Chapter 8: Tapping the Power of Family Belief Systems
(Rolland)
 Beliefs provide coherence to family life, facilitating a continuity between the past,
present, and future
o What else may beliefs provide?
 “Disease, such as lead poisoning, cancer, asthma, and HIV, which are more common in
inner cities, need to be viewed through this larger societal lens.”
o Why might this be important?
 Writer discussed asking in clinical interviews about core family beliefs…
o What are some of our core families’ beliefs?
 Normative Illness Experience (p.132)
o Two useful questions to ask about family’s illness beliefs

How do you think other families would typically deal with a situation
similar to yours?

How do you think families ideally cope with your situation?
 “Families that value high achievement or perfectionism are prone to apply unachievable
standards in a situation of illness.”
o
How might this impact members of the family?
 Normalizing Mind-Body Interaction
o Mindfulness meditation, yoga, guided imagery – signif affect coping &
adaptation
o How might spiritual beliefs contribute to suffering? Or reduce suffering?
 believe cancer is caused by “sinful living”
o “Couple and fam studies find that shared spiritual beliefs and practices
strengthen relationships and the ability to transcend troubled times.”
o “Profound religious beliefs regarding end-of-life decisions can tear families
apart.”


Thoughts on this?
Beliefs about control/Mastery
o To what extent do family health beliefs emphasize internal control, “powerful”
others, or chance and destiny?
o How can a family’s core beliefs be “shaken” by a specific disease or health
circumstance?
o “A family’s beliefs about mastery/control can affect tx adherence.” How so?

Family beliefs about causes of illness & disability
o Personal responsibility, punishment, blame, injustice, genetics, negligence,
Belief-system flexibility
“Clinicians need to be mindful that families with the strongest and most rigid beliefs
about personal responsibility and control may function well during earlier stages of an
illness but become vulnerable if the condition progresses beyond their control.”
“You seem very committed to your beliefs about beating this illness. Do any of you
foresee any conceivable problems with this?”
“What would it mean for you to redefine your beliefs about success with regard to your
(or fam member’s) condition in a more flexible way?”
Working with hope and optimism
Weingarten (2010) describes reasonable hope which includes fluctuations of doubt and
despair as part of hope’s complexities.
I liked this definition of reasonable hope, did others have a reaction to hearing this
term/definition?
Illness Narratives
“The story that fa members develop about an illness experience is a synthesis of their
core family beliefs and their attempt to restore order out of chaos and fear.”
“Tell me about your illness and what it has meant for you and your loved ones.”
Diagnosis and Labeling
Person-centered -- Joe has diabetes vs Joe is diabetic vs Joe’s diabetic family
ALL-ENCOMPASSING, pathologizing entire fam, STIGMA
Couples dealing with fertility issues – pathologizing/blame/shame/broken
Tourette’s syndrome, MS, Parkinson’s, seizure d/os, physical deformities
Cog impairment/ID/TBI
Pros and cons of diagnoses and labeling?
Mastectomy – cultural assoc. w/ breasts & a woman’s beauty, as well as maternal qualities
Chapter 9: Helping Families with anticipatory loss and suffering

acknowledging and adapting to genetic risk info
o How might this change based on different factors of the family?

anticipatory grief

“A close brush with death can lead fam members to develop a better appreciation of
their loved ones and a sharpened perspective on life that clarifies priorities.”
o Are their other effects that near-death experiences may have on the
family/couple/individual?

“foster a resilient narrative”
o What does this mean in our field?

Possibility vs. inevitability of loss

Expected Illness Course
o How might having a preconceived notion of what the illness progression will look
like affect how someone copes with the illness?

Relapsing Illnesses
o How might relapsing illnesses differ from terminal illnesses in the effects on the
family?

Societal Stigma – Thoughts on stigma associated with diseases that can lead to
death/loss of functioning?
o HIV/AIDS
o Lung cancer
o Diabetes