Gezinstherapie, vanuit psychoanalytisch gezichtspunt
Psychoanalytic theory strongly emphasizes the intrapsychic dynamics in its conceptualizations about personality development and its disturbances. It tends to neglect the formative impact of social phenomena and interpersonal relation ships. The clinical experiences of psychoanalytically oriented family therapists gave rise to new insights and concepts concerning the profound influence of family relations on the development and behavior of the individual. The individual is seen primarily as a part of a larger system: the family. Psychological boundaries between family members are rarely complete. In the development of a child there tends to be a gradual delineation of the self from an undifferentiated ego-mass. A lot of families are characterized by a distinct measure of egofusion between the members, partly caused by cultural factors, partly caused by pathogenie factors among which eparation anxiety plays an important part. In that case the dialectical process between ego and alter is impeded, ego-boundaries are only vaguely delineated, there is a state of merger and the family members are vitally tied to each other while they behave as if the other is a part of oneself, loved or hated. There is no confirmation of the other as a separate personality, but he is used in a certain fixated role dependent upon the homeostatic needs of the family and of the individual members. Of ten children are parentified, that is to say they are used as substitute parents of their own parents because of their unsolved dependency needs or other conflict-loaded needs. The psychopathological symptomatology of children and adults can of ten be understood as a compromise between tendencies to individuate and the urge, partly internalized, partly maintained by the ungoing communication in the family, to fullfil certain roles in regard to other family members. Sometimes the deviant behavior of a child is a kind of vicarious functioning for one or both parents, who can stabilize themselves by externalizing their problems. An important vehiculum by which family members succeed in fixating one another in certain roles is by ways of labelling the other. h is of great importance to estimate the commitment of a patient to a certain way of behavior in regard to the family climate he lives in. Often this is a powerfull motivation to maintain the disturbed behavior. Psychoanalytic treatment of individuals sometimes has to be done by influencing family relations. In all cases the family constellation has to be taken into account.