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Psychoanalytic Family
History and major founders
Key concepts
View of health/dysfunction
Role of the therapist
Common interventions/exercise
Research (effectiveness)
Recommended books & articles
Major Founders & History
Psychoanalytic has a long history that stems from the works of
Freud; the handout will provide a more detailed history
Pioneers of family therapy who were psychoanalytically
trained: Nathan Ackerman, Murray Bowen, Ivan BoszormenyiNagy, Carl Whitaker, Don Jackson, Salvador Minuchin
1960’s and 70’s, most family therapists rejected psychoanalytic
thinking; however, in the 1980’s, the psychology of the
individual returned
Freud (1909) introduced major psychoanalytic
concepts, but overall ignored the role of the family
Leading Figures
Erikson (1930) expanded ego psychology to consider
sociological factors
Cohen (1953) led the family schizophrenia research at
Ryckoff and Wynne (1960) introduced family dynamics
courses at Washington School of Psychiatry
Scharff (1975) helps the school become a leading
center in psychoanalytic family therapy
History Continued:
Theoretical Underpinnings
1) Freudian Drive Psychology
Libidinal and aggressive energy
2) Self Psychology (Kohut, 1971, 1977)
Every human longs to be appreciated
3) Object Relations Theory (Klein, Fairbairn, & Winnicott, 1965)
Mental images of self and others built up from experience and
The bridge between psychoanalysis (individual therapy) and family
Formation of early mental representations can create patterns of
interaction in the future (like attachment theory)
Object = person, relations = the relationship with the person
Defense Mechanisms:
Splitting = maintains the all good or all bad dichotomies that children
have of their parents
Introjection = repression of negative attributes of an object, person
becomes more susceptible
Example: pg. 152
Pseudomutuality: a family relationship that has the
superficial appearance of openness; however, it is rigid
and depersonalizing
Delineations: express a need within the parents;
usually affects adolescents in the way they maintain
behavior to address the parental need, (engaging in
misbehavior because the parent needs to discipline)
Projective Identification: unconscious act of projecting
a (usually) unwanted emotion or attribute onto
someone else
Key Concepts: Self Psychology
Two things are deemed essential for the development of a secure and cohesive self:
1) Mirroring: understanding plus acceptance
Example: attentive parents conveying a deep appreciation for how their children feel
2) Idealization: when children can believe their parents are terrific, and they are part of them
This helps create a firm base of self-esteem
There are many ways a family can experience dysfunction:
When families and individuals experience overtaxing stress,
they may become stuck in dysfunctional patterns
Fixation occurs when they repeat unsuccessful attempts
Regression occurs when they revert to previous levels of
Invisible loyalties: unconscious commitments children take
on to help their families to the detriment of their own wellbeing (scapegoat)
A “Healthy” Family
Parents who do not project their anxieties onto their children
Individuals within the family are differentiated; they do not react from unresolved dependency
Avoiding the “false self” (pretending to be what you’re not)
Mirroring and idealization help foster self-esteem
“An average expectable environment with good-enough mothering is sufficient” (Winnicott,
Create the container (trust, empathy,
Empathy helps create a “holding environment”
where the family feels safe to be vulnerable
Role of the
The therapist remains focused on process
Goal of the therapist is to free family members
of unconscious constraints so they can interact
as healthy, differentiated individuals
He/she will help clients identify how their
present difficulties emerged from unconscious
perpetuation of conflict in their own families
Create a climate of trust and proceed slowly
Assessment is continual, and a practitioner will not postpone treatment until they’ve “figured it
Five Important Questions: Bentovim & Kinston, 1991
1) How does the family interact around the symptom?
2) What is the function of the current symptom?
3) What disaster is feared in the family that keeps them from facing their conflicts?
4) How is the current situation linked to past trauma?
5) How would the therapist summarize the focal conflict in a short, memorable statement?
The signal of intrapsychic conflict is affect
Analytic therapists key in on strong feelings and use them as a starting point for a detailed
inquiry into its origins
Example: “when have you felt that way before?”
Takeaway: psychoanalytic family therapists form an initial hypothesis, then refine it through
exploration over the course of treatment
Common Interventions
Four Basic Techniques:
1) listening
Let go of the desire to “do something”
2) empathy
Express empathy in order to help the family open up
3) interpretations
Used to illuminate hidden aspects of experience
4) analytic neutrality
Helps establish a climate of exploration; suspends therapist’s anxious involvement in problem
Psychoanalytic therapists organize their explorations along
four channels:
1) internal experience
2) the history of that experience
3) how family members trigger that experience
4) how the context of the session and the therapist’s input
might contribute to what’s going on between family members
Critique (Strengths & Limitations)
Psychoanalysts have been criticized that their theories absolve individuals of responsibility
Very focused on mother-child relationship
The psychoanalytic approach is very process-oriented, and can help the “individual” within the
Insight driven for cognitive clients
Research & Support
Psychoanalytic therapists have generally resisted empirical attempts to validate their work, as
symptom reduction is not their goal
However, the following case studies have provided evidence for dealing with various emotional
and behavioral problems:
Childhood trauma (Mackay, 2002; Paris, 2013)
Adolescent depression (Christogiorgos et al., 2010)
Schizophrenia (Morey, 2008)
Borderline Personality Disorder (Allen, 2001)
Parent-Infant Relationships (Cutner, 2014; Diaz Bonino, 2013)
Recommended Books & Articles
Attachment in Psychotherapy, by David J. Wallin
Attachment Theory and Psychoanalysis, by Peter Fonagy
Object Relations in Family Therapy, by David and Jill Scharff
Self in the System: Expanding the Limits of Family Therapy, by Michael Nichols
A full circle: psycho-dynamic understanding and systems theory, by Arnon
Connection between object-relations theory and attachment theory, by Alan
Video of David Scharff explaining the
psychoanalytic process with an 11-year-old
Heard, D. H. (1978). From object-relations to attachment theory: a basis for family therapy.
British Journal of Medical Psychology, 51(1), 67-76.
Mackay, J. L. (2010). A psychodynamic understanding of trauma and adolescence—a case study.
Southern African Journal of Child and Adolescent Mental Health, 14(1), 24-36.
Nichols, M. P., & Davis, S. D. (2017). Family therapy: Concepts and methods. Hoboken: Pearson.