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Understanding Family Systems in Rehabilitation: The Role of Psychoanalytic, Learning, Cognitive Developmental, and Syste

Explore the intricate dynamics of family systems within rehabilitation contexts through psychoanalytic, learning, cognitive developmental, and systems theories, examining nature vs. nurture, cognitive development stages, and ecological influences.

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Understanding Family Systems in Rehabilitation: The Role of Psychoanalytic, Learning, Cognitive Developmental, and Syste

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  1. Week 3: What is Family? PSRT 4271: The Family role in rehabilitation

  2. Additional references for this lecture…

  3. Epistemology

  4. a Good TheorY? (Sigelman and Rider, 2003) • Internally consistent • Falsifiable • Based on data • (Based in logic?...)

  5. Basic development issues (Sigelman and Rider, 2003) • Nature vs. Nurture? • Biology or Environment? • Activity vs. Passivity? • Continuity vs. Discontinuity? • Gradual or abrupt? • Quantitative or qualitative? • Universality vs. Context Specificity

  6. Developmental Theories: 4 schools (Sigelman and Rider, 2003) • Psychoanalytic (Freud, Erikson) • Learning (Skinner, Bandura) • Cognitive developmental (Piaget) • Contextual/Systems (Bronfenbrenner, Vygotsky)

  7. Psychoanalytic theory (“Intrapsychic”) Freud Erickson Psychosocial development (8 conflicts) “Ego virtues” Biology + environment Difficult to test? Describes, doesn’t explain? • Instincts • Unconscious motivation • Id, ego, superego • Psychosexual development • Internally inconsistent? • Hard to test?

  8. Learning theory • Classical conditioning (Watson, Pavlov) • Preconditioning, Conditioning, Postconditioning • Operant conditioning (Skinner) • Reinforcement • Social Learning Theory (Bandura) • Humans as active cognitive agents • Observational learning • Not enough evidence that learning is responsible? • Too little emphasis on biology?

  9. Cognitive Developmental Theory • Constructivism • Interaction between maturing brain and experience • Stages • Sensorimotor (0-2) • Preoperational (2-7) • Concrete operational (7-11) • Formal operational (11-12+) • Too little emphasis on motivation, emotion? • Too narrow a perspective? http://www.youtube.com/watch?v=TRF27F2bn-A (6:18)

  10. Contextual and systems theories • Sociocultural perspective (Vygotsky) • Individual + culture • Language, communication • Cognitive development: a social process, beyond imitation • Bioecological perspective (Bronfenbrenner) • Nature and nurture (biology and environment) • Reciprocal influence • 4 systems: micro, meso, exo, macro • Standardized coherent theory impossible? • Too much “it depends”?

  11. Bronfenbrenner’s ecological system

  12. Systems Closed systems Open systems Input, throughput, output Information exchange • Transformation • Physical energy exchange

  13. General systems theory (Boulding, 1956)

  14. General systems Theory (Boulding, 1956) • Seeking “an optimum degree of generality” • The Republic of Learning is breaking up • A “desert of mutual unintelligibility” • Two approaches: • General phenomena • Population change and interaction • Equilibrium theory • Growth theory • Information and communication theory • Hierarchy of complexity

  15. General systems theory

  16. Looks similar to…

  17. Family Systems (Bavelas and Segal, 1982) • Roots in GST: studies of communications in families similar • Psychoanalysis “proscribes” therapist contact with families • Psychotherapists turn to “research” • Especially about schizophrenia, hitherto non-responsive to treatment

  18. 1950s: The batesonproject (Bavelas and Segal, 1982) • Disturbed behavior from disturbed communication • “In response to a particular interpersonal context” • Old scope of knowledge • Based on energy • Causality: Linear, sequential • 1st Law of Thermodynamics (transformation of energy) • Bateson’s new epistemology • Based on information • Causality: Circular, simultaneous • 2nd Law of Thermodynamics (entropy)

  19. Dr. Edgar Auerswald’s Assumptions • The study of families is rooted in science. • Evolution in family studies relates to evolutions in biology and physics. • All human “constructions” are “edits” of the universe, either local or universal.

  20. Auerswald’s Terms • Epistemology = rules used to define “universal reality” • Paradigm = rules used to define a subset of universal reality • Theory = an idea that contributes to a paradigm • Model = a metaphor for an epistemology, paradigm, or theory

  21. Family systems: 5 paradigms (Auerswald, 1987) • Psychodynamic • Group of interlocking individual psychodynamics at different stages • Family • Independently operating units from which individual pyschodynamics • General • A system with things similar to all other systems, within hierarchies, e.g. civilizations  societies  individuals  psyches, etc. • Cybernetic • System of circular information flow and regulatory mechanisms • Ecological • “Co-evolutionary ecosystem in an evolutionary timespace”

  22. Family systems: 5 paradigms (Auerswald, 1987) • Psychodynamic Abandoned by family therapists • Family • General Basis for “family systems therapy” • Cybernetic • Ecological Alternative reality system?

  23. Auersward: current state of family study…

  24. equifinality • Rejects “genetic fallacy”: Causes don’t dictate outcomes • Process can override and become the cause • Child and parents mutually influence http://www.youtube.com/watch?v=q2FixXF7yYs

  25. Bowen Family Theory (Brown, 1999) • Reduce anxiety by… • Understanding how family systems work • Increasing “differentiation” • 8 Elements • Fusion and Differentiation • Triangles • Nuclear Family Emotional System • Family Projection Process • Emotional Cutoff • Multigenerational Transmission Process • Sibling Positions • Societal Evolution

  26. Theories about schizoprenia(torrey, 2006) • Genetic • Neurochemical • Neurotransmitters? (Dopamine, glutamate, 100+ others…) • Neuropeptides (Endorphines…) • Developmental • Infectious • Nutritional • Endocrinal • Stress

  27. Obsolete theories about SZ (torrey, 2006) • Demons, masturbation • Bad mothers • “Schizophrenogenic mothers” • Bad families • Bateson: “Double-bind” • Lidz at Yale • “Expressed emotion” • Bad cultures • Margaret Mead, Ruth Benedict, Christopher Lasch • Fake disease • Thomas Szasz

  28. So what? Relating Family systems to Psych Rehab • How do family dynamics effect recoveries? • How broadly should families be conceived and defined? • How should providers think of families? • How should families be approached? • What role should practitioners expect families to play? • How can psychiatric rehabilitation practitioners lead others in their field? • What specific things can psychiatric rehabilitation practitioners do to optimize family engagement? • What should Psych Rehab learn from the history of family theories? • Do family systems theories matter?

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