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How important an influence is the family of origin, in the life of the individual and the difficulties which the client presents in therapy?

Patrick Kelly MIACP, BA (Hons.) Counselling & Psychotherapy
Oranmore Counselling Centre
Castlecourt
Oranmore
Galway

This essay is mostly based on “Families and how to survive them” by Robin Skynner and John Cleese. The book is in the form of a dialogue between Skynner and Cleese. It outlines a substantial amount of psychodynamic theory on the origin of personality and psychopathology. It also covers the developmental stages of the child, what is required at each stage and what can happen if the needs are not fulfilled. It also covers sexual identity and sexual dysfunction. Both of which are a function of one’s parents attitudes and expression around sex, intimacy and love.

The book posits that personality and psychopathology are a result of the interaction between the individual with the family of origin and in particular the mother. However, in some instances, Skynner does allow for genetic hereditary. He also takes into account environmental factors but mainly from the viewpoint of correcting something that was missing from primary care situation. For example one may find a caring teacher or mentor who supplies the boundaries or modelling needed that was not provided by the mother or father.  

As mentioned already the mother is taken to be the primary care giver. She is therefore primarily responsible for the physical and emotional well being of the child. However it takes two people to make a baby so how does a family start? First one must choose a partner. How is this achieved? 

Skynner (1983) proposes the concept of screens. Every family has them. The function of the screen is to screen off any emotion or feeling that the family is uncomfortable with. So in their everyday dealings with each other one or more emotions are put behind a screen. Therefore the offspring in a particular family are not exposed and have no experience of dealing with the particular screened off emotion. It is a familial taboo. Sigmund Freud believed that the two things we have no conscious choice over are our career choice and life partner. Individuals unconsciously seek out others with the same screened off emotions. We choose partners who have the same screens. Since the family backgrounds are the same, the children of a couple will have the same emotions screened off as both of the parent’s family of origin. 

For example: Ciara comes from a family who are uncomfortable with anger. In this family expressions of anger are considered inappropriate and are therefore screened off. Ciara marries Eugene. Eugene comes from a similar family. As an infant their daughter Aoife feels her parent’s discomfort with anger and associates it with rejection. She hides her anger from her parents and eventually from herself. As a teenager she has developed a propensity to self harm. She has learned to screen off her anger and internalise her angry feelings.  She also has low self esteem as she has a feeling of falseness about herself due to her concealment of anger from her parents.

The reason why the mother is so important in the person’s life, is that she is the first care giver, provider of food, love and warmth. In general the father has less contact with the baby for the first few months. The parents take up different roles. The mother tends to be more nurturing and the father tends to set and impose boundaries. 

The mother needs to emotionally connect with the child. There are varying levels of psychopathology that can arise if this does not happen. At one extreme Autistic Spectrum Disorder can occur. Psychoanalytic theory purports that people with this disorder tend to see people as objects and cannot emotionally connect. They also have no facility for imagination and communication tends to be impaired and awkward. In the seventies and eighties mother’s of ASD children were referred to as “refrigerator mums”, implying that they were emotionally cold to the child. This theory has come in for staunch opposition and criticism over the years.

When a child is born it has no sense of self. It cannot see itself as a separate entity to its environment or the people around it. In the first few months of life it learns that it is separate. This is done by the mother reinforcing the concept of separateness by teaching the child boundaries. If the mother is always there on demand, then the child cannot learn that it is a separate being. The child needs to be let down. If it is hungry for instance it needs to experience the hunger and instant gratification is not always helpful. If the mother has not allowed the child to experience itself as separate by putting boundaries in place and therefore the boundaries are “fuzzy”, problems arise which effect development and can lead to psychopathology. 

Winnicott (2006) distinguished between different types of mothers. He referred to the good enough mother as the healthiest for the child. The good mother smothers the child and provides an on demand service. The child will struggle with its own separateness and identity. The bad mother neglects or abuses the child leading to emotional instability. The good enough mother does not strive for perfection and provides a safe base from which the child can explore its world.

The child enters rage when hungry. Since it considers itself omnipotent it cannot understand why it is not being fed immediately. It enters a state of bliss when feeding. These are two extreme emotional states. It can perceive a good mother who feeds it and a bad mother who does not, even though they are the same person. If the child has not got clear boundaries it could end up projecting its uncomfortable emotions onto something outside itself while keeping the good emotions for itself. This can lead to a paranoid personality type. It is noteworthy that we all have some sense of paranoia, anytime we break things into good and bad we are reliving this childhood experience.

This paranoid behaviour can also be used to project the unhappy or negative emotions onto one sibling in the family. This person gets blamed for everything and becomes the family scapegoat (Satir, V. 1983) . This can affect self esteem and behaviour. Conversely there can be a “golden child”. This is someone who in endowed with all the good qualities. This can lead to a false sense of self and Narcissistic Personality Disorder. 

As the baby develops a sense of itself as separate it leaves this stage of development and starts to obtain object permanence (Santrock, J. W. 2001). If it cannot see itself as separate, then as it develops, it starts to see people as objects or in parts: neck; breasts; lips etc. This can lead to schizophrenia and/or addictive behaviours. This again is due to the lack of emotional connection from the mother and an inability for the parent to define boundaries. This is due to the parent’s own childhood experience. Some people with unhappy childhoods cannot connect with the child, because to go there is too painful. In some cases the mother uses the child to sooth themselves. The mother can go to the baby’s level but cannot get back to the adult self. For a child all the emotions, sensations and mental processes are very confusing and if there is no one available to sooth them, and indeed they have to deal with someone else’s confusion, they get overwhelmed and can end up disassociated and emotionally disconnected.

Severe neglect and abuse, in childhood, can also lead to psychopathology. The results are usually low self esteem and depression, eating disorders self harm, or harming others. This is due to the feeling of powerlessness, as a helpless child, or even identification with the aggressor.

The healthiest children, emotionally, are those that are cared for when they need caring. However all children suffer distress, discomfort and sadness. Some mothers, due to their own denial of a need for themselves to be nurtured, can not access the feeling of “healthy sadness”, so when the child is sad they react inappropriately.  They might become emotionally withdrawn. So the child is left helpless and left in the state of distress. Conversely they may rush in to stop the child’s pain every time, because this sad emotion is so unbearable for them.  If this happens the child will not be able to experience sadness themselves and continually require comforting without the full experience. This leads to avoidant behaviour. The feelings are cut off. One is left in “sadness limbo”. The full emotion is not experienced so one cannot come out the other side. This is depression.  Every time the sadness is avoided the feelings keep piling up behind their screen leading to further and deeper depression. This stage happens after the child has learned he is separate but the closer to the earlier paranoia stage the client is the more severe the depression. Manic depression is a form of severe depression. In a manic state the client can regress back into a paranoid or schizophrenic state.  

So far we have discussed the role of the mother but what part does the father play? The father needs to reclaim the mother from the child and needs to be the one who sets and enforces the rules. If this is not done the child will grow up with authority issues and have an inability to be authoritative and assertive, it may also lead to lack of confidence and role confusion among the children. 
If the child ends up taking sides with one of the parents against the other because the parents are in conflict, they can end up as a problem child. This is the child’s attempt at uniting the parents by putting themselves as the focus of the problem. This pattern is a hard one to break and can result in a underachievement or antisocial behaviour. Alternatively they can become ill in order to bring the parents together. This can result in somatoform disorder in adulthood. 

The relationship of the child with the parents also leads to gender identification and sexual identity. Firstly the child needs the parents to have a loving healthy sexual relationship. This is the model for them when they are seeking a partner. From the attitudes and expressions of the parents the child learns to form relationships and explore sexual relationships. Therefore the parent’s relationship has an impact on the individual’s future ability to form loving, caring and healthy sexual relationships. 

The mother is the primary love object. In order for a girl to have a heterosexual identity she needs to be able to stay identified with the mother but then the father becomes the love object. For boys they need to cross over and identify with the father’s masculine standpoint while keeping the mother as a love object. If this does not occur or they only make it a fraction along the way of the transitions then the child will become homosexual or may not be comfortable with their sexual identity. In former years this was seen as the model to “cure sexual deviance”. In these times it is rare for someone looking for a treatment to cure homosexuality. However this insight may give a therapist a glimpse of the family structure. This is also an aspect of psychoanalytic theory that has come in for some severe criticism.  

I struggle with accepting some of this theory, especially in relation to autism and homosexuality. Perhaps this has to do with my own denial about the influence that my family of origin had to do with my development. It becomes so much clearer when I see the impact of the family on others. My own screening must be at work here. Once I see it from the perspective that there is no blame being attributed it sits better with me.

Working from a psychodynamic framework, it seems that most presenting issues have their roots in childhood and the family of origin. The most notable exception to this being PTSD. However one must note that one’s predisposition to acquiring PTSD may also have its roots in family experience and indeed the disorder may be caused by the family of origin. There is continual debate as to causes of certain disorders and sexual identification issues. I do not believe the nature vs. nurture debate will ever be thoroughly resolved. 

Psychodynamic theory and the knowledge of the issues arising from the family of origin gives us a insight and a way of working with complex issues presented in the consultation room. One needs to also bear in mind the actual time in the person’s life that the problem began. Generally the earlier the problem started the harder it is to work with. I think it is always necessary to keep in mind that we are not playing a blame game here. These processes and family interactions happen at an unconscious level. Only by becoming aware of them can we do anything to change them.

Patrick Kelly BA (Hons.) Counselling & Psychotherapy
Oranmore Counselling Centre
OranmoreCo. Galway
April 2013

References:

Santrock, J. W. (9th Ed.). (2001). Child development. (pp 206-211). New York: McGraw-Hill.
Satir, V. (3rd Rev Exp edition). (1983). Conjoint family therapy. Palo Alto: Science and Behavioral Book.

Winnicott D. W. (2006) The family and individual development. Trowbridge: The Cromwell Press.

Bibliography:

Skynner, R. & Cleese, J. (1983). Families and how to survive them. London: Vermilion.

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