PSYCH218 Study Guide - Final Guide: Family Therapy, Play Therapy, Gender Role

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7 Feb 2016
Relational Level: Loss and the Family- A Systemic Perspective
- Each culture in their own way offers assistance to the survivors and mourners
oEx. In Hong Kong, mourners are given an envelope with a cloth, candy
and a coin
- In a family system’s perspective, loss is viewed as a transactional process
oInvolves the deceased and survivors in a shared life cycle
- In the past, there were high rates of mortality for infants, children and women in
childbirth along with a much shorter life span
oIt was rare to grow up without experiencing a death in the immediate
- These days, people tend to hide death and this makes the process of adapting to
loss more difficult
- Mourning responses vary widely
- Studies have found that the death of a family member increases vulnerability to
premature illness and death for the surviving members
- A Systems Perspective on Loss
oMurray Bowen and Norman Paul
2 processes in operation- intrapsychic (involves some sort of denial
of death) and closed relationship system (people can’t
communicate the thoughts they have and this upsets the family or
The intensity of the emotional reaction, time of loss, functional
importance of the member lost
“aftershocks: can happen in the extended family system
oFamily therapy’s inattention to loss goes hand in hand with a culture’s
denial of death
Our society treats grief in a private matter, this can cause many
oIn order to help families with loss, therapists have to look back at their
family history
Families have to be in a balance or harmony with their past
- Family Adaptation to Loss
oFamily life cycle model of Carter and McGoldrick
oFamily Adaptational Tasks
If these task aren’t dealt with, this can leave family members more
1. Shared acknowledgement of the reality of death and shared
experience of loss.
All families have to confront the reality of death in the family
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Visiting the dying family members whenever possible, find a
way to include children
Not being able to confront the reality of a death in the family
can lead to family members avoiding contact with the rest of
the family, becoming angry with others who are moving
Funerals and visiting the grave allows the members to have
direct confrontation with the reality of death and can pay last
respects, share grief
Emotional expressions may be blocked and this can cause
the blockage of open communication
If certain feelings, thoughts or memories are seen as taboo
or are disallowed in families, communication blockage can
cause symptomatic behavior or cause feelings to go
2. Reorganization of the family system and reinvestment in other
relationships and life pursuits
The death of a family member causes the family equilibrium
to disrupt and the family needs to find a way to realign
relationships and determine a redistribution of roles
Some families might hold onto old rigid patters that aren’t
Family members might not want to accept a new member
because they might be seen as replacing the deceased
when the loss hasn’t been fully mourned yet
oFactors Influencing Family Adaptation to Loss
The Manner of Death
Sudden or lingering death
oCan cause the family members to not have enough
time to prepare for the loss, deal with unfinished
business or even say goodbyes
oIf the dying process is prolonged, caregiving and
finances can get depleted, suffering and family strain
can take a toll
oMembers have the constant dilemma of maintaining
life support or not
Ambiguous Loss
oMember might be physically absent but
psychologically present
Ex. Hostages, disappearances
Uncertainty of whether or not they’re alive
Maintaining hope that they’re alive but also
fearing the worst outcome
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oMember might be psychologically absent but
physically present
Ex. Alzheimer’s disease
Help the family member deal with the loss of
important aspect without thinking the person is
already dead
Violent Death
oCan lead to PTSD
oBody deformity, dismemberment can cause trauma
and nightmares
oSense of security and invulnerability is shattered
oSurvivors have to live with the constant threat
- Family and Social Network
oFamily Cohesion and Differentiation of Members
A family that is enmeshed might only want to stay united and
disregard any individual differences
Disengaged families avoid the pain of loss but are distanced and
emotionally cut off
Family fragmentation causes members to be isolated with grief,
each has to fend for themselves
oFlexibility of the family system
Family rules, roles and boundaries need to be flexible and clear
Ex. A chaotic family won’t have leadership or stability to transition
Ex. A rigid family will have difficulty modifying old ways of pattern
oOpen communication vs. Secrecy
Open communication is important for the recovery process
If communication is blocked, it might be expressed through
destructive behavior or dysfunctional symptoms
oAvailability of extended family, social and economic resources
The availability of other resources can buffer the loss
oPrior role and functioning of the deceased member in the family system
The more important the person was in the family, the more central
their role is in family functioning and the greater the loss
Ex. Death of a parent or child, loss of a leader or caretaker, death
of an only child
oConflicted or estranged relationships at the time of death
The mourning process can cause relationships to have more
conflicts and this can cause fallouts
Hesitance to bring up painful emotions or old conflicts
- Life Cycle Timing of Loss
oUntimely loss
Dying “before one’s time”
Unfulfilled hopes and reams
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