A dominant aspect of family and relationship counselling is the focus of interpersonal relationships (communication that takes place between people), rather than the traditional counselling focus of intrapersonal counselling (communication that occurs within an individual) (Tracey, 1986 and Corey, 2009, p.415). Family and relationship counselling explores a circular concept of causality, rather than a lineal approach and focuses on interpersonal interactions and dynamics, rather than looking for the cause (Anderson & Sabatelli 2007). Sarah and John have entered family counselling to determine whether their relationship is retrievable. From the information provided in the case study, a genogram will be constructed to show Sarah and John’s current family relationships. Hypotheses will be created to demonstrate the couple’s relationship dynamics, using concepts from systems theory. The couple’s strengths and challenges will be identified and discussed. A series of questions will be developed to test the hypotheses; and finally, a narrative summary will be developed, to be provided to the couple as feedback from the counsellor.
Genogram
Hypotheses
Below are hypotheses created relating to Sarah and John, based on a family systems theory approach. Systems theory was developed by counsellors and researchers in the USA during the nineteen fifties and is now used world-wide. According to Von Sydow 2002, there are six core concepts of the systems approach in family & relationship counselling: all parts of a family system are connected; all systems have boundaries; all systems have internal rules of transformation; view the whole to understand parts of the system; systems behaviour affects the environment; stability is developed through reciprocal reinforcement (Von Sydow, 2002). Sarah and John have been going through a development change in their relationship, in the form of critical incidents concerning infidelity and John’s possible job loss. There have also been long term issues with the passing of Sarah’s father, nine years ago, and the departure of John’s biological father when he was only a young boy. These issues are discussed in further depth below.
Hypothesis – John. There has been an emotional cut-off with John opting to leave the family system and live with his mum and stepfather. According to Bowen family system theory, this concept describes people managing their unresolved emotional issues by reducing or totally cutting off emotional contact with them (Metcalf, 2011). The relationship between John and Sarah had become too difficult to maintain, resulting in John deciding to cut off emotional contact with Sarah to ease the tension. Although this may bring some short-term relief, cutting a person off emotionally may cause more stress in the long term as it leaves the underlying problems unresolved (McCollum, 1991).
John may have issues relating to the differentiation of self. According to Bowen family system theory, this concept relates to John’s sense of identity and ability to function on his own, rather than as a member of the family system. A person’s level of differentiation determines how confident they are in themselves and how much validation they need from others (Skowron & Friedlander, 1998). This is further demonstrated as John requires constant love and attention from Sarah, needing to be her priority over the rest of the family system. This issue is also linked to John’s fear of abandonment, stemming from his biological father leaving the family system when he was a young boy. Additional weight is added to this theory, as John’s older brother has also been experiencing relationship difficulties with his spouse.
Hypothesis – Sarah. Sarah suffered significant trauma with the suicidal death and passing of her father nine years ago. This was further enhanced by the circumstances of his death and subsequent shame that was felt by Sarah, her mum Kate, and younger sister Jenny, relating to the charges of fraud at his bank. Sarah says that she had a close relationship with her father, however, her subsequent anger towards her father was demonstrated by her expectation (and his failure) to protect and provide security to their family system. It is possible that, as the eldest sibling within the system, Sarah now feels that it is her responsibility to take over as head of the family; and this may be played out with feelings of resentment and anger towards her father. Congruent to these feelings, Sarah may also be experiencing significant anxiety and/or depression as symptoms to post traumatic stress disorder (PTSD); blaming herself for her father’s death, for not recognising the signs that something bad was happening to him.
John’s initial portrayal of Sarah; avoiding him and preferring to engage in domestic duties, could be a sign of Sarah’s coping mechanism; preferring to keep busy, to avoid reflecting about the pain associated with her father’s death. Sarah has said that John is irresponsible with money, through her description about accounts not being paid and his desire to work and invest in a company that she felt was doomed to fail. This situation could reflect the money theme that ultimately took the life of her father and would be a painful reminder of his death. Sarah may, consequently, feel that she must take control of all monetary issues to avoid a similar potential painful outcome, like what happened to her father. The estrangement of Sarah and John’s relationship has impacted Sarah’s close relationship with her in-law’s. This loss could represent further grief for Sarah to mourn, along with the loss of her father and husband. Through the losses of her close family and the two dominant male figures in her life, Sarah could have developed feelings of significant abandonment, resulting in trauma and lack of trust.
Strengths and Challenges
Sarah has demonstrated significant strength by holding together her family system, even though she has suffered trauma with the passing of her father and John’s departure of the current family system. Sarah has become a single parent and now parents their two children by herself, as well as working as a school counsellor, demonstrating strength, tenacity, courage and resilience. Sarah and her mother appear to have a strong relationship and Sarah relies on her mother to take care of the children, however, since hearing the news of Sarah’s possible reconciliation with John, Kate has not spoken to Sarah, a sign of her disapproval. This situation could pose a significant challenge for the couple as Sarah relies on her mum to care for the children while she is working. It could also present difficulties, creating a potential new triangular relationship between Sarah, Kate and Jenny. In the short term, triangulation allows people to let off steam, however, according to Bowen, long term may lead to physical or emotional, unresolved dysfunction (Goldenberg & Goldenberg, 2008, p. 185-186). Sarah also faces a significant challenge relating to trust, since John’s infidelity.
If the couple can work through their issues and insecurities, there could be a possibility of re-unification, which could bring the couple closer together, as they understand each other’s insecurities and how earlier events have shaped their current relationship. There may be challenges ahead to reassign parental roles to ensure that the heavy burden of parenting and finances is equally shared between both partners and, furthermore, to ensure acceptance with extended family members willing to accept past situations and look to a more positive future outcome for Sarah and John.
Questions to Test the Hypotheses
To test the hypotheses, the following questions have been developed. John: what brought you to the decision to leave the family home? Can you tell me a little about what you were feeling at that time? I’d like to talk a little about the memories that you have relating to your biological father leaving. What can you tell me about that? On a scale of 1-10, how would you rate your level of confidence?
John and Sarah: can you both remember a time when you felt secure and happy within your relationship? Tell me about that time and how you felt. Tell me how things have changed since that time and what you think needs to change for a reconciliation to be successful.
Sarah, tell me about the grief that you have experienced since your father’s passing. Is it still hard to talk about? Sarah, how did you feel when you learned of your father’s indiscretions and later fraud charges at his bank? What impact has this had on your life, relating to money issues? How do you feel about trusting people?
If a miracle had occurred, and all your problems had simply vanished overnight; how would that look like today? What would you be feeling? What are those problems that have vanished?
Summary
Sarah and John have suffered significant stress in response to previous critical incidents that have impacted their lives. These incidents have developed into long term issues that require the counsellor to understand the history of the events and the family’s response to them. The stress and anxiety of those events have played out in their current relationship as an existential crisis, generating feelings of invalidation by lack of communication, empathy, understanding and each partner not feeling heard. Sarah has suffered significant grief by the suicidal passing of her father and John still suffers with episodes of acute insecurity, stemming from the departure of his biological father when he was a young boy. John’s infidelity is a result of his loneliness within the marriage, as well as his fear of abandonment. These are all signs of underlying problems that have not been addressed or acknowledged (Corey, 2016).
Conclusion
The case study of Sarah and John has demonstrated complex family issues within a family system that is still struggling to come to terms with events from their past and allows for the deliberation upon multi-generational patterns of behaviour, rather than focusing on individual pathology. The use of the genogram clearly shows the main relationships that have affected Sarah and John’s current life crisis. The use of academic literature has provided weight to the concepts and ideas of systems theory, relating to the couple’s dynamics; and circular questioning provides a groundwork of basic questions that, hopefully, will gently probe the issues at hand. A final summary of events has been constructed, intended for the counsellor to feed back to the couple.
References
Anderson, S. A., & Sabatelli, R. M. (2007). Family interaction: A multigenerational developmental perspective (4th ed.). Boston, MA: Pearson Education.
Bagarozzi, D. A. (2008). Understanding and treating marital infidelity: A multidimensional model. The American Journal of Family Therapy, 36, 1‑17.
Bowen, M. (1978). Family therapy in clinical practice. Published by Jason Aronson Inc., USA.
Corey, G. (2009). Theories and practice of counselling and psychotherapy (8th ed.). Belmont, CA: Thomson Higher Education.
Corey, G (2016). Theory and Practice of Counselling and Psychotherapy. Cengage Learning, Australia.
Goldberg, H. & Goldberg, I. (2008). Family Therapy: An Overview (7th ed.). Published by Brooks/Cole, California, USA.
Hecker, L. L. & Wetchler, J. L. (2003). An Introduction to Marriage and Family Therapy. Published by Haworth Clinical Practice Press, NY, USA.
McCollum, E., E. (1991). A scale to measure Bowen’s concept of emotional cut-off. Contemporary Family Therapy, 13(3), 247-254.
Metcalf, L. (2011). Marriage and Family Therapy: a practice-oriented approach. Published by Springer Publishing, USA.
Nichols, M., P. (2014). Family Therapy: concepts and methods (10th ed.). Published by Pearson Education Limited, UK.
Papero, D., V. (1990). Bowen Family Systems Theory. Published by Allyn and Bacon, USA.
Skowron, E., A., & Friedlander, M., L. (1998). The Differentiation of Self Inventory: Development and initial validation. Journal of Counselling Psychology, 45(3), 235-246.
Tracey, T., J. (1986). Control in Counselling: Intrapersonal Versus Interpersonal Definitions. Journal of Counselling and Development, 64(8), 512-515.
Von Sydow, K. (2002). Systemic attachment theory and therapeutic practice: A proposal. Clinical Psychology and Psychotherapy, 9, 77‑90.