Wednesday, December 21, 2011

Holidays are a Stage for the Family Drama

When you go "home" for the holidays, do you feel every bit the competent, professional adult, or do you sometimes feel disconcerting echoes of a younger, more vulnerable self?

I, for one, find that certain places and people bring up long-dormant thoughts and feelings from my youth - reminders of how I felt and what I experienced in my most vivid memories of childhood locations and relationships, layered over (under?) my adult experiences. Going back to my high school is a good example of this phenomenon: I am aware of all the ways the school seems different, but somehow feel as if I am 15 again.

Of course, the phenomenon is much more intense - and emotionally fraught - when we're talking about family. Many of our most significant and/or emotional experiences happen in families, so it makes sense that being around family will bring out old emotions and patterns of relating that our adults selves hardly recognize. Perhaps if you haven't experienced it yourself, you've seen your significant other or a close friend transform around his or her family of origin.

Coupled with unrealistic expectations and pressure to have a "happy" holiday, it's really no surprise that so many clients 1) approach the holidays with no small amount of trepidation, and 2) return from holidays having regressed in one way or another. Perhaps it should be more of a surprise that anyone comes out intact!

I find it useful (and fascinating) to reflect on a client's role within their family system, and whether/how this role interacts with the client's presenting problem. The most obvious example is when the client is the "identified patient." Similar to a scapegoat role, the client may be seen as the token "sick" or "troubled" family member when the client's problem is really a symptom of dysfunction within the family as a whole (abuse, neglect, addiction, etc). Other common roles include:

  • The "hero," "good" or even "perfect" child. This family member excels outwardly, and may be idealized by parents or other family members, while being resented by siblings who get compared...unfavorably. However, no one is really "perfect," or "good" all the time. Symptoms may appear as a result of the pressure of unrealistic expectations, or in the form of problem behaviors (e.g., addictions and eating disorders) that help maintain the otherwise "perfect" facade, at least temporarily. 
  • If one child becomes the "good" one, it's no surprise when another child becomes the "bad kid" or "screw-up." This child's philosophy may be: "If I can't be perfect, why even try?" or even more black-and-white, "If I can't be perfectly good, I'll be perfectly bad." Problem behaviors may begin as part of this image, and symptoms may arise from ambivalence or sadness about the role, internalization of criticism, and the like.
  • While both "good" and "bad" children can draw attention away from any sort of broader family dysfunction, two other roles provide a more effective diversion/distraction: the "mascot" attracts attention by being cute and lovable, while the "clown" attracts attention using humor or harmlessly "screwing up." As with the other roles, symptoms may occur as a result of the pressures of playing the part, or as a prop in the "act."
These roles can certainly take on a life of their own, begin to feel scripted, and prove difficult to change. Even after a period of separation from the family system, it is very easy to find oneself falling into role without meaning to, or sometimes even realizing it! It's often a good idea to prepare with clients for the possibility that family dynamics may be reenacted alongside holiday rituals and traditions. 

That may not be all bad, however, especially if clients have done some work and can apply what they've learned in treatment to regaining equilibrium after a family function. In fact, it may be an opportunity to increase mastery of old issues, and gain additional insights into the family dynamic, including the ways problems/symptoms may have served a purpose in the family system.

How do you think about and work with clients around family issues that may arise, or have arisen, around holidays?

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