Psychoanalytic Family Therapy

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PSYCHOANALYTIC FAMILY THERAPY

Psychoanalytic family therapy is based on the observation that for any group that calls itself a family in a given culture, there is an objective interdependence between the subjects comprising it, owing to the hierarchy of generations and the distribution of roles within it. There are also areas of subjective interdependence.

Difficulties concerning the treatment of some patients led therapists to become interested in these individuals' families, which were viewed as pathogenic; the family and the mental patient were examined as a whole, and their specific modes of functioning highlighted. In the 1950s, researchers at Stanford, influenced by systems theory (Ludwig von Bertalanffy), described the kinds of communication that occur in the families of schizophrenics. From this arose a vast area of research that came to be applied to "systematic family therapies."

Concurrently, research on groups was conducted in the field of psychosociology (Jacob-Levi Moreno) and from a psychoanalytic perspective (Siegmund H. Foulkes, Wilfred Bion, Henry Ezriel). In France, Jean-Bertrand Pontalis, Didier Anzieu, and René Kaës proposed new concepts such as the group mind, inter-fantasizing, and group transference.

Family groups whose members had a life in common, both past and present, have been the object of a number of specific experiments conducted by psychoanalysts. Freud suggested the concept of "psychic apparatus" to account for the existence of mental factors associated with this apparatus's ability to distribute and transform psychic energy. Borrowing this model, René Kaës forged the concept of "group psychic apparatus," which he defined as "an efficacious and transitional fiction—that of a psychic group, backed up by a mythical group, which is seeking to become real by the construction of a concrete group."

In this connection, family therapists conceptualized a family group mental apparatus, one which originated archaically in the individual psychic "deposits" and the psychic contents of the transgenerational heritage. Their fusion created an unconscious psychic basis, common to members of the family group, inducing a specific experience of belonging, with "a feeling of familiarity," unlike anything else. Individual fantasies were articulated on this psychic basis, from which they derive some of their content. The family psychic apparatus (FPA) is a conflicting co-construction formed from the elements of internal group feeling of each family member, and elements of a common psyche and of the social group. The FPA, as a category, includes the sexual nature of the roles active in family relations.

In therapy, this psychic organization of the family group is realized within the framework proposed by the therapist. The therapist ensures psychic security, allowing the deployment of the therapeutic process through the free verbalization required, the stability of temporal-spatial conditions, the fact that the duration of the cure is not determined a priori, and the rule of abstinence. In their observations and interventions therapists focus especially on group aspects as based on the transference/counter-transference. The essential goal of therapeutic work lies on the level of the paradoxical narcissism-antinarcissism duality that is active from the very beginning in each subject and primal component of the familial psychic apparatus. This objective transcends the treatment of the symptomatology of the "designated patient." The goal is autonomy for the individual psyche and access to the oedipal conflict, through a sufficient development of the couple/group tension that is always conspicuous within the family group. However, René Kaës has expressed doubts about the "accepted name, Analytical Family Therapy," thinking it should rather be known as "Psychoanalytical Psychotherapy of the Family."

Family therapy requires preliminary work to allow the family group to accept this unusual situation. Maurice Berger developed a "new theoretico-clinical field," in which reference to the group and to psychoanalysis was preserved. He drew on Winnicotian concepts, and developed the idea that the framework could not be determined ahead of time by the therapist, but had to be constructed with the family. At the limit, the very notion of therapy was eschewed (but not the goal of treatment).

The training of family therapists requires a personal psychoanalysis, but how necessary it is to have psychoanalytical experience with members of one's own family is, as of 2005, still open to debate.

FranÇoise Diot and Joseph Villier

See also: Double bind; Group psychotherapies; Individual; Individuation (analytical psychology); Intergenerational; Secret.