You are in an archived section of the AIFS website. Archived publications may be of interest for historical reasons. Because of their age, they may not reflect current research data or AIFS' current research methodologies.

Family Matters No. 37 - April 1994

Responding to Family Crisis

Past and Future Roles of the Professional Helper
Lawrie Moloney

Abstract

A key issue identified by the National Council for the International Year of the Family is that of addressing the needs of families facing personal crisis. This article addresses the personal nature of family crisis and the extent to which personal helping services have shown themselves capable of responding to such crises. It argues first that in responding to crises, professional counsellors and therapists have generally been more concerned with individuals than families; and second, that family therapy, itself a response to the inadequacy of such a focus, has only in the past few years evolved to a point where it comfortably accommodates both the family system and the people within it. (Author)

A key issue identified by the Committee for the International Year of the Family is that of addressing the needs of families facing personal crisis. This article addresses the personal nature of family crisis and the extent to which personal helping services have shown themselves capable of responding to such crises. It argues first that in responding to crises, professional counsellors and therapists* have generally been more concerned with individuals than families; and second, that family therapy, itself a response to the inadequacy of such a focus, has only in the past few years evolved to a point where it comfortably accommodates both the family system and the people within it.

Notwithstanding the above, it is also argued that there remains a need for good quality counselling and therapeutic services aimed at promoting the survival and continuing development of families. This argument in no way detracts from the ongoing requirement for educative and preventative programs, economic and legislative reforms and policy advances which aim to reduce stress levels and improve quality of life for families. These initiatives, especially those which directly address questions of poverty, educational opportunities, workforce participation and structurally based power imbalances, have a major impact on the number and level of severity of crises experienced by families. They are dealt with more fully in the article by David Eldridge elsewhere in this issue.

The focus in this article is on the personally constructed nature of crises - on the fact that the same external occurrence can strengthen the mutual ties of one family and leave another teetering on the brink of collapse. Counselling and therapeutic services deal with family crises within this particular framework. Although such services tend to be seen by the policy makers as akin to an ambulance at the bottom of the cliff, the reality is that no matter how effective the policies and how lavish the resources, cliffs will continue to appear, sometimes in quite unexpected places.

Crisis as Personal Events

Personal crisis can be associated with a wide variety of situations. It can be the end result of an exploitative relationship or of structurally induced hardship such as unsatisfactory working arrangements, unemployment or family poverty. It can follow upon a catastrophic event such as a flood or bushfire or a significant personal loss. Addictive behaviours can lead to crisis for the addicts or for those who care about them. Affairs within relationships can have similar effects.

Personal crisis can also be touched off by more subtle cues - the unexpected juxtaposing of a memory and a current stressful event, or the reassessment of the meaning of an event hitherto deemed to have been insignificant or benign. Some personal crises have a level of predicability in that they relate to developmental and maturational tasks. Marriages, for example, often falter within the first year, or around such events as the birth of the first child or the time the children leave home.

Caplan (1970), whose research on acute crisis has generally stood the test of time, suggests that a personal crisis occurs when an individual is confronted with a problematic situation for which his or her typical way of operating in the world and usual supports are not sufficient. When an individual, family or system is in a state of acute crisis, many of the normal rules governing human interaction are thrown into doubt or simply cease to operate. At such times, we experience 'another side' of ourselves, of our partners or of others whom we previously thought we knew. In the crisis which can surround a marriage breakdown for example, it is not uncommon for people to believe that they or their partner or the world have quite literally gone crazy. In many ways the manner in which such events are handled, contributes to the crisis as much as (if not more than) the events themselves.

At its peak, an acute personal crisis is a frightening experience in which the world seems to lose most of its elements of predicability and safety. Crises usually represent turning points in our lives. They are times of dangerous opportunity in which we tend to feel strangely separated from those around us. But even if in our confusion or fear or pain we feel quite isolated, personal crises normally connect with and reverberate through our support networks. Most crises touch families in one way or another. They have the capacity to make or break individuals and to make or break the families with whom they are connected.

Caplan and others believe that from the point of view of the individual, an acute crisis is usually time limited - that the feeling of being out of control is so uncomfortable that we are normally highly motivated to find some sort of resolution. For many, the quality of the resolution appears at the time to be less important than the relief afforded by the resolution itself. This has important implications with respect to the speed with which service providers are willing and able to respond. The situation is somewhat (though not entirely) analogous to the sort of medical crisis with which most of us are more familiar. In a medical crisis, the body is in some way overwhelmed. The common sense response to medical crisis includes the belief that help is required immediately or as quickly as possible.

Some people deal with the extremely uncomfortable feelings associated with a crisis or impending crisis by avoiding situations or avoiding revisiting situations in which they have previously been propelled into crisis. The fear which feeds this avoidance seems to be mainly a fear of loss of control. At the same time, the avoidance compels the person to live significantly below his or her capacity and is frequently the antecedent to a variety of psychological states such as chronic anxiety or depression, some obsessive reactions and what is popularly called agoraphobia.

Professional Helpers and the Social Context

Counsellors and therapists are primarily concerned with personal responses and personal adaptation. However an analysis of who defines behaviours or attitudes as problematic and who is granted or refused resources to offer help, inevitably reveals something of our cultural assumptions and the power structures which support them. Consider the simple yet profound question of how long and in what manner one should grieve for the death of a close family member. Consider how a state employed therapist might have worked with Hamlet, whose grief had been declared by his stepfather/king as too long, too intense and (worst of all), 'unmanly'. How much pressure would our Danish therapist be under to solve the problem of Hamlet's protracted grief by simply declaring him to be mad?

Bailey (1986) is amongst those who suggest that, having been professionalised, counsellors and therapists find themselves tightly constrained by the prevailing cultural norms. He observes that throughout history, professional helpers have always been the 'quintessential middlemen' who may aspire neither to positions of great power, nor identify too closely with the powerless. A question which arises from such an analysis - a question raised also by David Eldridge elsewhere in this issue - is whether counsellors and therapists can ever do any more than assist individuals or families make adjustments within existing power structures?

In recent years, analyses of power have become a critical issue in the counselling and therapy literature - see, for example, Goldner (1985), Leupnitz (1988), Flaskas and Humphreys (1993). These feminist inspired analyses contrast with the writings of early theoreticians such as Bateson (1972). Bateson, whose influence on the family therapy movement has been considerable, strove to shift the focus of the way we view problems from that of linear causality, to a systemic understanding of the recursive nature of all interactions. In so doing, however, he declared the notion of power to be an 'epistemological error' (p.486) because he believed one person can never hold unilateral power over another.

But one way or another, the services of professional helpers tend to be paid for by those in positions of power. In an individually and technologically oriented age, it seems no accident that in terms of training costs and rebates via the public purse (medical insurance being perhaps the clearest example), most of the money available for assistance with personal problems goes to those professional helpers who define the difficulty as largely medical and/or as residing in the individual. Generally speaking, counsellors who deal with families, especially socially disadvantaged families, are near the bottom of the financial totem pole. Frequently they lead a precarious professional existence in which in order to attract modest recurrent funding, they must justify their worth from year to year.

For many, a counselling response which is oriented towards families and larger systems can in any case seem too daunting a task. The research literature constantly reminds would-be family counsellors that the effect of their interventions are difficult to demonstrate in a convincing way. Indeed most research oriented publications suggest there is little hard evidence for the value of a family approach. From a researcher's point of view there simply seem to be too many variables to attend to.

Other difficult questions, not often attended to during most therapists' and counsellors' training, can arise for the family oriented worker. Who is my client? How do I deal with issues of confidentiality? How can I scientifically validate the effect of my interventions? Against what criteria do I assess this family's level of functioning? How do I separate out the issues in this family from the issues in my own family or in my own family of origin? If the counsellor is working in private practice, even the question of who pays for a family oriented intervention can be problematic.

Paradoxically, the traditional mainstream counselling and therapeutic models have tended to begin with the assumption that the origin of many problems lies within family functioning but have then proceeded to focus on the individual. Whether the orientation be behavioural, humanistic or psychodynamic, the aim of therapy frequently has a strong element of liberating the client from the clutches of an oppressive family or an oppressive family member. For much of this century, the oppressor has been seen to be the mother who in some way has failed to meet all the family members' needs. More recently, the focus of oppression has turned to fathers. In this context, a good therapeutic outcome is seen to be the triumph of the individual over and oppressive family or an oppressive family member. Eastman (1989) has identified aspects of feminism and the 1960s anti-psychiatry movement as lending support to this view.

In our own culture, a similar triumph of the individual is constantly reflected in film, literature and sport. Even in team sports, especially male team sports, the interest is mainly focused on individual contributions. Our economic theories also continue to support the assumption that the almost exclusive promotion of individual prosperity necessarily enhances the prosperity of all. This assumption remains current despite the fact that the boom of the early eighties and the property boom of 1987 has produced a huge number of chronically underemployed and a widening gap between rich and poor.

The dominant culture of individuality is further reflected in academic courses for the helping professions. In Australia for example, there is no degree course in couples or marital counselling; and the first post graduate degree in family therapy began only this year. On the other hand, the prestige courses in clinical psychology and psychiatry adopt a strong individual focus, reflective of the medical models of intervention from which they have sprung. With one or two possible exceptions, degrees in counselling psychology are also predominantly individually oriented. And though a greater number of family counselling and family therapy subjects appear within some social work degrees, the curricula within many of these courses reflect a high level of ambivalence towards counselling, often favouring the promotion of changes in basic structures in preference to the 'band-aid' approach of therapy.

As products of this cultural, economic and educational system, therapists are inclined to adopt an individually oriented approach almost by default. Others are clearer in their stance, believing for example that the combination of patriarchy and privacy within families has too often been associated with diminished public responsibility and personal abuse. They are aware that such a position has a long history of support from many quarters. In his 1967 Reith Lectures for example, the British anthropologist Edmund Leach was moved to suggest that 'the family, with its narrow privacy and tawdry secrets, is the source of all our discontents'.

Even those movements which attempted to move beyond family privacy and secrecy by promoting the raising of children as a scientific endeavour (for example, Adler 1932, Dreikurs 1957), have been viewed, at least in retrospect (Reiger 1985), as developments which stifled individuality by imposing another largely role-related set of expectations onto women. Systemically oriented family counselling owes some of its early ideas to Adler, Dreikurs and the child guidance era, and in the minds of some therapists, this connection is in itself enough to foster a continuing suspicion of a family approach.

Counselling in a Family Context: Early Theory and Practice

It is more than thirty years since counsellors, therapists and researchers began to react to the dominant individual focus by systematically exploring ways of working with families. Family therapists, as they came to be known, developed theories aimed at shedding greater light on what had always been intuitively understood - that in matters of personal wellbeing, we are not only affected by but in turn have an effect on those around us.

Perhaps the best known of the early family therapists is Salvador Minuchin. Minuchin, who still writes and practices in the United States, had grown up in a large rural family in Argentina. Mainly in response to working with poor dysfunctional families in New York and Philadelphia, he developed a theory which became known as 'Structural Family Therapy' (Minuchin et al 1967, Minuchin 1974). His theory and his work were radical and exciting in at least two senses. Firstly they presented the possibility of working not only with the individuals in the family, but also with the spaces between them and the structures these spaces created. Secondly, Minuchin made no formal assumptions about developmental blocks, pathology or faulty learning. Symptomatic behaviour was more benignly interpreted as being in the service of family preservation. The symptom was understood to be a sign that the family system had reached an impasse. By working with spaces and structure, the system was capable of making readjustments with no blame being attached to anybody.

Though it represented a significant departure from an exclusive focus on the individual, family therapy, as its name suggests, retained much of the thinking which informed traditional medical style interventions. Put simply, the medical model assumes that there is something wrong with the system (in this case the family rather than the individual) which requires fixing through the intervention of an external agent.

At the time Minuchin published his early material, others such as Virginia Satir in 1956 were working with families in a way which focused more on the recursive nature of the individual relationships between family members. But the avalanche of writing in family therapy through the seventies and well into the eighties became increasingly oriented to finding keys - or even the key to the family system. Where other counselling and therapeutic models had neglected context - especially the reality of an ongoing family context - family therapy went through a period in which the individual virtually became lost. As Goding (1992) put it: 'Many therapists were becoming increasingly alienated from the families with whom they worked. [They] increasingly came to stand above the family as if they could perceive what was really happening out there.' (p.23)

Counselling in a Family Context: An Integrated Approach

Though published in 1992, Goding's historical analysis of family therapy effectively ends in the mid to late eighties. Since that time, developments have occurred within family therapy which provide a much stronger theoretical basis for simultaneous intervention at both the systems and individual level. Briefly, these developments include the feminist contributions (already noted) relating to the analysis of power, the post modern narrative and constructivist approaches to therapy and the recognition (again strongly promoted by feminist thinking) that theory must take account of the fact that the therapist is a part of the system.

The constructivist orientation, (Anderson and Goolishian 1988) is a therapeutic adaptation of personal construct theory (Adams-Webber 1979). It takes as its starting point that each individual's and each family's unique interpretation of events is the reality to be worked with. In Australia, a closely related approach which begins with family and individual narrative has been extremely well articulated by writers such as White and Epston (1989).

Seeing the counsellor as part of the system is the logical and necessary corollary of adopting a stance which takes personal construction and narrative as its starting point. The counsellor's own narrative is neither superior nor inferior to the narratives of family members. The counsellor has skills in the facilitation of process but does not stand apart from family members as an expert with answers. Interestingly the one way screen, behind which expert family therapists tended to sit in judgement on a family during the seventies and early eighties, has now become a tool which provides therapists with the opportunity to reverse roles with the family. Many therapists now form 'reflecting teams' in which, in the family's presence, they speak of what they saw from behind the screen. In seeing themselves so reflected, the family members come to see and appreciate themselves in a somewhat different light and at the same time, see alternative ways of defining their relationship with each other. In so doing they restructure the family in ways suitable to their own needs. The effect can be dramatic and emotionally very moving.

Family and Personal Autonomy

At about the same time that family therapists formally began to articulate the need for less emphasis on the structure of families and more emphasis on how individuals constructed their lives in relationship to each other, McDonald (1988) published an article examining the question of personal autonomy and the family from a sociological and historical perspective.

McDonald (1988) pointed out that living alone did not mean living unconnected to others and that too strong a focus on structure can support misleading conclusions about the state of the modern family. There was ample evidence for example, that in times of crisis or when purchasing a home or seeking additional help with child minding, people made considerable use of their extended family networks. Studies also showed that many older people living in apparent isolation, were in regular touch with other family members. McDonald emphasised the importance of distinguishing between family structure and the way in which persons functioned within families and family networks. Personal autonomy did not mean emotional separation or detachment.

McDonald traces the historical antecedents of an emphasis on personal autonomy back to the Enlightenment. He notes, however, that the pace of change in the movement away from prescribed roles was much slower in the private sphere of family than in the public sphere of commerce. He also notes some of the critical events such as control of fertility and the establishment of equal pay - which have supported the struggle for greater autonomy within the family. The expression of these struggles has in turn led to periodic responses, generally from conservative forces, which while strongly supportive of autonomy in the workplace, link autonomy within the family to the disintegration of family life.

While the structure of families is clearly changing, the evidence remains strong that most of us continue to have a desire to live our lives in committed relationships and to be part of a family. Indeed there are indications that contemporary aspirations in this regard remain quite conservative. For example in reporting on a large representative sample of individuals in the National Social Science Survey completed in 1989, VandenHeuvel (1991) concluded that, 'whether men or women ... the vast majority saw marriage as the ideal arrangement'. In addition, 'over two thirds of the sample agreed that the companionship of marriage was more important than personal freedom.'

A result consistent with these findings emerged from an Australian Institute of Family Studies survey of young adults' attitudes in the 1990s (Millward 1991). Most young people in the study 'expected to marry, made positive comments about marriage, regardless of sex, nature of personal relationship and family background ... [and] ... marriage was taken for granted, even by those who had not seriously considered what it means'.

How can such views be reconciled with growing aspirations for personal autonomy? The issue is less perplexing if we consider McDonald's distinction (p.47) between autonomy and individuality. The evidence is overwhelming, he suggests, 'that we are irreducibly social and that we have a strong psychological need for companionship and intimacy'. In this sense Kant's definition of autonomy as 'the individual capacity for self direction' allows for choices with respect to the number and nature of relationships we wish to have, including, I would suggest, our relationship with ourselves.

This view of autonomy assumes an ongoing but positive tension between the desire to have our needs met as individuals and the desire to be in relationship with and be of service to others. In one way or another, that tension is played out in every individual, in every family and in every society. The recognition and acceptance of that tension in oneself and in one's clients would seem to be an essential element in any approach to counselling and therapy.

Conclusion

This article focuses on the personal nature of crisis for both families and individuals and suggests that counsellors and therapists have a role to play in assisting in the process of adjustment. At the same time the article points to three problematic aspects of the counselling/therapeutic response to personal crisis. The first relates to an awareness of social context. A crisis which is inappropriately personalised can reinforce or prolong a situation brought about or maintained by abuse or structural inequalities. For example, the poor need material resources; victims need guarantees that abuse will stop.

The second is that, given evidence of a strong need for intimacy and companionship and the desire of most to live within a family setting, therapies which focus only on individual internal processes, may be doing their clients a considerable disservice.

On the other hand, there is historical evidence that attempts to respond therapeutically to the family as a system have at times depersonalised the process to the point where individual family members and the quality and importance of their relationships have been ignored.

Despite these difficulties, Caplan and others have shown that at times of crisis, good quality timely intervention which empathically monitors and gently challenges personal responses and personal interpretations of the event, can have a critical impact on future functioning. For the reasons outlined, this article supports the value of a personalised approach with a systemic and family orientation. However, it suggests that only since the mid to late 1980s has family therapy begun to take an adequate stance regarding issues of power differentiation, structural inequality within families and inequalities between families and external institutions. During this period, family therapy has also endorsed a more realistic and more mature sense of autonomy both with respect the family's relationship to the counsellor and the family members' relationships with each other. These developments signal an important direction for future therapeutic intervention with families in crisis.

References

  • Adams-Webber, J. (1979), Personal Construct Theory: Concepts and Applications, Wiley, New York.
  • Adler, A. (1932) What Life Should Mean to You, Unwin Books, London.
  • Anderson, H. and Goolishian, H. (1988), 'Human systems as linguistic systems: preliminary and evolving ideas about the implications for clinical theory', Family Process, 27, pp.371- 393.
  • Bailey, J. (1986), 'The paid helper's position in power', Journal of Employment Counselling, September, pp.98-99.
  • Bateson, G. (1972), Steps to an Ecology of Mind, Ballantine Books, New York.
  • Caplan, G. (1970). The Theory and Practice of Mental Health Consultation, Basic Books, New York.
  • Dreikurs, R. (1957), Children: The Challenge, Duell, Sloan and Pearce, New York.
  • Eastman, M. (1989), Family, the Vital Factor: The Key to Society's Survival, Collins Dove, Melbourne.
  • Flaskas, C. and Humphreys, C. (1993), 'Theorising about power: intersectingthe ideas of Foucault with the "problem" of power in family therapy', Family Process, 32, 1, pp.35- 48.
  • Goding, G. (1992), The History and Principles of Family Therapy, Victorian Association of Family Therapists, Melbourne.
  • Goldner, V. (1985), 'Warning: family therapy may be hazardous to your health', Family Therapy Networker, 9, 6, pp.18-23.
  • Leupnitz, D. (1988), The Family Interpreted, Basic Books, New York.
  • McDonald, P. (1988), 'Families in the future: the pursuit of autonomy', Family Matters, No. 22, pp.40-47.
  • Millward, C. (1991), 'What marriage means to young adults in the 1990s', Family Matters No.29, pp.26-28.
  • Minuchin, S., Montalvo, B., Guerney, B., Rosman, B. and Schumer, F. (1967), Families of the Slums, Basic Books, New York.
  • Minuchin, S. (1974), Families and Family Therapy, Tavistock Publications, London.
  • Reiger, K. (1985), The Disenchantment of the Home: Modernising the Australian Family 1880-1940, Oxford University Press, Melbourne.
  • VandenHeuvel, A. (1991) 'The most important person in the world: a look at contemporary family values', Family Matters No.29, pp.7-11.
  • White, M. and Epston, D. (1989), Literate Means to Therapeutic Ends, Dulwich Centre Publications, Adelaide.

* The terminology which defines what professional helpers do is extensive - frequently generating more confusion than clarity. The differences in terminology are not addressed in this article and the generic terms counselling and therapy are used interchangeably.

Lawrie Moloney is a Senior Lecturer in the Faculty of Economics, Education and Social Sciences at La Trobe University. He teaches post-graduate courses in counselling psychology and in conflict resolution. A former Director of the Family Court Counselling Service, his research interests include children's rights, gender issues around parenting after separation, and the evaluation of family mediation services.