Living Well, Feeling Good

In structural family therapy, the main goal is to alter any dysfunctional structure in order to encourage growth in individuals, subsystems, and the family as a whole, as well as increase the support in the family as well as the individual responsibility and self-reliance of the family members and the subsystems. Part of creating a healthy structure includes establishing a clear hierarchy between parents and children, with the parents having more power than the kids. In other words, the parents should be on a purposeful team and the children should be in their own subsystem. In the restructuring process, clear boundaries replace diffuse and rigid boundaries between all individuals and subsystems.  To be more concise, the main goals of structural family therapy are:

1. to make the patterns of interaction more flexible
2. to restore hierarchy of power (usually strengthening the parental subsystem)
3. to create engaged/clear boundaries
4. to decrease homeostatic anxiety

An example

Here is a simple diagram of a healthy family structure according to structural family therapy:

In the structure, the father and the mother are above the child vertically, which indicates that they have more power than the child, and are therefore able to make the important decisions revolving around family life, as well as be responsible for the outcomes. The dotted line between the parents and the child indicates a clear boundary, neither rigid nor diffuse, allowing a balance between autonomy and togetherness.

Another family could come to therapy with the following structure, which is very common:

F | M C

In this family, there is an unconscious, “covert coalition” between the mother and child, who have a rigid boundary between them and the father. In addition, the child is at the same level vertically as the father, indicating that they share equal power in the family. This lack of structural hierarchy is apparent when families say that things like “the kids don’t listen” or “are a handful” or “are out of control.”

With such a family, four goals immediately become apparent:

1. illuminate and dissolve the covert coalition between the mother and the child
2. restore the power hierarchy between the parental subsystem and child
3. create a clear boundary between the parental subsystem and child
4. correct the rigid boundary between the father and the rest of the family, creating clear boundaries that allow for more connection and communication

How these corrections are made is where the art of structural family therapy comes into play. The interventions and techniques of structural family therapy are numerous, and range from direct verbal explanation about family structure, to more subtle adjustments such as arranging the family seating to reflect a healthy family structure, or adjusting the degree of emotional intensity of messages.

Share/Bookmark

I define culture not just as ethnicity, but as one’s entire worldview resulting from a lifetime of past experiences (most notably, from their family of origin). The structure in a family will contain aspects of the structure of the mother’s and father’s families of origin.

If two architects got together to design a house together, that building would be a “blending” of the two architectural styles.   So it is with families when two adults join to create a life together.  They subconsciously “design” it to resemble what they have known and grown up with.  Many parents have already done some work to analyze structural “flaws” in their own families of origin, and have worked very hard to correct for these ineffective patterns.   Everyone brings into their current family some of the tools, rules, lessons, and patterns from their old family, most of which are good, but some of which need reshaping.

Not only family of origin, but other significant social relationships, culture, and religion all play a role in a person’s “architectural style” they employ when they create the structure of their families. Sometimes problems emerge when two architectural styles are combined, and the two designs are incompatible. Other times, there is simply bad “engineering” involved, and corrections need to be made in order to restore safety, stability, and comfort in the structure.

Share/Bookmark

You may ask, why would a family ever maintain patterns of inner interaction and structure that is unhealthy?  Why don’t they simply straighten themselves up and evolve more healthy patterns? The answer is that establishing new patterns can be scarier than staying with old patterns that don’t work well. Family systems can and do fall apart, as evidenced by divorces, separations, and estrangements that happen commonly in society. When families undergo change (for example, in how they handle conflict or negotiate responsibility) there is a great deal of risk involved. Even if the change may lead in a positive direction, families often unconsciously resist changes out of the fear of what may result from the change. In other words, the potential benefit from the change does not seem to outweigh the potential risk. The name the structural family therapist uses to describe this phenomenon is homeostatic anxiety. Homeostatic anxiety is the tendency to seek equilibrium (homeostasis) out of the fear of the unknown.  All members of all families have some homeostatic anxiety, and just like individual anxiety, a small measure of cautiousness is normal and healthy. However, when families become too rigid and stuck in patterns of interaction that are unhealthy, is it indication that their anxiety about change is far too high. Therefore, a main goal of structural family therapy is to decrease homeostatic anxiety so that structures and interactions can become more flexible and change can occur.

Share/Bookmark

Boundaries are invisible barriers that regulate the amount and type of contact with others. Boundaries are a part of the rules and interactional patterns (structure) of the family. Boundaries affect levels of closeness, levels of involvement, how problems are solved, how skills are developed and how independence and responsibility are balanced with interdependent in connection.

There are three types of boundaries:

• rigid boundaries (too far, too closed-off), which cause a lack in communication and rigid, restricted patterns. These type of boundaries lead to disengagement between family members and subsystems.  Sometimes people will talk about there being a “wall” between various members in the family. They are referring to rigid boundaries.
• diffuse boundaries (too close, ), which lead to overinvolvement between family members. If one family member suddenly becomes upset, everyone is upset. If one family member is feeling weak, everyone is affected. Diffuse boundaries lead to enmeshment which is a condition in which no one seems to be their own person, which causes people to try and overcontrol each other.  If a rigid boundary is like a wall, a diffuse boundary is like a spider web, easily broken and sticky.
• Engaged (clear) boundaries (just the right amount of closeness), which involve a normal range of communication and involvement between family members. Clear boundaries lead to a balance of independence and interdependence between family members. They provide opportunities to offer support and help, as well as allow each other the freedom to experience and solve their own problems.

Boundaries protect individuals’ autonomy and differentiation from each other, and they manage the level of closeness between family members as well is the distribution of power among the various hierarchical levels of the family. In structural family therapy, boundaries are explored and corrected between and among all subsystems.

Share/Bookmark

A subsystem is simply a part of a larger system. Families are subsystems of society. Nuclear families are subsystems of extended families. The “husband and wife” or “spousal” unit is a subsystem of the nuclear family. Finally, each individual is a subsystem of the family.  Other subsystems include the sibling subsystem, the younger generation subsystem, the middle generation subsystem, the older generation subsystem, the female subsystem, the male subsystem, the nurturing subsystem, the disciplinarian subsystem, etc.  Subsystems can even form around interests or hobbies (e.g., the rowdy subsystem, the mellow subsystem, the sports-lovers subsystem, the nature-lovers subsystem, etc.).

Problems occur in the family structure when covert coalitions form between or among subsystems. For example, when a parent and child form a covert coalition against the other parent, the structure of the family is not solid and conflict results.

Share/Bookmark

It is difficult to conceptualize the “structure” of the family.  The structure of the family is the set of rules that govern interactional patterns. Most rules in a family are covert. This means that they are not explicitly stated or consciously recognized by the family members.  They are unconscious because they have been established over the course of many years of interaction. Clues to the rules that are part of the family can be found largely in the nonverbal communication of family members (e.g., vocal tone, facial expressions, body language, hesitation, eye contact, etc.) the family rules serve many purposes: regulating closeness and distance, distributing power, negotiating areas of specialization and expertise, and promoting cooperation.

In a sense, any group of human beings can be seen to have a structure, just as society as a whole has a structure. A key difference in society, however, is that more of the rules are written down in the form of laws and are more explicit.  There are also unwritten rules in society that compose the culture of the society.  Society’s rules do not change as easily as rules in a family can. Just as a society collapses or becomes depressed if the laws and culture become too rigid or flexible, so too will the family experience high levels of conflict or distance if there covert rules that have been formed become unworkable for the family’s current reality.

Share/Bookmark

Structural family therapy is based on the metaphor of (surprise!) a structure. Just as an architect sees a building as a whole composed of various parts (walls, pillars, foundation, etc), a structural family therapist sees a family as a whole unit composed of individuals, boundaries, hierarchies, and subsystems.

Just as a house is composed of different parts that are connected in such a way that keeps the structure intact and standing, families are composed of individuals who have come together to form rules and interactional patterns that hold the family together.  With a building, it is possible for one pillar or beam to be breaking, showing the most obvious signs of danger and urgency.   However, often this one component breaking is actually a result and symptom of a problem in the designed structure.  If you attempt to fix the one pillar while ignoring the rest of the house, it may continue to break under the weight of the stressful structure.

This is stressed pillar is analogous to the family’s “identified patient” that is brought to therapy with the most severe symptoms.  Families often have one or two members who are exhibiting the greatest struggle – for example, a rebellious teenager getting into trouble, or a child “acting out” at school or a depressed or angry parent.  A structural family therapist will not only look at the “identified patient” but at the entire family as a whole, in order to illuminate and eventually repair the rules, roles, and interactional patterns that are creating a stressful environment in which such symptoms can more easily emerge.  Once the family structure is corrected, the symptoms in the individuals tend to dissipate.

Underlying Assumptions

Structural family therapy assumes that change in a family for its own sake is good. In structural family therapy, it is assumed that family problems largely result from “rigid, repetitive patterns of interaction” and that increasing flexibility is the road to change. The direction or type of change is less important than the fact that change occurs. This is reflected in another assumption that “action proceeds understanding,” which means that the first step towards making the family healthier is simply getting unstuck and trying something new. After the family members have learned a new “dance” and played out a “different ending” to the persistent conflict, understanding about the family’s problems and solutions will become more apparent.

Structural family therapy in my practice

I find structural family therapy to be extremely useful in conceptualizing problems that families face. In my practice, I will frequently think in terms of and discuss boundaries, flexible interactions, anxiety about change, and establishing a healthy hierarchy with the parents clearly in charge. I believe that strengthening the parental subsystem is the central goal of couples therapy, which also creates much healthier families.  I structural family therapy’s focus on the present very useful when combined with other family systems approaches that focus on the past, such as intergenerational family therapy.  I believe understanding the structure of the families from which the parents came is crucial to truly understanding their current family.

Share/Bookmark