In his book, David M. Allen, M.D. unifies individual psychotherapy with family systems theory and practice to present a ground breaking eight-stage approach to the therapy of adults exhibiting personality disorders. He proposes a way to reconcile major opposing views on the origin and treatment of self-destructive behavior and goes beyond to provide a new understanding of the unique relationship between individuals and their families. He shows how this understanding can help therapists from all orientations and backgrounds improve their work with clients.
A PRACTICAL, STEP-BY-STEP MODEL
The author argues that individual problems and related family difficulties can be remedied through individual psychotherapy with just one family member. He offers a practical, step-by-step model for teaching individual clients to initiate effective family problem solving and change unhealthy family dynamics. The book includes case examples for each state of therapy to illustrate specific interventions.
"The first book that clearly shows how family and individual therapy can be integrated. I particularly like the concrete examples derived from the sophisticated theoretical frame. This is joining theory and practice. It will make a difference in thinking and practice in the future." - Allen E. Ivey, professor of counseling psychology, University of Massachusetts, Amherst.
"A timely and welcome volume. Allen's sensitivity to the dynamic reciprocity of self and system is refreshing, and his clinical recommendations are clear and practical." - Michael J. Mahoney, professor, University of North Texas and member, board of advisers, Society for the Exploration of Psychotherapy Integration.
"Full of highly provocative, incisive, and bold disagreements with most systems of marriage and family therapy. Many family therapists will disagree with its hardheaded (un)common sense, but almost all can learn considerably from Allen's independent thinking" - Albert Ellis, author of The Practice of Rational-Emotive Therapy.
Part One: Linking Individuals, Families, and Cultural Systems
1. Relationships Between Self and System examines the viewpoints of notable therapists - such as Bowen, Kohut, Jung, and Perls - to come to a new understanding of the relationship between the psychology of the individual and the dynamics of his or her family of origin.
2. Emergence of the Self from the System looks at how problems arise as people try to break free from the limiting roles they often play in their families and develop distinct ideas and life styles.
3. Sacrifice of the Self describes how members of unstable families mask their feelings and develop "false selves" to prevent discord and maintain seemingly harmonious relationships. It reveals why this kind of self-sacrifice backfires.
4. Dysfunctional Interaction in Families discusses how recent charges in sexual mores, marriage customs, and parenting responsibilities can strain relationships and generate unhealthy interactions within families as well as dysfunctional personality traits.
5. Personality Disorders in a Systems Context demonstrates how certain cultural and family systems contexts generate responses characteristic of severe personality dysfunctions, such as the borderline and narcissistic disorders.
Part Two: A Unified Approach to Psychotherapy
6. Systemic Change Through Individual Therapy outlines a practical, step-by-step therapeutic method for teaching individual clients to initiate effective family problem solving and so improve family dynamics. Shows how clients can learn to empathize with other family members, discuss sensitive issues rationally, and help the entire family function better.
7. Involving the Patient tells therapists what to say and do to build client trust and gain cooperation. Advises how to ask important questions without making clients defensive, explain the process of therapy, minimize transference, and more.
8. Framing the Problem shows how to gather accurate descriptions of family history and behavior patterns, uncover the reasons for dysfunctional behavior, and encourage patients to work on new solutions to problems.
9. Coaching and Role Playing provides specific strategies designed to prepare clients for discussing problems with their families and overcoming potential resistance. Case examples indicate how clients can learn to deal with defensiveness and efforts to subvert genuine communication.
10. Special Problems and Termination focuses on handling special problems - such as potential power struggles between client and therapist - and shows how to complete therapy and prevent relapses.
Conclusion: The Duality of Self and System summarizes the key elements of a unified approach to therapy and explains why this approach requires an understanding of the unique and paradoxical relationship between individuals and family cultural systems,
DAVID M. ALLEN is Associate Professor of Psychiatry and Director of Psychiatric Residency Training at the University of Tennessee, Memphis.