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Involving Families Enhances Patient Outcomes

Addressing Conflict in Families

The families that come to us for counseling are those who are so discouraged about their ability to solve their own problems that they are afraid that their family will implode or explode.  They come to us in the hope that we can help them avert disaster.

We can offer them this frame: Fundamental to our work is the belief that people almost always have the capacity to solve differences. It does require that everyone understand that being unhappy with each other for awhile doesn’t mean that love is lost. Knowing how to work out differences while maintaining loving connection is crucial to the health and longevity of a family.

In order to teach classes in family therapy, I needed to clarify the principals that underlie my work. The list is not intended to be sequential. Nor is it intended to indicate an order of importance. The headings are my ongoing internal guideposts for my work. I share them here. Those who have been doing family therapy for awhile will recognize them, I’m sure. If you are new to family work, this may serve as a helpful overview:

Conflict is inevitable: No matter how much people love each other, they are going to fight. It’s inevitable that family members will find that some differences in opinions, values, beliefs, or goals are in conflict. Patients need reassurance that conflict is a normal part of family life.

Conflict is a place of growth. It’s new information to some people that conflict is not necessarily something to be upset about. Conflict signals our growing edge; the place where we have work to do in order to become our best selves as individuals and as family members. I worry about families who say they never, ever fight. I worry that someone is so afraid of conflict that they give in rather than have it out or that someone becomes so defensive that the fight becomes destructive. Everyone else walks on eggshells rather than get into it with them. If so, it’s likely that the relationships will stagnate or splinter.

Blame stands in the way of solving problems: I often ask people, “Do you want to establish blame or solve the problem?”  Even if we do establish blame, the problem is still there. So, yes, it’s important that people take responsibility for their part in any conflict — and it is important that family members hold each other accountable. But if we stop there, the family has meted out some idea of justice but hasn’t grown.

Defensiveness impedes growth: When someone in the family is constantly defensive, there will be little movement in treatment. A person in a defensive posture can’t listen. They are too busy internally rehearsing how they will defend themselves. Stop the conversation if someone is digging in and arguing. Defensiveness is often rooted in shame or anxiety or fear. Ask family members to address that person’s feelings directly before getting further into content.

Broken agreements: When people make an agreement or “contract” during a therapy session and they don’t hold to the agreement, they are not being “bad” or “resistant” clients. It’s a signal that we didn’t have a real agreement they could keep. It falls on everyone to revisit the issue to understand what got in the way. We can then find an agreement that is sustainable.

When they keep it up: Similarly, when people feel and say that they have done their best to be respectful and clear with each other about an issue– and they are still fighting – it means that we are all missing a bigger problem. It may be that whatever they think they are talking about is not really what they are talking about. For example, a mother may think she is only correcting a child’s behavior but she is really afraid that the behavior she is correcting indicates that the child will get into trouble just like her brother did. Her anxiety about a repeat of her brother’s impact on a family is fueling the fight.

Resolve family of origin issues. It’s important that each adult in a family work on themselves to become a full adult member in their own family of origin. Often unresolved issues get played out in their marriage or in their parenting.

Trauma history: If either member of the couple has unresolved past trauma involving the family of origin or sexual assault as a child or teen, address it directly. If you don’t have the skills to do so yourself, refer to a trauma specialist. If the family has experienced a traumatic experience together (such as the loss of a child or loss of their home in a natural disaster), chances are that an unrelated presenting problem (such as worries about a teen’s rebellion) is a way to distance from the pain of that loss. Deal with the loss before moving on. It’s likely that other issues in the family will be resolved in the process.

Perfection is toxic: Teach family members to have the courage to be imperfect – and to let other people also stumble in the relationship. It’s unfair and unrealistic to hold ourselves or each other to a standard of perfection. To do so is a recipe for disappointment in self and others.

Martyr and victim roles are both toxic in families. No one should give in all the time. No one should be victimized or take the role of victim in order to have a place. Each member needs to give at least 75% of the time. That doesn’t mean that anyone will lose 25% of the time. If everyone is giving most of the time, everyone will feel supported in the relationships.

Score keeping doesn’t belong in families. It doesn’t matter who “owes” who an apology, a turn hosting an event, or the return of a call or a visit. People’s lives are complicated. Sometimes circumstances, energy level, illness, or other demands make it difficult for a family member to do his or her “turn.” If someone wants to be in touch, does it really matter who makes the call? Staying in contact is more important than taking turns or expecting someone else to make the first move.

Mutuality: One sided relationships seldom last. Support people in expressing interest in each other’s daily lives. Yes, it’s nice to hear about someone’s successes, worries, and events. But if the relationship is to be rich and loving, there must be room for the other people in the family to share their successes, worries, and events.

Time together: It’s easy for people to get so wrapped up in personal busyness that they forget that nurturing family relationships takes some time. Email and social media allow family members to keep in touch more often. But there is nothing like face to face, up close and personal time to enrich relationships. Nonverbals tell each other as much or more than a quick tweet or even a long email. Families that stay close make a point to get together at least a few times a year when there is distance; more often when they live close together.

Express love. Some people assume that, of course, family members know they are loved so they don’t have to say it. Some people were raised in families where there was little expression of love except through material gifts. Coach family members in the importance of giving each other both verbal and nonverbal expressions of love. Touch is often just as important as loving words. Reassure them that people are never spoiled by being told they are loved.

 

 

 

 

Addressing Conflict in Families


Marie Hartwell-Walker, EdD

Marie Hartwell-Walker, Ed.D. is an author, licensed psychologist, and a marriage and family therapist who has been in practice for more than 35 years. She is a regular contributor to Psych Central and one of the therapists who answer questions at Ask the Therapist.

 

APA Reference
Hartwell-Walker, M. (2019). Addressing Conflict in Families. Psych Central. Retrieved on December 12, 2019, from https://pro.psychcentral.com/addressing-conflict-in-families/

 

Scientifically Reviewed
Last updated: 1 May 2019
Last reviewed: By John M. Grohol, Psy.D. on 1 May 2019
Published on PsychCentral.com. All rights reserved.