family

that were difficult because most of our most difficult things we process in counseling and Psychotherapy are our childhood relationships right that formative period so and and then also if you you're working with adults let's say or you're working with teens and children they have families who are essential structural family therapy I don't think you can do good therapy with children and Adolescence without having a very strong understanding of structural especially if you work with them individually it's just essential but then if you're working with adults who have children just understanding structural family therapy is essential

um to discussing any issues related to Parenting to co-parent ing it really is a essential one I would say one of the top 10 most essential theories to know regardless of whether you're an mft a social worker a counselor a psychologist I don't care um th this these are just some really important Concepts to understand in the field period end of sentence now pretty much every licensing exam you know when they have even if you're if you're an mft you're going to see a lot of structural family therapy questions but even in counseling psychology and

social work when they have family systems type things this is one of the two main theories the other being more of a systemic strategic type of concept uh theoretical approaches but structural and systemic strategic um on all the other licensing exams besides mft that when they talk about family therapy they're usually thinking of these this approach combined with systemic strategic approaches so really really key and essential to know whether you're working with individuals couples or families but structural family therapy is just um just invaluable and it's when you begin to really get these Concepts your

work especially when talking about family relationships um is just going to be so much easier so I hope that got your attention even if you're like I don't want to work with kids or I don't want to work with families um I promise you this is super super important regardless of who you are working with because you know we come from families many of us have you know you know have our own families um and so all throughout our lives especially when we come into the process of psychotherapy and counseling family therapy we are talking

about these relationships and so in structural family therapy I think of it as like kind of getting an x-ray of the family and so we talking about the structure so think about it as an x-ray of like the skeleton um of the family um of the family system and so compared to the other kind of foundational family therapy approach systemic strategic work where they're in systemic strategic work they're looking at the interaction patterns and kind of the dynamic that gets created that's much more difficult I think to learn structural family therapy you know when I

when I teach a CH therapy class students are like okay wow that that strategic systemic stuff was like impossible to understand but structural I can sort of understand it so I always love uh talking about structural because for most people there's an intuitiveness you're like ah yeah that makes sense and so I love teaching this because my students nod more nod in understanding and un and ask few questions while uh learning structural family therapy so hopefully this will be a nice kind of relaxing kind of fun Theory to learn so let's go ahead and get

started here we go so in a nutshell the least you need to know so so structural family therapy is a an approach that uh certainly developed you know as a family therapy approach first and foremost but IT addresses both individual syst symptoms as well as relational problems and so especially when looking at children and adolesence over the years when we look at the research many if not almost all virtually all evidence-based treatments that work for children and teens have a strong structural family therapy component and so that is one of the reasons why whether you're

working with kids individually you know or as a family understanding structural family therapy is essential I you should not be working with children or adolescence without understanding the basics of structural family therapy if you look at what the research actually says so it really is foundational to doing work with individuals couples and families and so fundamentally what this approach is doing is helping to realign the boundaries and hierarchies which we will Define very soon here but realigning the family structure to promote the growth of all individuals of the s in the the system as well

as the development of the system there's a family life cycle that has its own developmental stages as well as to resolve all the symptoms so we're realigning the family boundaries hierarchy and structure to promote the growth of each member as well as to resolve whatever symptoms so when you're looking at um you know a family if you especially if you've got kids who are symptomatic or teens who are symptomatic um we're we're looking to adjust the structure to promotee their growth and to resolve the any type of symptomatic issues there is an emphasis on strengths

um and so that looking to you know seeing people um as doing the best they can kind of getting stuck maybe in a family transitional phase um but seeing families who are needing assistance to expand their coping skills especially to deal with developmental um issues in looking primarily at the family life you know cycle of development so you know going from a couple to having their first child to you know entering the school years to entering adolescence you know launching um those sorts of things that's typically were families get a little hung up when the

shifts in the family development needs change but the structure doesn't adapt to meet the developmental needs of either or the um children and or the family itself so looking at all of that so for those of you who are familiar with my unifying framework you're familiar with this table so we basic so I have I've de working on a unifying framework for Psychotherapy and counseling that basically breaks down um conceptualization of problems from all the different theories including the 50 theories in my textbooks both Counseling and Family Therapy looking at the there four basic levels

and each one of these breaks down down into two parts and so this is just giving you really broad Strokes of like how to compare structural some other approaches so structural is going to be looking very much at the behavioral you know what people are doing it's also looking at what are called complimentary patterns those are opposite patterns so for example in structural family therapy we talk about having diffuse boundaries where there's enmeshment right there's not the boundaries are blurry versus rigid or rigid um boundaries okay and so those are actually complimentary patterns I mean

minucha doesn't quite uh cover it this way and someday I will write a book that goes through all the major you know theoretical foundations from you know Freud to postmodern to ebts but you'll notice most every approach there are some exceptions but virtually every approach that does a formal case conceptualization they they look at complimentary patterns they just call them very different things right so so like you know you at defense mechanisms have a variation of this um in humanism they look at polarities right the various schools look at that it's a tears you know

family systems you know looks at all the different um roles family members play like the blamer and the plater those those are like two compliment complimentary um opposites and so structural family therapy does it too they just it's just less obvious um and when you look at you know the different types of boundary patterns um you'll see that same examination of complimentarity so if you think of complimentarity in mental health is we're always looking at polarities and when those polarities become rigid and extreme you you typically will have some type of symptom whether it's individual

like depression or anxiety or relational like conflict or or cut off so structural does that by how it's looking at the boundaries and also as to a certain degree at the hierarchy is where you see there a handling of complimentary patterns and then they also address the cognitive um approaches or cognitive beliefs of the family system they do not directly focus on emotions and um the societal narrative direct as directly I mean certainly you can bring in of um of course an awareness of societal influences into any approach it's not kind of cooked in and

baked in at the fundamental approach um at least traditionally in um structural family therapy so a lot of what we're looking at here is what's happening behaviorally and then what's happening cognitively those are the main areas with with attention to those complimentary patterns so this is really useful um if you have my textbooks where we you know you have all these different theories using this unifying framework helps you kind of understand the similarities and differences across approaches for example like all of the humanistic approaches in Family Therapy are looking at very similar family Dynamics but

they're focusing primarily on the emotional levels with some of them focusing more on attachment based emotions and others talking about more the reactive kind of emotions on the surface so anyway um interestingly enough the other family therapy approach that looks at these two levels uh is similar to cognitive behavioral does just the observable Behavior cognitive behavioral is one of the only approaches that doesn't really focus on complimentary patterns the way most other approaches do as well as the cognition so there's a similar feel that you might experience to some of the um cognitive behavioral approaches

but it doesn't have but it adds a complimentary piece that those other ones don't okay so moving on the juice the significant contributions in the field so those of you who are familiar with my textbook specifically my family therapy textbooks this is one of the few approaches that gets multiple forms of juice because it's just that foundational to understand um you know no matter who you are where you're working and so if you haven't read my books I talk about the juice if there's one thing from this chapter you remember it should be now I've

had professors really get annoyed with that phrase most students love this section it's like okay this is the Highlight thanks for pointing that out so but the juice is really the these are the things that I no matter you know whether or not you want to be a structural family therapist is your primary approach I think these concepts are so valuable to anyone practicing Psychotherapy or counseling period end of sentence so in any of my books um when you see the juice this is what I think these this is their gift to the field it's

kind of what I think of it it's this is the gift to the field so boundaries which has really slipped into the vernacular popular disc uh discourses you hear and can read about on social media and various other you know news feeds all about boundary setting boundaries got to have boundaries and so everyone's spouting about boundaries most people talking about them misunderstand them and in many cases I think actually do not do justice and don't even sometimes use them for in ways that I don't think are actually all that emotionally healthy so hopefully after listening

to this you're going to have a much clearer understanding what boundaries are and helping your clients understand and how to work with boundaries more effectively because I certainly do see and read a lot of things that make me cringe nowadays when you know people are talking about setting boundaries so and so I'm going to start with this so when structural family therapists and I think any well-trained mental health professional speaks about boundaries what they are talking about the rules for relating um with others okay so and generally you want you don't want to cut people

off just because you don't agree with them or like what they're saying and and even if they have not if they're not always nice to you there are ways to set healthy boundaries that doesn't end a relationship and so boundaries should never be used or understood as a way to end relationships if you listen to my uh intergenerational bunian family therapy lecture cut off is usually a sign of emotional maturity so we're not going for cut off with these boundaries these boundaries are just kind of describing way the rules for relating and how we manage

distance and closeness between family members obviously this term can be applied to anyone friendships co-workers Etc but boundaries is about how our rules are for managing closeness and distance in relationships and there are three basic types okay there are what is called clear boundaries now it is so important to understand that there is a wide range of healthy clear boundaries and most of us in fact all of us hello all of us we we think of clear boundaries as going into our own lives our own cultural and gendered norms and all of our societal norms

and we each have our own kind of unique definition of what a clear boundary is however we need to be very careful as mental health professionals to not project those onto our clients because there's a very very wide range so for example many of us come from um cultures that are more communal than individualistic and so like I come from a very very immigrant very um rural so rural communities in general tend to be more communal um Greek immigrant poor background and so you know what boundaries were normal in my family of origin are very

different than the average family boundaries in the United States and so I had to learn and really adjust what was normal you know I I I literally there um McGoldrick has written several books called ethnicity and family therapy that goes through 70 or more different ethnicities describing their family structures I think it is you know um and even though obviously every family interprets their dominant culture version of um uh culture differently you know every family within a given culture does not interpret the dominant Society the same um but it's a very useful book for when

you're working cross-culturally with lots of different clients because you should not be asking your clients to educate you about their culture but understanding some of these f um norms and this is one of the best books um which has been edited over the years for just describing the general Contours but understanding where you come from and I remember I had it was her book that helped me understand individualistic cultures because I truly did not I thought I got them and I sort of grew up in one but I really didn't get them till I read

her book I'm like oh this is the logic of an individualistic culture because I literally had to read her book to get it so that means as someone coming from a highly communal based value culture when I look at more individualistic families where everyone's doing something different you know they don't all get together for the holidays or birthdays you know they you know remember you I would hear things I'm like that's just not that's not right that's not normal you know but that's just not my normal and so it's very important for you to understand

you know kind of where your family may have defined healthy normal clear boundaries how that fits maybe not only within the dominant culture that you're living in you may be more similar or less similar but then also how that relates to where your clients are sitting so just know that clear boundaries are not the family you grew up in and you may go yeah yeah yeah I know and it's also not the map you have in your head and so there's no one set of behaviors that Define clear boundaries and and so the one the

litmus test minuchin always said about how you knew that you we're looking at Clear boundaries is that no one has symptoms in the family system so if no one has symptoms then you then that's generally a sign that they're clear boundaries but any other set of behaviors like do you knock on a door before you come in or does everyone do family dinner together or does everyone show up for someone's performance or for a holiday or for a birthday or do you prioritize your personal needs over the family needs that is dependent on on many

other values I mean um and priorities that you as the clinician cannot be defining that for your clients and so you have to look at whether or not people in the system are having um symptoms or their relational symptoms symptoms hitting their developmental milestones and that's how you know whether things are clear or not so then so if you've got clear and there's a whole wide range of clear boundaries not just the ones that you think are clear then knowing that there are one extreme is having in mesed or diffus boundaries and so this is

where um the needs of the group supersede the needs of the individual to the point where there's it's detrimental to the individual this means there's a over Reliance on each other and there isn't enough space to develop one's own individuality um where disengagement is you're privileging um the individual needs over that of the group and so the there's this disengagement there are rigid boundaries there isn't enough emotional closeness to help have everyone um meet their developmental needs or the needs of the system so either extreme creates problems and and you just want to be slow

before you go around labeling friends family and clients um around their boundaries because you you we all have a bias where we stand and so you you know in the first few years of doing this work hopefully you're learning about where your biases are and learning to get better at correcting them and so it's real important you're slow to slap these labels on people um and kind of assessing the boundaries so like I've said that the the healthy is there's a wide range of potential forms of healthy that can look very very different and it's

not a particular Behavior that's healthy it's just how does that all what do how do those rules play out in the system um itself and so also knowing that culturally these boundaries can look very very different for example um a lot of folks in like North America who might look at for example like an Asian family or an Asian-American Asian Canadian family they may look on the surface sometimes disengaged because there may culturally there's less emotional expression but the actual structure of the family might be much more what would be called in meshed or diffused

boundaries for example with parents weighing very heavily on let's say you know the child's career choice or marital choices that sort of thing and again you you just have to step back be slow to label anything as problematic and even when you're working you know with um clients from different cultural or other backgrounds you know what is in mesh you're looking at the structure not just the emotional expression and for a lot of unshed um communal cultures have a lot tend to have higher emotional expression but it's not always the case and so you need

to be slow and thoughtful when you're assessing these it's it's just not what you see on the surface it's the structure of how things are relating and whether or not symptoms are developing is really important when um identifying boundaries and so this is different than setting boundaries so setting boundaries is kind of more in the pop psychology language in um structural therapy they're talking about boundaries are just the rules for relating they exist they are it's not something that you're setting and that is a different vacular and so as a professional to make sure you

keep these terms straight there's a lot of what people call Setting boundaries intergenerational family therapists would be calling cut off and they're cut off is not healthy and there's a boundaries can be healthy and they can be problematic so it's much more generic when you're using the term professionally the other thing to understand from Bowen I mean not Bowen sorry sorry talking about Bowen but um for from um and structural are enactments and enactments are just some of the most if you powerful interventions in I would say uh couple family therapy and in many ways

galed enactments with the empty chair technique so rather than having the empty chair that doesn't talk back to you enactments or when you have two or more people in the room who need to com you know communicate with each other enactments is the strategy for doing that and so this is where you you know have the families complaining about a particular problem and so you have them you identify that and you you have them engage and talk to each other directly but you're coaching them okay so there are three phases of a proper enactment and

you probably want to learn to do this under direct supervision but let's go over the basics here the first is um you want to observe the spontaneous interactions following of course both the content and the process the pro processes of how they are relating and you're listening for the rules and assumptions that are coordinating these interactions and after you then you have assessed the boundaries and we'll talk about hierarchy these enactments are designed to help correct and teach the family in Vivo how to relate in a more effective way and that's essentially what this is

so but you don't ever want to jump into an enactment without having a a good assessment so and so you know what you're going to need to do to get them to have a better interaction right so do not have this be your way of assessing and I just you know I never have a let a couple or family argue so I can see what it's like I don't know what to I don't need to see what it's like they can describe the awful fight that happened you know later earlier that week verbally in past

tense and that is hot enough never I I do not recommend letting couples or families argue and spiral in front of you so that you can see what it looks like I that is that is there is no family therapist who advocates for that and that is not a good thing so don't let that don't do that by there very few things I say don't do but letting just a couple argue to see what it looks like is horrible because they're going to get too hot too triggered for you to do good intervention they're going

to be too upset and many people feel very betrayed by you and you let that happen don't do that so what you do do is you you you allow them to start whatever the um Pro or reenact typically the um argument that they had but you are very quickly going to step in and direct them on how to um have a more effective conversation so if if this is a family that tends towards a meshman you um you will like often be pausing letting the other person person you know speak holding you know waiting and

allowing them to have Turn showing them how to do that you might even move rearrange their chairs a bit if there's been triangulation you will often reorganize the chairs that have two people who need to be talking talking and the third person has been drawn into the conflict conflict further away if you have a family that's more disengaged you're going to have you know structure the the enactment to have them more directly talk to each other you're going to you're bossy in an enactment and you do not let things SP out of control in an

enactment you're highly active helping them practice healthier ways of communicating experiencing what that type of conversation is like so that they can practice those and this is so transformational um if you are familiar with emotionally uh focused couples and family therapy they do a lot of these enactments to repair the attachment emotions and attachment bond with the couple and these are just can be really transformative very very quickly but you have to know as the clinician where when and how to um direct the conversation how to help each party do learn some new skills in

all of this to to make these be um effective so never do these willy-nilly never just say oh just show me what happened you know unless you you've really got a clear handle on the structure and what you would need to do to intervene okay so let's look real quickly just kind of at the big picture um in terms of the overview of what treatment typically looks like in structural family therapy so there are three basic phases the first is what they call joining the family and accommodating to the family's style so and we'll talk

a little bit more about this but um minuchin is the one who um used the term I think joining first and he talks about how he's joining this system he's learning to talk in the way that they talk and interact and they so he's like studying the system there's a bit of like being an anthropologist in this then you map the family structure boundaries and hierarchy so you get that x-ray of the structure and not just the surface level but really what are the rules for relating how do they work and how are they relating

to symptoms both at an individual and relational level and then you're intervening so you connect you join the system you you you part of it where you create that sense of safety for them you assess and map the structure boundaries hierarchy and then you step in to intervene now obviously this mapping the structure and intervening you know those two things will kind of continue throughout you're always maintaining the joining but those are the three basic phases um and generally structural family therapists prefer to work with the whole family whenever possible but not always insisting on

it um historically there were some family therapist that did okay so next let's look at what the therapeutic relationship looks like um so joining is a structural term that's often used pretty broadly in Family Therapy in general um but you're accommodating to their style their way of talking their way of being and it's more of an attitude than a technique or something you're doing to them it's just your way of you know I always tell my clients I'm I'm going to kind of follow your style and I would say let me know if I get

it wrong but you know you you're you're kind of following how they talk like recently I was working with this one couple and they were just hilarious I and so we ended up having unusually hilarious sessions but because that was their style they were super funny right I have other families who are much more there's this um more of a calm Rhythm to them everyone has lots of time to speak and no one's talking over each other and so I will follow that style as well so you're kind of like adjusting to their family culture

rather than having them adjust to your therapeutic you know relationship approach and so there is a term um called mimesis that meant copy in Greek that you're kind of copying and not in a mimicking way but like you're going to be super flexible to relate to them and in a way that feels very natural to them and this is particularly important when working with um clients who might be different from you and in culturally or in other ways um that you're going to accommodate to their style rather than uh to your style and that's also

part of how you're you're getting to understand the rules for relating is you're going to be using some of those rules right um and there is also this talk about um cultivating therapeutic spontaneity which is a relationally and contextually responsive expression of self so kind of authentically being yourself but within kind of the broader context of the logic of their system and so this therapeutic spity there's this authenticity that you have but you're also adapting to the family style and how you do that so I can be authentically funny with some families I can be

authentically you know calm and um allowing a lot of space and time and Silence with other families or clients and so I can adopt a lot of different um styles and so I can do that authentic authentically um because hopefully especially as a mental health professional we have lots of ways of being in the world that are authentic and you're going to bring that style um but it's it's funny you kind of allow in some ways the family to set the Rhythm like that one couple that was they were just the funny I think the

funniest clients I've ever had but I have several clients where we use just a lot more humor you'll watch them with certain clients and you'll just we were just funnier together right and some it's more of a witty humor they're different types of humor some do word play right I have one client where we just have this thing where we do word play I'm like oh I just I just have to say this pun right and so it's just part of how we relate and join we like witty banter um obviously it needs to be

appropriately timed but you know you have this that you you're authentic but you're still adapting to their style and then there is a a basic rule that they talk about which is make it happen and if you're familiar to any of the recovery oriented work and mental health they have the same motto structural family therapist had it long before that but whatever happens what whatever's going on it's a therapist job to make it happen to make change happen and we need to keep adapting figuring out reassessing stepping back asking ourselves what do we need to

do differently to make it happen and so so also being o open to playing whatever role is necessary and beneficial for a particular family in a given session and so your role might be more hierarchical or less hierarchical depending um more direct Less Direct just depending on what that client or that family needs from you to um promote change and it's not about this role that you always play with all your clients you're constantly adapting and with what you're doing isn't working do something different um okay so and obviously there's empathy is part of this

okay oh we got double bullets here okay moving on here so case conceptualization so the first thing that one of the one of the first things that a structural family therapist looks at um especially his traditionally when working with a a family but you're going to do this with IND individuals and couples too right and with couples you've got like each of their families U of Origins to look at if they each have had kids with different systems you got to look assess all of those families some you're sometimes you're assessing multiple family with multiple

subsystems but typically let's say um in a nuclear family you're going to start by looking at the couple system which is the like um you know the married partners and but often times especally in a nuclear family that's the parental system so this two people make up the same subsystem and so this is one of the kind of default goals and things that they target is the marital system clearly defined from the parental system and and many families it it becomes especially the way we we raise families and children in the United States right now

which I think is very problematic it's like what happens for a lot of couples in the US and there's a lot of societal pressure and it's very normal and common I'll say common maybe not normal but there's a lot of pressure for the parental subsystem to take over and there's no time left to feed the the marital subsystem and this is a very common pattern in um North American families that I've been seeing for several decades at least two decades here it wasn't always like this but this incurrent you know well so you're looking at

parental and um subsystem is different you can have a child in a parental subsystem you can have a grandparent in a you know it's parentified child right so they would be in child would be in a parental subsystem you can have stepparent you can have grandparents you can have aunts and uncles in a parental subsystem so you want to assess who's in those two systems you want to look at the sibling subsystems and then you just want to look listen for and look for other types of subsystems sometimes families can have very strong gendered subsystems

right or maybe particular interest like a sport or you know people who like to go camping and the people who hate to go camping in this family or whatever it might be there might be the characteristics like I've seen the introverted you know half of the family and the extroverted half of the family whatever the family has you know they develop really strong alliances and then of course you do have boundaries with outside systems which can be open um um versus closed that should not be that should be open versus Clos there's a c missing

on that slide um so is the family open to outside systems is it too open is it not open enough does it doesn't let anyone in right then looking at their boundaries with extended family community schools there's a lot of different types of subsystems and external systems that you the family can be interacting with and so those again can be more open or closed which are basically diffuse or rigid and so uh you're looking at all of these different Dynamics and like I said you get a blended family you've got a lot of family systems

to kind of understand their structures and that's often where the conflict will arise as well then we talked about boundaries all but so that's one of the major so after you get the subsystems you want to know what the boundaries are like between all of those subsystems and including individuals form to theoretically kind of their own little subsystem of one person the next big thing you're looking at um so you got the subsystems you've got the boundaries and next we going to look at hierarchy typically hierarchy applies to child parent child relationship sometimes you can

have three generations In some cultures there is an expected hierarchy between um especially a husband and a wife is in some traditional cultures so so that's something to be aware of so there's a whole cultural component on what forms of hierarchy we're looking for but in general you're just looking for hierarchies um and so the parental hierarchy though is typically what you're assessing especially if you've got a kid who's got Behavior avoral issues and again an effective parental hierarchy cannot be just cookie cutter defined it should must look like this at this stage when the

child's at this age right again like boundaries effective hierarchy is you know are are there are is there is are the parents able to set age appropriate you know limits and manage behavior in an age appropriate way and so there is range of what that can look like there's no like one if they're not doing this they have failed parental hierarchy again like boundaries you have two Extremes in One Direction you find ineffective parental hierarchy where the parents are not able to manage the child's behavior and there's too much what we call permissive parenting um

in North America especially United States in the last 20 years there's been a lot more of this type of parenting compared to traditionally there were used to be more of an excessive hierarchy so um where the rules are too strict and unrealistic and so it's too rigid and so you you know you can have either extreme and sometimes you'll have parents polarize one becomes the nice you know parent the one the other one's a strict parent that is not a healthy you want each individual person to have effective hierarchy whoever's in the parenting system um

so so understanding this and so often kids with behavioral issues there has been inefficient hierarchy or excessive hierarchy you get kids with behavioral issues with both of these extremes and so that's real important especially with behavioral issues and then you have things like a child who has let's say ADHD they've been diagnosed with ADHD they need a particular type of Parental hierarchy for that to be effective and so what is an effective hierarchy for a child diagnosed with ADHD might be different than a child who's not is is is typically different than one who is

not diagnosed with ADHD so it's really what's effective for that child in working to allow the the children and the parents and the family to hit their developmental Milestones so but a hierarchy is a very important concept and and understanding how that works across the child's lifespan is also important okay role of the symptoms so one of the things that's very classic in family if you're new to family uh therapy approaches is looking at the role of the individual system within the individual within the broader family system and um historically a family therapist would look

at a an individual's symptom and make sense of how it helps balance the family's homeostasis or or or behavioral norms and so and so that's a very traditional way of looking at um family systems and the the role of the symptom because some of the thought here is so let's say you're under you know a lot of stress or you know whatever is going on the form of you know what your depression symptoms or anxiety looks like or what that even looks like is shaped in one way or another and even if you have a

largely biological causes let's say and let's say there's less you know psychological or relational causes the family and the culture we know is also shaping that in subtle or not so sub subtle ways but there are three ways that structural therapists look at the symptom and how it might be related and maintained or be benefiting the family system so um so in this case one role of the symptom might be um the family is an ineffectual Challenger of the symptom so so basically what's happening it's a highly enmeshed family system or highly disengaged and it's

it's not um it's failing to challenge the symptomatic member right another one where the family is shaping the individual symptoms where the family structure helps shape their experience and behaviors and then there's another view where the family is the beneficiary of the symptom so an ineffective Challenger is kind of where the kids end up with more power than the parents so the parents are not setting a healthy they don't have a healthy parental hierarchy the kids have way too much influence and they're they're not able to um challenge the um the acting out child okay

so that's one version of that where the family is the shaper of the individual symptoms um so this can take a lot of forms the first example that's coming to me is um there there's actually fairly common um believe it or not it took me a while to believe this um when I enter the field but it is not uncommon for one child to remain highly symptomatic um when it's time to launch so like a teenager Failure to Launch and it is because oftentimes there is tension in the marriage and it's um the family is

kind of shaping that not consciously or intentionally but it's shaping it um oh I got and then that's also where the family is the Ben beneficiary of the system so the um the family is benefiting actually that's the the Failure to Launch one sorry sorry because this is what I was going through this list um so so that child's let's say depression Failure to Launch or failure to just show up academically you know I've seen kids fail out junior senior year right often the youngest child in the system the family's benefiting from them having those

symptoms um and so the F the family as a shaper is oftentimes where um the family structure is shaping the individual's behavior let's say a certain type of anxiety is is being shaped by the rules of the S system like um I've seen kids with certain forms of anxiety that where the family has been shaping their particular fears or worries so um there are thing we talked about he normal subsystems there are some particularly problematic subsystems which are called cross-generational coalitions and these are when a parent and a child form a coalition against the another

parent usually the other parent in this case obviously this is super common in divorce super unhealthy in divorce it's what makes divorce so toxic but you will find many intact families where this happens in fact sometimes I sit there with a teenager in the first 10 15 minutes I'm listening to him like so let me get the what it sounds like there's almost you and your you know let's say your dad against your sibling and your mom is that what I'm hearing like they two teams in this family they'll go Yep they're two teams in

this family that's a double cross generational Coalition always unhealthy never good and so that's one of the first things that you're going to want to go in there and sever um and this is these get super extreme in divorce which is where so much of the um if there is emotional damage that comes from divorce it is often because of these multiple cross-generational coalitions occurring and they can be very covert they may not always be on the surface sometimes you're everyone's conscious and well aware of who's on what whose team and sometimes it's a lot

quieter um more of a passive aggressive so targeting change one of the things I love about structural family therapy is it's got some clear boundaries you can use with all your clients goal one clear boundaries between all subsystems which include individuals the couples families siblings parental hierarch and um parental and marital which is actually so important that it is the second goal goal so having a clear distinction between the marital subsystem and the parenting subsystems very very important or uh I get did I say that wrong the marital couple subsystem and the parental subsystem those

need to be distinct so this can be sometimes as easy as just we're doing date you're going to have to start doing date night once a week but parental subsystem is different from the marital couple subsystem and for a lot of Co a lot of families today this is um they might come in with a kid as the presenting issue but often create recreating and re strengthening the marital subsystem is often very key to even help manage child issues then having the effective parental hierarchy which includes severing all of those cross-generational coalitions and and then

having finally kind of like your long-term goal is a family structure that promotes the development and growth of the individuals and the families as a whole so we're not cutting people people off with these boundaries okay we're keeping clear boundaries that allow for closeness and you know individuality so how do you maintain a relationship and your individual identity that is a m that is a very difficult life skill and that's what we're trying to help people do not just cut off every relationship that they find triggering or upsetting to [Music] them [Music]