As a child and adolescent psychotherapist, a big part of my work involves working with families. One might think that when it comes to family therapy there is no room for psychoanalysis, the unconscious and the exploration of hidden meaning behind a psychiatric symptom. Actually, one would be wrong! It’s a different kind of psychoanalytic practice when in the room with the whole family but psychoanalytic nonetheless.
In this blog post, let us look at one way that psychoanalysis applies to family dynamics and try to shed some light on the issue of using psychoanalytic thinking to the practice of family therapy. No matter whether you are a layperson or a clinician, if you are interested in the work of psychoanalysis with families, this post is for you.
First, when we speak of psychoanalysis, we usually think of the unconscious, right? Believe it or not, there is room for the unconscious when we think of family dynamics. For example, mental health clinicians, who specialize in working with trauma, encounter manifestations of the uncosncious in what we call “transgenerational transmission of trauma.”
Transgenerational transmission of trauma is when trauma is unconsciously transmitted in our psyche from one generation to the next – from mother to daughter, from grandparents to grandchildren, etc. The concept is mostly known in relation to holocaust survivors but it applies to all traumatic experiences – physical or sexual abuse, domestic violence, rape, suicide in the family, war, natural disasters, political persecution or refuge, genocide, slavery, etc. All of these experiences become a part of a family’s history and are “inscribed” in the psyches of family members.
In psychoanalysis, we believe that if a traumatic experience cannot find expression into the symbolic, meaning if it is not spoken about within the family or individual discourse, it re-appears in the body in the form of a symptom or psychiatric complaint.
This symptoms could be pretty much any psychiatric diagnosis – depression, anxiety, substance abuse, psychosis, suicide attempts, etc. In the context of a family, that may be what we usually refer to as the “identified patient,” meaning the person, who exhibits the concerning symptoms or behaviors within the family. Sometimes, it is more than one person; sometimes, it’s the parenting couple itself or two or three people, all within the same family system.
As a child and adolescent psychotherapist, I have worked with many families, in which one or both parents come from traumatic backgrounds, some with quite horrific personal stories. The reason why they come to seek help is typically because of concerns for one or more of their children. It is not news to child and adolescent therapists and especially to psychoanalytic psychotherapists that when a parent has a traumatic history that was never addressed or worked through in psychotherapy, most often than not, it surfaces one way or another in his/her children later in life.
Now, please, don’t read this the wrong way – this is not an attempt to blame any parent for their children’s struggles! Quite the opposite. Many parents do their best not to repeat their parents’ mistakes and to protect their children from the traumas they went through when they were younger. In psychoanalysis, we show great respect for the human condition and leave no room for blaming.
This phenomenon of trans-generational transmission of trauma is a recognition of the power of the unconscious and the resiliency of the human mind. As I’ve explained elsewhere, in psychoanalysis, we believe that a person’s symptoms and actions are repeated in an unconscious attempt to cope with them and to turn the passive experience of trauma into the active one of taking control.
So, how do we use this in family therapy? We look for what has never been spoken about in the family’s present and history, and we find a way to talk about it as it relates to the presenting struggles today. Better yet, we listen for repeated patterns across generations and we ask questions or make statements that encourage the whole family to speak about their internal experiences in the present moment. We pay attention to the relationships within the family system and how one person’s actions impact the rest of the family. It makes sense, doesn’t it?
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Do you have questions about psychoanalysis and family work? You can ask them in the comment section below.
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