I’ve noticed in my NYC therapy practice that family therapy often doesn’t occur to most folks as an option. As I pointed out in my previous blog post “Family Therapy: For New Yorkers An Unconsidered Therapy Option,” New Yorkers, in particular, don’t always immediately seek family therapy as their first choice for help.
Our conception of therapy in popular culture and everyday conversation is usually individual therapy, occasionally couples therapy and rarely group therapy (generally as a context for jokes). It’s almost never family therapy. So when should you seek family therapy?
Why Do Patients Seek Family Therapy?
There are two broad circumstances from which people often seek family therapy. There are other variations of course. But, typically, one is a family with adult children (who perhaps have kids who may be involved in the treatment, though most commonly not). In these instances, the family is seeking family therapy because there is a clearly recognized problem in how the members of the family are relating to one another.
Sometimes this is acute. For example, it could be related to a challenge dealing with care-taking an aging parent. In other cases, there is a broad understanding that the family communicates poorly, fights often or certain relationships within the family are tense or fractured. At times, we recommend family therapy as a brief engagement for individuals we already see in psychotherapy and other times, families approach us for help.
The second instance most commonly involves one or more children, who are identified by the parent or someone close to the family as having a problem. In these situations, parents might seek therapy for the child or children who are struggling. When family therapy is sought, there is an understanding on the part of the family–arrived at on their own or through a recommendation–that their challenges exist in and of a family. The family, as a whole, may have work to do to change the context in which one or more children are struggling.
People Also Seek Family Therapy Because They Want More For Their Family
It is also important to note that the initiative to reach out isn’t always problem-driven. People can seek family therapy because they want more for their family. Families can always grow. We can be closer, revisit how we do conflict, and examine and develop our family’s culture and values.
Individual therapy isn’t just about problems–we can work on making more money, creating deeper relationships and achieving our goals. The same can be true for family therapy. Illness or dysfunction isn’t a precondition. Just as there’s value in going to the doctor regularly when you’re not sick, you can seek family therapy as a type of check up to ask, “How are we doing? What may be failing to work and yet, we’re not aware?”
Family Therapy Helps The Family See The System
We tend not to talk about and think of pain as existing within a system. Much of the descriptions and metaphors about therapy, trauma and emotionality locate these things "within" an individual (generally in his or her brain). Change is often assumed to be a thing individual’s do.
But, having a family in the therapy room, live, is so rich with opportunities to see this system in action. Families often wonder if everyone will be on their “best behavior” with the family therapist. But once things get cooking, the ways that individuals in the family relate to one another become incredibly clear.
People can come to see themselves, their family members and the family as a whole relationally rather than individualistically quite easily. Once it’s pointed out and some language is offered other than pathologizing and blaming, we can “see” the system. We can come to understand this conceptually and be open to (and invested in) having a skilled therapist highlight both the presence of systemic patterns generally, as well as the difficulties that are present in specific situations.
