Object Relations Family Therapy Addressing the shadows of the past

Goal of Treatment Enable family members to relate to each other in a genuine and rewarding manner rather than being trapped by the shadows of past relationships

Theoretical Framework Object relations theory ==“objects” represent the internalized representation of others How are others and their behaviors perceived relationships are a core need—life is the story of the need to be connected and to separate early life experiences shape later relationships

Object Relations theory Child can deal with frustration by Repression –removal from consciousness Splitting—separates the good from the bad “Teddy” is the bad one, I am good “bad Mommy” says no to a cookie Child can assert that his teddy bear does the bad things, he does the good things—thus does not have to own the “bad” part of himself

Attachment Theory Infant dependent upon parents for survival and can engage parents Children able to cope with a degree of frustration When child is overwhelmed Copes by splitting into good (satisfying) and Bad (not satisfying) If circumstances are too frustrating, child cannot be open to new circumstances that modify the child’s sense of others and self in response to new experiences--growth is stunted Children who have learned to distrust can thus not build in trust when they experience people who try to meet their needs in a trustworthy manner

Child splits mother into “Bad Mommy” who said NO

Attachment Theory con’t Winnicott Good enough mothering/parenting Mother (father) both provides engagement, holding and permits child appropriate separation Serious problems—child develops “false self”to please others and protect from pain

Fathering bonding with new daughter

Object relations The response of the parent to the anxious and frustrated child either helps the child to cope with these feelings eg I know you are angry but I still love you Or is unable to tolerate—lashes out verbally or physically or withdraws Gives child no tools on ways to cope with anger and anxiety

Object relations These early life experiences can help set the tone for future family relationships anticipation of rejection –fear loss, remain aloof or cling Expect acceptance and open to receiving and giving affection

Projective Identification Project my conscious and unconscious internal object relationships onto others I feel weak and require my partner to be strong (not open to more complex picture) Couple duet as each partner acts out the process of projection/collusion eg –not reveal any doubts This process meets needs but impedes genuine relationships (eg of Emily and Lewis)

Projective identification Picture of a very small person (internalized object) in terms of a very large (internalized object)—actual people are of equal size but the projected people are very different in size See next slide

My image of myself (green) and my imagine of you (green). We are blues

Promotes Resiliency Addressing risk factors associated with the reactivation of unresolved past interpersonal relationships Strengthening protective factors by helping family members resolve past interpersonal relationships and thus potentially creating positive and trusting family relationships based on realistic appraisals of the current relationship

Role of the Therapist Therapist enables the family members to tolerate and experience difficult painful life events in such a way that they can tolerate the anxiety and integrate them in an manageable way. The therapist encourages understanding and the ability to handle anxiety. The therapeutic stance is calm and helpful. Self understanding by the therapist is crucial

Major tenets Family members bring to current family the object relations system developed during earlier life experiences Individuals project their conscious and unconscious internalized object relations onto the other spouse or family members Problems occur when family members cannot separate from these projections

Major Tenets con’t The task of the family therapist is to enable family members to cope with their anxiety and begin to recognize and respond to people in a more open and healthy manner Transference and counter transference are important tools in the therapeutic process

Therapy Process Assessment and treatment Focus on relationships between members and with members and therapist (transference) /and therapist and family (counter transference)

Therapy Process Listen to the family members’ tell their story --alert to possible omissions and potential meaning Emotional exchanges as replays of earlier life experiences As family members reenact earlier patterns, the therapist can help them draw connections

Therapeutic process Empathic listening –gives support to family members through verbal and non verbal responses Clarifying comments shared with family members Shaping comments—helps put issues into words, draws attention to repetitive patterns

Therapeutic process Identification of unconscious projective identifications—helps family members recognize their own repressed wishes (I wish I could be stronger)

Therapeutic process Interpretations-comments that link life events (could your fear here be linked to your fear when you father left the family?) Do you still feel this sense of being anbandoned,

Treatment process con’t Importance of transference (family’s response to therapist) and counter transference (therapists response to family) give crucial clues in terms of early life experiences Eg. Distrust, view counselor as the rescuer,