Family therapy is the latest broad category of mental health providers. Family therapists broke the mold and actually started to see whole families at one time. At first, they were accused of “contaminating the transference” and any number of things by traditional (read psychoanalytic) therapists. While some were working within the basic model provided by Freud, many were breaking new ground and looking at the family as a system, just as an economic system, digestive system or electrical system is studied (and then later, computer systems). This view, using cybernetic theory and General Systems Theory became a break through method of looking at groups of people, especially families.
Interestingly, one of the main people behind this was Gregory Bateson, an anthropologist who started to study families and communication patterns at the Mental Research Institute in Palo Alto California, along with other pioneers such as Jay Haley, Paul Watzlawick, John Weakland and others. They were the first to think of therapy as something that could be done briefly and started to use the idea that the therapist could be more directive and be an active agent of change (strategic therapy). Much of what they did was to see how problems were formed and what kept them going in a person’s mind or in a family, coming up with clever ways of breaking people out of stuck patterns.
Family therapy became very wide-ranging after that. Family structures were studied and changed, family histories and the emotions that went with them were studied and mapped in specialized family trees called “genograms”. Individuals were worked with, but coached in how to deal with their families more effectively and for them to have more of a life of their own.
One very interesting development was the concept of “Internal Family Systems”. The developer, Dr. Richard Schwartz (his Ph.D. was in family therapy), was working with families of bulimics, when he came across a case that should have changed, but didn’t. He decided to think outside the (at that time) limits of family therapy and ask the person what was going on inside their head! He thereafter developed, with the help of his patients, a model of the mind that uses many people’s common experiences: we have different parts of us that want different things! After a while, a pattern emerged and he found that while there are parts that try to run things, either proactively (like the part of you that helps you keep appointments or might even be an inner critic) or reactively (like the part that has to run to the cookie jar for comfort) there were also young parts that held onto pain from early experiences (and sometimes adult experiences) and were often kept separate by the others. As these parts were healed, learned to deal with each other and to move past their old pains, the Self, the real person became stronger and became the leader of all the internal parts.
Of course, all these internal experiences still interfaced with the family, with society and the world as a whole, but this model allowed Schwartz to be very flexible in his approach and to see that everyone has a Self that is centered, caring, calm and oftentimes courageous in being able to take reasonable risks in life.
In studying Schwartz’s work, I’ve started to incorporate more and more of it into my own, adding in my own perspectives learned from body centered psychotherapy, NLP, hypnosis and other parts models of the mind. In short, family therapy has come a long way from its early days and continues to develop and enrich the lives of many.
Now, what does one need to be a family therapist? There are many programs with Master’s level clinicians being graduated, as well as the occasional Ph.D. to research and teach. Psychologists can get training in their own programs as well learn from free standing institutes that give post graduate education. Some Social Work programs (such as the one I went to at the University of Michigan) allow you to major in family therapy and focus in on that as your main model of helping others. A few psychiatrists will even venture into the area, some of them going on to do further work in research or teaching, like the early psychiatrists who helped to pioneer the movement.