My “I”, my character, my name - everything was in the hands of adults; I learned to see myself through their eyes, I was a child, and a child is an idol that they create out of their disappointments.

Jean Paul Sartre

Systemic family therapy is based on the premise that the individual human personality can only be understood in the context of its social environment. In other words, given the ontologically inherent way of existence of a person, he is “sentenced to communication.”

System-communicative family model

In the 1950s-1960s. this type of psychotherapy was just in its infancy, as stated in a review study by K. Broderick and S. Schroeder, published in 1991. According to the authors’ point of view, these two decades witnessed the establishment in science of the general theory of systems in biology and cybernetics, in computer technology. Instead of, according to the scientific tradition, analytically dividing the phenomena under study into the smallest elements, for example, electrons, neutrons, etc., the general theory of systems (L. Von Bertalanffy) defended the priority of 1) the principle of integrity, the irreducibility of the whole to the sum of elements, 2 ) the principle of development through the establishment and complication of intra-system and extra-system connections. The problem of improving “feedback” mechanisms, i.e., came to the fore. methods of communication, management and control common to both biological and cybernetic systems (N. Wiener).

In its most general form, a system is understood as a set of elements that are in constant interconnection. For example, the family as a system does not simply include x individuals. It also covers their cross-relationships, as well as the overall context in which the family lives and the existing set of rules of that family. Even permanent role titles assigned to various family members, such as “parent” and “child,” make it clear that there is a stable connection between the two designated individuals.

A system is a set of elements organized in accordance with certain rules. The principles of organization suggest that as soon as a stable combination of interconnected elements is made up of disparate elements, a unity is created, an integrity that is not reducible to a simple sum of its constituent units. The marital system, for example, can only be divided into two components (two separate individuals), which are two individual subsystems. But between individual individuals there is a stable relationship that creates a marital subsystem: thus, in the marital system it turns out that 1 + 1 = 3.

The system is organized in such a way that connections between elements determineborders both around the system as a whole and around each subsystem included in it. In biology, these boundaries are clearly distinguishable: every cell has a membrane, every animal has skin. In systems whose elements are people, boundaries are often more abstract; they are set by the rules of relationships. For example, the rules of monogamy help define the boundaries of traditional marriage. A spouse who has had sexual intercourse on the side “crosses the line” or begins to act beyond the boundaries of the relationship between the spouses. Bordersmay be veryunclearAndvague; they are defined by vague rules about who is allowed to interact with whom and how to interact. In families where incest is practiced, the boundaries between the subsystems of parents and children are so poorly defined that the relationship between the subsystems borders on pathology. Rules against incest are very important, if only because they help define the boundaries of healthy family relationships. However bordersmay be excessiverigid, without allowing adequate interaction between the individuals that make up the system or between different systems. Thus, families who abuse children are often severely isolated from larger social systems and therefore unable to receive public support that could help stop the abuse. Another example: if the life of a family passes under the motto “We are united and Friendly family!”, then any abuse of family members will be regarded by them as “pathological fantasies,” and their real victim will thus be isolated and ostracized “from within.”

Systems are connected to each other through several hierarchical levels. Each system consists of lower order subsystems and in turn is part of a larger system.

The family system consists of individual subsystems - marital, child and parental. In addition, the family system is part of the larger system of the local community. That, in turn, is hierarchically linked to the larger system of the territorial community, which ultimately is an integral part of the nation.

For systems to function effectively, they needcontrol methods behind their organizational structure. Living systems can be likened to stable, dynamically developing states. They reflect the state of a system that does not change structurally over the years. Systems theory emphasizes the balance or stability of relationships between elements of a system. Very often these two qualities are mistaken for lack of flexibility, i.e. as a forced and inert formation of behavior patterns. In fact, the theory under discussion emphasizes the controllability of change, which makes it possible to develop an impressive number of very complex types of relationships. Control mechanisms allow system elements to maintain dynamic relationships with each other. The elements of the system have the ability to enter into meaningful relationships with each other, and therefore there is a whole set of very sophisticated control mechanisms. Control, on the one hand, it allows you to keep the elements of the system within certain limits, and on the other hand, adapt to changing conditions of existence.

Control over adaptation is a key point in conscious system change. Controlled growth leads to an increase in the physical mass of cells, differentiation of biological tissue, organs, and also to the development of human personality. Uncontrolled growth, such as the increase in the number of cancer cells, entails disorganization and even death of a living system. The concept of homeostasis, or equilibrium, of the elements of a system helps explain how living systems control and maintain the stability of their state. Physiologist Walter Cannon in 1939 first described a set of mechanisms of internal regulation of the neuroendocrine system, the functions of which are to maintain constant parameters of the internal environment of the body - constant blood pressure, temperature and water content. If changes within the body begin to exceed safety limits, the regulatory mechanisms of the hormonal and autonomic nervous systems are activated to return the condition to normal.

Family systems also have their own mechanism for controlling the activities of their elements. Their goal is to maintain an acceptable balance in the behavior of family members. The researchers note that there is a surprisingly stable balance of verbal communication. In family systems with a high degree of verbal communication between family members, there is a stable rate of verbal communication when family members come together, while the degree of verbal activity of individual members can vary greatly.

Mechanisms that significantly influence the processes of self-regulation of marital or family systems are similar to servomechanisms in cybernetics (N. Wiener, 1962) Feedback cycles are the most important

nal control mechanisms. Two events can be connected not only by linear cause-and-effect relationships, but also by cyclical relationships, distinguishing feature which - positive or negatively expressed feedback.

With positive feedback, quantitative and qualitative changes in one of the elements of the system have a reciprocal effect on the quantitative and qualitative state of another element. This type of sequence assumes an increase in the return effect in case of deviations from the norm. Thus, positive feedback increases deviations and serves as a mechanism of self-destruction; it can be likened to the situation of runaway boiling water, when the framework of the normal existence of relationships between elements is broken, and the system is no longer able to function. Thus, violent quarrels in the family can get out of control, since the anger of one spouse fuels the anger of the other and returns back in a significantly intensified form. The release of anger into the atmosphere can temporarily disable the system, or even completely destroy it.

Negative feedback, on the contrary, balances various deviations between the elements of this particular system. It helps maintain stability in relationships in marriage and family as a whole. If one of the family members expresses irritation, then another family member will painfully experience this outburst. And if both deviations from the norm balance each other, then hostility is created in the family, which is maintained at a constant level.

Living systems are characterized by openness. This means that they can both throw energy beyond their limits and receive it from the outside. Information is an extremely important form of energy for living systems because it serves to reduce uncertainty. An increase in the volume of information can significantly increase the level of structural organization of the system. If the information is properly programmed or grouped, the functionality of the system becomes more perfect. Information transfer (communication) includes the transformation of information from one state to another or its movement from one point in space to another.

The fundamental concepts of general systems theory and cybernetics provided a powerful charge of intellectual inspiration to the developers of innovative methods of systemic therapy. Since there is no generally accepted point of view on this type of psychotherapy, this work will consider three approaches - communication-strategic, structural and M. Bowen's theory. Systemic therapy is focused on patterns and patterns of relationships between members of the system, and not on the fate of an individual, therefore, in our presentation we omit those aspects of the corresponding methods (approaches) where personality theory is considered. However, in all three approaches, significant attention is paid to the disruption of intrafamily communication as a

the general mechanism of development, maintenance and stabilization of psychopathology and, accordingly, family psychotherapy - as a way to get rid of it.

• Servo mechanisms are automatic devices whose purpose is to provide feedback and notify that errors have been detected.

Let's briefly talk about the directions and schools of foreign family psychotherapy.

Palo Alto School

Jay Haley, a representative of the Palo Alto School, became the author of the “problem-solving therapy” method. He borrowed many techniques from Milton Erickson. Haley believed that family relationships were determined by the outcome of the spouses' struggle for control over other family members. A symptom is one of the ways to control the behavior of others. According to Jay Haley, the task of psychotherapy is to provide people with other means of influence. The therapeutic effect of family therapy increases significantly if all family members gather at the therapy session. Haley's contribution to family therapy included various directives (tasks) to family members. Completing tasks ensured equality, each family member had the right to express their opinion or do something. The psychotherapist gives tasks both during the session and at home. The purpose of these tasks:

change the behavior of family members;

find an additional incentive to build relationships between the psychotherapist and family members;

study the reactions of family members when they perform tasks;

provide support to family members, because During the performance of tasks, the psychotherapist seems to be invisibly present.

Haley also used metaphorical and paradoxical tasks. The first were built on the search for analogies between events and actions, which at first glance are completely different; the latter are instructions that family members resist and thereby change their behavior in the desired direction.

Another major figure at the Palo Alto school was Murray Bowen, who is considered one of the founders of family therapy in the United States. By the mid-60s of the 20th century, he developed a method of family psychotherapy, consisting of 4 principles:

Defining and clarifying relationships.

Teaching spouses effective emotional communication;

Lesson “I-positions”.

Family psychoanalytic therapy

The goal of psychoanalytic family therapy is to change the personality of the participants in psychotherapy so that they are able to interact as holistic, healthy individuals based on the present reality, and not on the basis of unconscious relationships of the past. Psychoanalytically oriented therapists are also less directive than other schools of thought.

The following techniques are used in this therapeutic direction: confrontation, clarification, interpretation and processing of experience, techniques for improving communication abilities, and “free association” techniques. Psychoanalysts prefer to observe and listen, abruptly stopping empty discussion with questions.

Family systemic psychotherapy

The largest representatives of this direction are Mara Selvini-Palazzoli, Clu Madanes, Salvador Minuchin, etc. Currently, the systemic direction is considered one of the most widely represented, promising, economically feasible and therapeutically effective areas of family therapy. The development of this direction was significantly influenced by the provisions of the general theory of systems of Ilya Prigogine.

In systemic family psychotherapy, the family is viewed as an integral system that strives to preserve and evolve existing connections. Throughout their existence, families go through natural developmental crises (marriage, separation from parental families, pregnancy, the birth of a child, the child’s admission to preschool/school institutions, his graduation from school and choice of his own life path, separation from parents, parents leaving for pension, etc.) It is during these periods of their existence that families find themselves unable to resolve new problems in the same ways and therefore face the need to complicate their adaptive reactions.

The main steps of family systemic psychotherapy are as follows:

Uniting the psychotherapist with the family, joining him to the structure of roles presented by the family.

Formulation of a psychotherapeutic request.

Reconstruction of family relationships.

Termination of psychotherapy and disconnection.

Mara Selvini-Palazzoli introduced a working principle where a team of therapists of different genders work with a family, while others observe their work behind a one-way transparent mirror. The unit of psychotherapy is the participation in all sessions of all members of the family living under one roof. The frequency of meetings was 1 per month, up to 10 sessions in total. Her method was short and sudden, she used the method of paradoxical prescriptions, and sought to bring about changes in the family with a sudden decisive movement. The paradoxical task (otherwise known as the “invariant prescription”) was developed very carefully and involved all family members in a series of actions that contradicted the rigid rules and myths that had developed in the family.

Strategic family psychotherapy

This method of family therapy is also called “problem-solving”, “short”, as it is focused on solving problems. The most famous figures in this direction are Jay Haley, Carl Whitaker, Clu Madanes. In their work, psychotherapists of this direction do not concentrate on the personality characteristics of family members. This approach is characterized by extreme attention to the details of the symptom and less interest in the family. This direction gained wide popularity by 1970. Representatives of this method gleaned many ideas from the work of Milton Erickson. His practice is characterized by two approaches: the use of indirect methods of influence and the acceptance of everything that the client offers.

The essence of the strategic approach is to develop a strategy for solving problems, since changes in the family are more important than understanding the causes of violations. Strategic therapists examine the factors that contribute to the persistence of a problem that is maintained by existing family interactions and therefore seek to identify the behaviors that reinforce the problem. Many strategic psychotherapists believe that a well-functioning family is one that avoids symptoms and is able to function as required by changing circumstances.

Family behavioral psychotherapy

Family behavior therapy, as its core principle, sees behavior as being reinforced by consequence, which means that a behavior pattern is resistant to change unless more favorable consequences arise. Representatives of this direction are interested in analyzing the sequence of actions. The basis is the position that satisfaction in marriage is to a much greater extent determined by the absence of mutual frustrations than by the amount of pleasure delivered to each other.

One of the most commonly used techniques is behavioral parent training. The process of psychotherapy begins with the therapist reformulating the client’s ideas about the essence of the problem and possible ways to solve it. Behavioral psychotherapists are one of the few who do not invite the whole family for treatment, but only the child and one of the parents. Behavioral training for parents aims to increase their competence in raising children, recognizing and modifying patterns of emotional and behavioral response.

The most popular working techniques are:

shaping - achieving the desired behavior in small portions through consistent reinforcement;

token system - uses money or points to reward children for successful behavior;

contract system - includes an agreement with parents to change their behavior synchronously with the change in the child’s behavior;

exchange of changes for a fee;

interruption (timeout) - punishment in the form of isolation.

Family behavioral psychotherapy is one of the most popular methods due to its simplicity and economy, although often therapeutic changes are one-sided or short-term.

Other directions

Family communication therapy emerged from the Palo Alto area. Its leading representatives are P. Vaclavik, D. Jackson and others. The goal of family communication therapy is to change communication patterns, or “consciously act to change dysfunctional patterns of interaction.” At first, representatives of this trend, for example, Virginia Satir, aimed simply at improving communication in the family, then this idea narrowed to changing precisely those methods of communication that support the symptom. The main groups of family communication therapy techniques are: teaching family members the rules of clear communication; analysis and interpretation of communication methods in the family; manipulation of communication in the family using various techniques and rules. This type of family psychotherapy has not been able to establish itself as a highly effective method.

Among the representatives of the field of experiential family psychotherapy, the most famous are Carl Whitaker and August Napier. This method is based “on experience and common sense” (Eidemiller, Justitskis, “Psychology and Psychotherapy of the Family”, 1999).

Marital psychotherapy

Marital psychotherapy is a form of psychotherapy that is focused on a married couple, helping them overcome family conflicts and crisis situations, achieve harmony in relationships, and ensure mutual satisfaction of needs. It can work as an independent method and as a stage of family psychotherapy.

The work is carried out either with a married couple or with one of the partners who came to see a psychotherapist. In this version of marital psychotherapy, the psychotherapist does not discuss the problems of the spouse, but only those thoughts, feelings, experiences that the applicant has problems with his (her) marriage.

Currently, dynamic, behavioral and humanistic approaches are the most common in marital psychotherapy.

With a dynamic approach, marital disharmony is considered from the point of view of the internal motivation for the behavior of both partners. Dynamics can be traced interpersonal relationships and its connection with the dynamics of mental processes.

The goal of the behavioral approach in marital psychotherapy is primarily to change the behavior of partners, using conditioning and training methods, which ensures:

Managing mutual positive behavior of spouses;

Acquiring the necessary social knowledge and skills, especially in the field of communication and joint problem solving;

Development and implementation of a marital agreement on mutual change in behavior.

The behavioral direction in marital psychotherapy is currently the most common. Its most popular forms are concluding marital contracts, communication trainings, constructive disputes, problem solving techniques, etc. Currently, many specialists use an integrative approach, most often combining methods of cognitive behavioral therapy and systemic psychotherapy.

The basis of the contract is an agreement in which the spouses clearly define their requirements in terms of behavior and the circumstances assumed. When formulating demands, it is recommended to use the following order: general complaints, then their specification, then positive proposals, and finally, an agreement listing the responsibilities of each spouse.

In the humanistic approach to the psychological correction of marital relations, the leading ideas are that a harmonious marriage is based on openness, authenticity, tolerance, the need for self-expression, belonging to another and the independent development of each person’s personality. This approach has evolved as the opposite of the dynamic approach, which is overly focused on the influence of the spouse's historical past and his family of origin, and the overly manipulative behavioral approach. Here the psychotherapist creates conditions in which spouses strive to verbalize their feelings and thereby improve mutual understanding. The principles of an open marriage were formulated, creating the most favorable conditions for the personal growth of partners:

The principle of reality, “here and now”;

Respect for your partner's privacy;

Mobility in fulfilling family roles;

Equality;

Authenticity - knowing yourself and your worth, appreciating the right of another to live according to your ideas;

Open partnership - everyone has the right to their own interests and hobbies.

Family psychotherapy (FP) is the modification of relationships in the family system using psychotherapeutic and psychocorrective methods in order to eliminate negative psychological symptoms and increase the functionality of the family system. In family therapy, psychological symptoms and problems are viewed as the result of dysfunctional interactions among family members rather than as attributes of a particular family member (the “client identified”). The SP implements not an intra-, but an interpersonal approach to solving problems, and the task of the psychotherapist is to change the family system as a whole with the help of appropriate influences.

The significant prevalence of divorce, marital conflicts, family disharmony, alcohol abuse, and misunderstandings in families with war veterans necessitate psychocorrectional and psychotherapeutic work.

The goal of psychotherapy is to harmonize family relationships, improve mutual understanding in the family, and eliminate negative emotional attitudes between spouses towards each other.

Objectives of group family psychotherapy:

Elimination of inappropriate forms of response, communication and behavior due to personality characteristics;

Establishing an adequate attitude of the wife to her husband’s problems related to military service;

Reduced wife's neuroticism;

Strengthening orientation towards a healthy lifestyle.

Family therapy includes an assessment phase and four correction phases.

Evaluation stage.

Criteria that distinguish functional families from dysfunctional ones:

1) trauma in the family is not denied, but accepted;

2) the problem is distributed across the whole family, and does not lie solely with the “victim”;

3) the family is focused on solving the problem, not blaming;

4) the family is characterized by high tolerance (tolerance);

5) there is high attachment among family members;

6) open communication in the family;

7) the family is highly cohesive;

8) has a flexible distribution of family roles;

9) to solve problems, the family attracts not only internal resources, but also extra-family resources;

10) there is no violence in the family;

11) the use of narcotic drugs is not accepted.

Stages of correction.

Stage 1: Building a therapeutic alliance

When the family and therapist have decided to conduct psychotherapy, the first step is to get as many family members as possible to express their personal experiences and their dissatisfaction with family relationships. The therapist expresses recognition and understanding of their suffering. Demonstrating respect for each family member by the therapist creates an atmosphere of trust and helps the therapy move forward. Gradually highlighting individual differences in the reactions of family members leads to the next stage.

Stage 2: Recreating the problem.

Each family member provides their own perspective on the traumatic situation. By listening to each other, family members become clearer about how the problem affects each of them. The therapist encourages a discussion that shifts the focus of the problem from the family member, the so-called “victim,” to the family as a whole. At this stage, the “victim”’s feelings of guilt are recognized, explored and overcome. During the discussion, the therapist draws attention to the positive consequences of the traumatic event (for example, a sense of value in life after a close encounter with death).

Stage 3: Restructuring the problem.

After discussing the personal experiences, emotional reactions and points of view of each family member individually, they are all brought together into a coherent whole. The therapist should help the family reframe personal experience and understanding the problem into a joint experience, so that in the future the process of building a family “healing theory” occurs. Veterans often suffer from isolation because their wives, feeling helpless and unable to help their husbands suffering from PTSD, refuse to talk to them about the tragedy. By helping the veteran at this stage of therapy perceive his wife’s behavior as a manifestation of love, and not rejection, the therapist ultimately stimulates the process of returning the lost integrity and cohesion to the family.

The problem is seen as a normal obstacle that can be overcome.

Stage 4: Development of the “healing theory”.

The goal of family therapy is to develop a coherent view of what happened in the past and an optimistic view of the ability to cope with difficulties in the future. A vision shared by all family members, taking into account everyone's reactions, bringing cohesion is the "healing theory." It is suggested that the emergence of a “healing theory” may be a criterion for successful completion of family therapy.

In accordance with the above, the following can be formulated: principles of counseling families with varying degrees of severity of psychological violence:

1. During psychological counseling of families with problems of violence, priority attention should be paid to psychological violence;

2. If this is a family with problems of psychological abuse, priority attention should be given to inadequacy (pathology) of parental functions;

3. If this is a family with inadequate parental functions, priority becomes mechanisms of self-rejection among parents;

4. When it comes to counseling parents with problems of self-rejection, the priority becomes the intrapersonal processes of blocking (frustration), dissociation (splitting) and displacement from the consciousness of parents of their own essential (in a broad sense - vital) manifestations, that is, the dynamic aspects of “negative psychology” "(A. Menegetti), personalization processes (A. B, Orlov) - formation of personal and shadow personal components;

5. When counseling parents with pronounced effects of the personalization process, precedents and process conditions become a priority personification(A. B. Orlov), alternative to personalization processes.

This strategy of consulting psychological practice opens the way to the creation of new, violence-free forms of parental function.

Regarding family therapy with parents of victims of sexual abuse, according to Orenchuk-Tomiuk, Matthey, and Christensen (1990), the model of therapy that is best used in this case is the so-called resolution model, which consists of 3 stages:

– stage of denial;

– intermediate stage;

– resolution stages.

At the denial stage, the non-abusive parent denies the abuse, accuses the child of deception, and defends the abuser. In the intermediate stage, he begins to believe in the fact of violence and becomes an ally of the child. During the resolution stage, this parent begins to provide support to the child and works through the guilt of refusing to protect the child during the denial stage.

The abusive parent in the denial stage refuses to accept responsibility for the abuse or denies it; at the intermediate stage, admits the fact of violence, but blames the child; During the resolution stage, the child accepts responsibility for the violence and adopts more productive parenting roles.

This model involves the use of individual and group counseling at the denial stage, and family and marital therapy only at subsequent stages, while the child can be included in family therapy only when he is ready for this.

In the process of family therapy with victims of sexual violence, one can also use the approach proposed by K. Madanez (1990), in which victims forgive male rapists. This procedure takes the form of a ritual where the rapist repents and seeks forgiveness from the child.

Group work can include parents, guardians and other people directly responsible for the child. Before starting a group, it is necessary to analyze the individual characteristics of the proposed participants:

– adults with various forms mental disorders, drug or alcohol addiction, and those avoiding parental responsibilities should not be included in the group;

– Adults who doubt the truthfulness of their children and maintain close relationships with a rapist who denies his guilt may actively resist therapy;

– adherents of strict religious systems, where open discussion of sexuality is prohibited, can complicate group work;

– serious intra-family disagreements between spouses can distract the group from its goals. In such cases, only one spouse should participate in group activities.

The rule of confidentiality regarding everything discussed in group sessions should be emphasized. It is also important that adults have a clear understanding of the expectations of group therapy participants. To do this, they are offered a contract, which stipulates the basic rules of the group; issues of absences and tardiness; conditions for early exit from the group; description of the structure and main content of the group’s work.

Parents who find themselves emotionally isolated after an incident often fear that other group members or the psychologist will blame them for what happened. This fear, generated by one's own feelings of guilt, is usually deeply hidden and expressed indirectly - in the form of hostility and cynicism. Adults hide their anxiety about the group and may fear rejection from other group members. On the other hand, working in a group gives them the opportunity to receive support and understanding, so the psychologist must strengthen the parents' desire to participate in group therapy, despite their fears and doubts.

Family or couples therapy is also an appropriate way to work with rape victims. Since the reaction of others is often accusatory towards the victim, sometimes even rejecting the victim, family members should participate in therapy. Typical reactions of parents and spouses to rape include feelings of helplessness, anger, frustration, and fantasies about killing the rapist (Emm and McKenry, 1988). Therefore, participation in therapy can contribute to the reorganization and restoration of family integrity. In couples/family therapy, family members will be able to discuss the cognitive and emotional components of their responses to trauma.

There are 4 stages in the joint venture:

1) diagnostic (family diagnosis);

2) elimination of family conflict;

3) reconstructive;

4) supportive.

A family diagnosis is understood as determining the typology of disturbed family relationships, taking into account the personal properties of family members and the characteristics of the pathology of one of them. Diagnosis of family relationships is carried out by a psychotherapist who puts forward and tests problematic diagnostic hypotheses. The peculiarity of the family diagnostic procedure is that it is end-to-end in nature, i.e. it accompanies the SP at all stages and predetermines the choice of psychotherapeutic techniques. Another feature of the diagnosis is its stereoscopic nature. This means that information received from one of the family members in one-way meetings must be compared with information from other family members and the general impression that the psychotherapist has based on questioning and observing the behavior of the participants in the joint venture. At the second stage, family conflict is identified and its origins are clarified, and then it is eliminated through the emotional response of everyone involved in the conflict, against the backdrop of creating adequate contact with a psychotherapist. The psychotherapist helps the conflict participants learn to speak a language that everyone understands. In addition, he takes on the role of mediator and transmits information about the conflict from one family member to another. The nonverbal component of this information can be transmitted by a psychotherapist during a joint meeting session, for which the “robot manipulator” technique is used. After listening to the contradictory message of the participant in the session, the psychotherapist translates it into sign language, correlating the expressiveness of gestures with the sensitivity and tolerance of the participants. At this stage, the leading role belongs to such psychotherapeutic methods as: non-directive psychotherapy, aimed at verbalizing unconscious aspects of relationships, as well as methods of group psychodynamics. At the stage of reconstruction of family relationships, current family problems are discussed: either in one family or in parallel groups of clients with similar problems and their relatives. In the same groups, role-playing behavioral training and training in the rules of constructive dispute are carried out. At the supporting stage, or the fixation stage, in the natural conditions of family life, the empathic communication skills acquired at the previous stages and an expanded range of role behavior are consolidated, reports on the dynamics of intra-family relationships are heard, and acquired communication skills are corrected in relation to real life.

The identification of stages allows you to structure the SP process and justifies the order of application of certain methods depending on the goals and the volume of diagnostic data. Most often, psychotechnical techniques used in group psychotherapy are used in the joint venture:

1) use of silence;

2) listening;

3) learning through questions;

4) repetition (summarizing);

5) clarification (clarification) and reflection of emotions;

6) confrontation;

7) playing roles;

8) creation of “living sculptures”;

9) analysis of videotape recordings.

The main theoretical basis of the joint venture is the principle of systematic family relationships, i.e., the mutual determination of individuals and interpersonal relationships. According to this theory, the style of communication, the nature of interaction, the type of education, on the one hand, and personal characteristics family members, on the other hand, form a closed, constantly reproducing homeostatic cycle. SP is a method of breaking such a cycle when it becomes pathological and creating constructive alternatives to family functioning.

Family system parameters. The family system can be described in several ways. There are six informative parameters:

1) features of relationships between family members;

2) public and unspoken rules of life in the family;

3) family myths;

4) family boundaries;

5) family system stabilizers;

6) family history.

The last parameter is important because to successfully work with a family, it is necessary to know not only the current state of affairs, which is described by these parameters, but also how the family reached this position.

More information about various theories of family therapy can be found in the following works: Bandler et al., 1999; Varga, 2001; Whitaker, 1998; Minukhin, Fishman, 1998; Whitaker, Bamberry, 1997; Kratochvil, 199-1; Madanes, 1999; Myager, Mishina, 1979; Pezeshkian, 1993; Papp, 1998; Richardson, J994; Simon, 1996; Satir, 1992, 1999; Freeman, 2001; Haley, 1995; 1998; Chernikov, 1997; Sherman, Fredman, 1997; Eide-miller, Justitsky, 1989.

Systemic family psychotherapy considers the family as an independent organism with its own history, values ​​and laws of development. The therapist is sufficiently involved in the therapy process, he observes or acts as a coach. Along the way, he asks questions, controls, and can create an artificial conflict or some other situation. The systems direction is currently the leading one in family psychology.

Older directions considered one person as an object of psychological influence, while the systemic one takes the family and its entire system as such an object. Such a theory arose not from any pre-existing psychological knowledge, but from cybernetics. Cybernetics has a general theory of systems. It says that the whole is greater than the sum of its parts. All parts and processes of the whole mutually determine each other.

A family system is a group of people with a common place of residence, connected by certain relationships. It is argued that the actions of family members are subject to the laws and rules of the entire family system. Things don't always happen because of the wishes of family members. The family system constantly communicates with the environment.

Goals and methods of systemic family psychotherapy

The therapist allows everyone to speak and makes others feel comfortable. Together with his family, he is looking for an opportunity to change the functioning of the family system for the better. There is no task of changing individual people entering the system. System family psychology has several trends, some of which do not require the presence of all family members at the psychotherapeutic session. They work with those whose problems and behavior have become the reason for the whole family to turn to a psychotherapist. Through it, negative aspects of intrafamily communications are eliminated.

Any mental pathologies are regarded as manifestations of inadequate relationships within the family. Families have their own rules, myths, and patterns of behavior. It is their specificity that can provoke mental illness in family members. During childhood, a child accumulates negative patterns of behavior observed in adults. Subsequently, he begins to unconsciously reproduce them in adult life.

Therapy methods: circular interview. One family member is asked how the other two treat each other. Sometimes the therapist resorts to supervision by placing his colleagues behind a one-way mirror. Colleagues observe the process and share their thoughts. The therapist also uses this technique as a positive redefinition of the problem with which the family came. The point is not to downplay the difficulties, but to present them as friends who will help find a way out of the situation.

4.1. Definition of systemic family psychotherapy

Family psychotherapy is generally understood as a set of psychotherapeutic methods and techniques aimed at treating the patient in the family and with the help of the family, as well as optimizing family relationships(Eidemiller E.G., Justitskis V., 1990,1999; Family psychotherapy, 2000; Systemic family psychotherapy, 2002). Family psychotherapy - This is a special type of psychotherapy aimed at correcting interpersonal relationships and aimed at eliminating emotional disorders in the family, which are most pronounced in the sick individual. Currently, there are several main directions in family psychotherapy: psychodynamic (Myager A.K., Mishina T.M., 1976; Ackerman N., 1958,1966,1982), systemic and strategic (Eidemiller E.G., 1990, 1992; 1994, Selvini Palazzoli M. et al., 2002; Minuchin S., Fishman H. S., 1981; Fritz B. Simon, Helm Sterlin, 1984), as well as eclectic (Eidemiller E. G., 1980; Zakharov A. I. , 1982).

Historically, the first direction in family psychotherapy was psychodynamic, which grew, as is believed in the West, from the analysis of the case of “Little Hans” (Freud Z., 1990). Hans's father, one of Z. Freud's students, consulted with him about his son, who suffered from an obsessive fear of horses. In several conversations and letters, Freud gave his father advice on how to talk to his son. Such indirect interpretations and influences led to Hans's complete recovery.

The psychodynamic approach to family therapy is a psychological impact on the individual. By clarifying and correcting the relationships of family members, such psychotherapy helps the individual become more mature and thereby helps overcome family difficulties. The emphasis in this approach is on the individual rather than the family as a whole. The focus of the psychotherapist is the analysis of the historical past of relatives, their unconscious desires and psychological problems experienced in the early stages of ontogenesis. The goal of psychotherapy is to achieve insight - awareness of how unresolved problems in the past affect relationships in the family at the moment and how neurotic symptoms and unconstructive ways of adapting to life in some of its members arise from this disturbed context.

Currently, this approach, which requires a lot of effort and a huge investment of time on the part of both the psychotherapist and the clients, is considered not economically feasible, but at the same time highly effective.

With an eclectic approach, psychotherapeutic work with families randomly combines methods and techniques of personality-oriented and behavioral psychotherapy, as well as suggestions and changes in consciousness based on the therapeutic effect - hypnosis, AT, meditation, etc. For example, members of one family are immersed by a psychotherapist in a hypnotic trance . Then they are offered key words-symbols, which are a metaphorical form of presentation of real family problems of the past and present. In response to these stimuli, emotional reactions arise, various verbal associations occur, a reaction occurs on an unconscious level, a peculiar cohesis"a(feelings of cohesion) (Czabala J. Cz., 1990; Meinhold W. J., 1990).

At the present stage of development of family psychotherapy, systemic psychotherapy is considered to be one of the most promising areas from an economic and therapeutic point of view. Its representatives view the family as an integral system. In this approach, the individual is not the client or the target. The whole family is a client.

Like all living organisms, the family system strives both to preserve the existing connections between elements and to their evolution. In a living system, which is formed and preserved due to the effect of exchange of energy and matter under non-equilibrium conditions, vibrations, both internal and external, transform it into a new structure (new quality). There is an increase in its complexity, differentiated™. Figuratively speaking, the family, like a living system, exchanges information and energy with the external environment. Oscillations are usually accompanied by a reaction that returns the system to its stable state. But when they intensify, a crisis may occur in the family, the transformation of which will lead it to a new level of functioning.

Throughout its existence, the family goes through natural “developmental crises” (Family psychotherapy..., 2000): marriage, separation from parental families, mother’s pregnancy, birth of a child, his entry into preschool and school institutions, adolescence, graduation school and choosing “your own path”, breaking up with parents, retiring, etc. It is during these periods of their existence that families are unable to

We have to solve new situations in the same ways, and therefore they are faced with the need to complicate their adaptive reactions.

As already mentioned, families perform their functions with the help of certain mechanisms: the structure of family roles, family subsystems, external and

internal borders.

Family Role Structure prescribes to relatives what, how, when and in what sequence they should do when entering into relationships with each other (Minuchin S., 1974). Repeated interactions set certain standards, which in turn determine with whom and how to interact. In normally functioning families, the structure of roles is holistic, dynamic and alternative in nature. If relatives' needs are not met within the existing structure, they make efforts to find alternative options for fulfilling roles. According to our research, 66% of families in which adolescents with neuropsychiatric disorders lived had either strictly fixed pathologizing family roles or an initial absence of this structure. Pathologizing family roles are understood as those that, due to their form and content, have a psychotraumatic effect on family members (Eidemiller E.G., Yustitsky V.V., 1990).

Family subsystems (holons)- this is a more differentiated set of family roles, which allows you to selectively perform certain functions and ensure life activity (Nickols M„ 1984; Minukhin S, Fishman Ch., 1998). One of the family members can be a member of several subsystems - parental, marital, children's, male, female, etc. However, simultaneous functioning in several subsystems is usually ineffective.

Boundaries between subsystems- these are the rules that determine who and how to perform family functions in a certain aspect family life. In normally functioning families, the boundaries between subsystems are clearly defined and permeable. In the dysfunctional families we examined, either rigid or blurred boundaries were observed. In the first case, communication between subsystems is sharply limited; there is no exchange of information. In the second, stress experienced in some subsystems is easily irradiated -

they rip into others.

Based on this, the tasks of systemic family psychotherapy can be formulated as follows:

1. Uniting the psychotherapist with the family.

2. At the first stage of psychotherapy - the assimilation and maintenance of processes that ensure the preservation of the usual functioning of family subsystems, the distribution of roles and boundaries between subsystems.

3. At the second stage - by connecting the psychotherapist to different subsystems, creating a situation of frustration in order to initiate the transition of the family to a different, more complex level of functioning.

4.2. Indications and contraindications for systemic family psychotherapy

Family systemic psychotherapy is indicated for the following nosological classes: neuroses and other borderline neuropsychiatric disorders, psychosomatic diseases, alcoholism, low-progressive schizophrenia. In addition, an indication for family psychotherapy is a number of psychological problems - the desire of relatives to resolve acute and chronic conflicts, to optimize their relationships, especially if there is a danger of transforming the structure of pathologizing roles and dysfunctional subsystems into a family with a “symptom carrier”.

Contraindications include: persistent character deviations in one of the family members in the form of hysteroid, epileptoid and paranoid psychopathy, as well as temporary psychotic states - disturbances of thinking and consciousness, severe depressive and manic phases, delusional experiences. In these cases, it is necessary to prescribe appropriate biological therapy, and then decide on the choice of method of psychotherapy, its tasks and scope.

Family psychotherapy is not indicated in cases of rigidity in life attitudes, especially those associated with old age. Possible changes in family functioning can lead to psychosomatic disorders in older people and even death.

Extreme caution must also be exercised in cases where, as a result of a violation of the context of the relationship, one of the relatives - a child - becomes ill, the family agrees to treatment, but destructive tendencies prevail over constructive ones, and the risk of parental divorce is very high. In such situations, spouses tend to transfer responsibility for their divorce to the psychotherapist and sometimes attempt to take revenge on him.

4.3. Basic techniques of systemic family psychotherapy

These exercises are presented in accordance with the stages of development of the process of family psychotherapy, combined by topics and tasks with a predominant orientation of classes on interaction “here and now”. As mentioned above, we distinguish two stages in the process of family systemic psychotherapy. At the first stage, the psychotherapist joins the family system, identifies, differentiates and complicates cognitive scenarios with the help of which family relationships are regulated. At the second stage, the reconstruction of these relations is carried out.

Techniques of the first stage of systemic family psychotherapy

As a rule, the “initiators” of contacting a psychotherapist were the mother and the child—the “symptom carrier.” At the first stage of work, the psychotherapist was faced with the task of creating and strengthening the motivation of these clients to invite all family members living together to the next session. This proposal often met with resistance. It could be weakened if one of the following techniques was used.

S Providing clients with information about the role of the family in the development of neuropsychiatric disorders in children and adolescents. Emphasizing the fact that in any family there is not only and not so much a pathogenic factor, but a sanogenic one.

S Positive emotional reinforcement of the very attempt to seek help: “Only a very responsible person like you could take the initiative and come to the appointment. I think that this quality will help you influence the rest of the family.”

S An appeal to the sense of justice of the “initiator” of the appeal: “You and your son discuss your problems out loud, but other family members do not have this opportunity.”

■S Indication of the likelihood of an incomplete solution to the problem and uneven distribution of efforts to solve it due to separate meetings with several family members and lack of involvement in the psychotherapy of others: “While we are working here with you, they are coming up with something of their own. They won’t help us, and we won’t help them.”

Thus, the psychotherapist sought to ensure that all relatives who live together and are therefore psychologically dependent on each other took part in each session.

The next task is to connect the psychotherapist to the family. To this end, in his behavior he tried to move from the roles of “observer”, “arbiter of destinies”, “magician”, “all-powerful wizard” (their family tries to attribute them to him) to the position of one of the elements of the family system (“the one who speaks as we”, “the one who, it turns out, has the same problems, but he has already solved them”). Accession is facilitated by compliance important rule- maintaining the family status quo. If there is a clear leader in the family who strictly prescribes certain behavior for the others, who is used to speaking for others, depriving them of their voice, or being a “translator”, voicing the thoughts of his relatives, then the psychotherapist makes all calls to the family through such a leader. "Can I ask your wife?" - he addresses the male leader, etc.

When family members begin their story about the problem, it is very difficult for them to figure out what is important in their message and what is of secondary importance. Therefore, in order to structure the information, the psychotherapist usually repeats in a concise form the most significant of what was said: “As far as I understand, we are talking about...”.

The family as a system reveals to the psychotherapist a certain language of verbal and nonverbal behavior, with the help of which its members ensure their integration and integrity. There are highly expressive families

with fast speech, active gestures and facial expressions, there are very restrained ones, controlling both the manifestation of emotions and the words spoken. Using reception mimesis"a(imitation) the psychotherapist tries to enter into communication in a language that is understandable and characteristic of a given family.

Other psychotherapeutic techniques are used at the moment when family members formulate their problem. They aim to hide from clients the fact that they are being controlled and that they are being provided with emotional support. Non-directive leadership (“leadership behind one’s back”) consists of the fact that the psychotherapist, with interjections and remarks such as: “Wow!”, “How interesting!”, “Oh!”, “Mmm,” and also with gestures helps the participant in psychotherapy to come into contact with something - important for yourself. At the same time, the verbal “slag” does not receive any reinforcement from the psychotherapist.

Demonstration of the psychotherapist’s personal involvement in a family problem is used in cases where relatives talk about difficulties that were or are relevant to him. In this case, he does not hide, but, on the contrary, shows how close it is to him. This is one of the ways to convince participants in the interaction that psychotherapy is the real work of real people with a therapeutic goal, in contrast to the illusory ideas widespread in society about the mysterious possibilities of manipulative influences.

Our experience in conducting systemic family psychotherapy has shown that in the first sessions one should not reflect on emotional reactions, analyze the motivation of the behavior of session participants, or use value judgments. On the one hand, this blocks the personal growth of clients and puts them in clearly unequal conditions. On the other hand, it strengthens the mechanism of both individual and group psychological defense.

We came to the conclusion that family members should also not be encouraged to accelerate the development of communication and analysis skills in the “here and now” situation, as is the case in some models of group psychotherapy. This is due to the fact that the desire to speak out and look for the cause of the problem not in the present, but in the past, is very strongly expressed in the families surveyed. We call this technique “a smooth transfer of analysis from the “there-and-then” situation to the “here and now” situation.

We have also developed a special program of psychotherapeutic exercises, the purpose of which is to develop the skills of non-verbal communication, empathy, expression of one’s experiences, development and enrichment of cognitive scenarios. This program is carried out either in classes that are conducted in parallel with the main psychotherapy, under the guidance of a co-therapist, or fractionally and sequentially in the process of systemic family psychotherapy itself.

Techniques of the second stage of systemic family psychotherapy

At the second stage, family relationships are reconstructed. The criterion that a family is ready to confront its unconscious problems is the trust and freedom with which its members begin to talk about themselves, to cite facts that previously caused them expressed negativity.

tive reactions. Using his personal and professional potential, the psychotherapist consistently frustrates various subsystems of the participants in psychotherapy. The following techniques are used for this:

Changing seating arrangements;

Separation of family members and unification into new coalitions;

Positive reinforcement of participants in some subsystems and blocking

Analysis of thoughts, feelings, actions that arise “here and now.” Updating and structuring of the received material is carried out with

using role-playing situations and Gestalt therapy exercises:

- “rounds”;

Dialogue of parts of the “I” of a family member;

Nonverbal dialogue between participants of different family subsystems. Based on a specific situation, during a session or as assignments for

The home therapist can give the family special directives. Let us distinguish three types of them: direct, metaphorical and paradoxical. The purpose of these tasks:

Change the behavior of family members;

Give additional incentive to build a psychotherapist relationship

with family members;

Study the reactions of family members when they perform tasks;

Provide indirect support to family members, since during the task the psychotherapist seems to be invisibly present among them.

To successfully implement directives, motivation to complete tasks should be strengthened. To do this, it is necessary to reach agreement between family members and the psychotherapist in formulating and achieving goals. This situation often occurs in later sessions of the second stage of family psychotherapy. In this case, the task is given in the form of direct instructions. With indirect instruction, all attempts to resolve the situation that family members have made previously should be discussed. Each solution option should end with the words: “It’s a pity, but this didn’t work either...” After such a discussion, the participants, as a rule, have great confidence in the psychotherapist’s directives.

If family members show despair, which is reflected in remarks like “How bad we feel!”, the psychotherapist agrees with them: “Yes, you feel bad!” Then a unification occurs based on the emotion of despair. In case of expressed resistance, the psychotherapist accompanies his task with the words: “This is so insignificant that it is not worth talking about.” For families who are enjoying dramatic changes in their lives, the special importance of the task should be emphasized. The success of its implementation is facilitated by the psychotherapist's exercise of power. To do this, he assumes the role of a competent expert: “I know this very well...”, “All my experience says...”, “In such cases, the famous American psychotherapist Salvador Minuchin does so and so...”. If the therapist believes that the task is too unexpected or may pose a threat to the hypernormative attitudes of the family members, then the directive should be prefaced with the following words: “I want to ask you to do something that may seem stupid, but I want to ask you to do it anyway.”

The wording must be clear, understandable, and specific. It is necessary to monitor the reactions of family members and encourage them to master the task. You can ask therapy participants to repeat the therapist's verbal instructions.

Examples of direct directives. If a psychotherapist notices that during a session a coalition is formed, for example, between a grandmother and a granddaughter, and the girl’s mother is deprived of all influence on her daughter, you can try to change this situation, since her long-term experience in family life has caused the girl’s symptoms of neurosis. The psychotherapist gives the girl the task to do something that the grandmother really doesn’t like, and the mother gets the task to protect her daughter at all costs. The result of such interaction may be an increase in the distance between grandmother and granddaughter.

In the case of conflicting relationships between representatives of family subsystems, for example, in the case of a mother who has a negative attitude towards her daughter despite the fact that the father is either not at home until late or passively watches their quarrels, you can offer to “build a wall for them.” During a session, the psychotherapist makes it impossible for mother and daughter to communicate with each other: “If you want to say something to each other, then do it through your father.” At home, for a certain time, they are asked not to communicate with each other, and also convey all their wishes through their father. Completing such tasks leads to the elimination of the conflict and, in addition, activates the role of the father, who, perhaps for the first time, realizes that a lot depends on him, and he begins to like it.

To improve the empathic abilities of a mother who is in a symbiotic relationship with her child, to help her establish distance with him and accept his autonomy, she can be offered a home task: hide some thing from the child so that he spends no more searching for it ten and at least five minutes. The mother must repeat this task until she succeeds.

In the case of depressive reactions in psychotherapy participants, they may be offered a series of tasks that require activity. For example, a psychotherapist says: “Now I’ll ask you to play the role of a timekeeper, you will count to yourself how much time each person speaks. Then you will report the result." Performing such a task can cause emotions of irritation and even anger in the performer, which will ultimately weaken the depressive reaction.

Metaphorical tasks. Such tasks are based on searching for analogies between events and actions that, at first glance, are very different.

A brilliant example of metaphorical tasks that Milton Erickson used in his work is given by Jay Haley (Haley J., 1976). A married couple feels frustrated by the monotony of their sexual relations, however, does not dare to discuss them directly. Then the psychotherapist comes up with an analogy for sexual intercourse - the procedure of having lunch together. “How do you have lunch?”, “Do you ever enjoy your food when dining together?” - these are the questions the psychotherapist asks the spouses. He then encourages discussion about aspects of the meal that may resemble sexual activity. For example, he might say, “Sometimes my wife wants to taste the appetite-stimulating spices before eating and eat slowly. While my husband likes to immediately pounce on potatoes and meat.”

Or: “Some husbands praise their wives for making everything so beautifully cooked, but others don’t pay any attention to it at all, and therefore their wives don’t try at all.” Next, you can move the conversation to a neutral topic so as not to scare the psychotherapy participants, and then touch on other aspects of the dinner: “Some people like to dine by candlelight, while others like bright light where everything can be seen.” At the end of such a discussion, the therapist should instruct the spouses to have lunch together. They should choose a night when they are alone and cook a nice dinner together; it is necessary to respect each other's tastes, and they should talk only about the pleasant aspects of the feast, and not about the worries of the day. The wife should try to whet her husband's appetite, and he, in turn, should provide everything to please her. If the dinner goes well, then the very experience of the joy of communication will lead the spouses to sexual intercourse. The incentive to change activities thus operates at an unconscious level, and the changed behavior subsequently leads to an increase in the spouses' awareness of their experience.

Paradoxical tasks. In this case, the psychotherapist gives such instructions so that family members resist their implementation and thereby change their behavior in the right direction. The use of such techniques is justified in cases of pronounced resistance to therapeutic changes. Tasks can be given to the entire family and its individual subsystems. Instructions to the whole family require very careful preparation and monitoring of their implementation.

As an example of a paradoxical task for the marital subsystem, we will give one that we often use in our practice. A married couple who often quarrels and resolves conflicts unconstructively may be given the task of quarreling for at least three hours upon returning from work on certain days. The rational explanation for the task that the therapist gives to the spouses is to observe and study each other during a quarrel. The purpose of the task is to reduce the number of quarrels, since people do not like to make themselves unhappy if it is someone

orders.

Each task of a psychotherapist must be completed, with the exception of any objective reasons that prevent this. Failure to comply prompts an analysis of its causes so that families can understand that they themselves are responsible for it and are depriving themselves of the opportunity to learn something new and valuable about themselves.

We also used paradoxical tasks to stop psychotherapy when we became confident that the family system had changed its functioning and began to effectively solve its problems. For example, a psychotherapist, who until recently played an outwardly invisible role and established communications between subsystems, suddenly declares: “None of you knows your problem as well as I do, so do this and that...” Such a contrast in His behavior usually causes protest among family members, a desire to unite and stop visiting the doctor who has become so “stupid.”

Another example of a paradoxical task addressed to spouses, which is used to facilitate the completion of psychotherapy, is the following statement: “It seems to me that in the near future you will quarrel.” After this-

Then the spouses have an incentive to strengthen unity and free themselves from the influence of the psychotherapist.

The successful implementation of systemic family psychotherapy is greatly facilitated by the directive position of the psychotherapist. This is due to the fact that throughout his work he personifies power, which is used not only to initiate changes in relationships, but also to optimize the functioning of the subsystems of the family group, which retains its fundamental significance: spouses realize the needs for reciprocity, parents raise children, children socialized, etc. This is the difference between the position of a family psychotherapist compared to the model of group psychotherapy, in which all participants can claim any group roles, and therefore such explicit management of the therapeutic process is not required.

4.4. Model of integrative systemic family psychotherapy

We have developed a model of integrative systemic family psychotherapy. It can be described in the form of the following technological chain.

1. The psychotherapist joins the role structure presented by the family.

/ Establishing a constructive distance - free arrangement of family members.

■/ Joining through synchronization of breathing with the family member who is reporting the problem.

/ Techniques mimesis(Minuchin S., 1974) - direct and indirect “mirroring” of poses, facial expressions and gestures of psychotherapy participants.

■S Attachment according to the prosadic characteristics of speech to the applicant of the problem, the identified patient (speed, volume, intonation of speech).

■S The psychotherapist’s use of predicates in his speech that reflect the dominant representational system of the problem applicant and other family members.

■/ Tracking the oculomotor reactions of psychotherapy participants in order to verify the correspondence of the verbally presented problem with deep experiences.

s Maintaining the family status quo, that is, the structure of family roles that participants demonstrate to the psychotherapist. In this case, there may be a clear leader, the initiator of the appeal and the applicant of the problem. The leader can hide behind silence and non-verbally instruct one of the family members to play the role of a “translator” who speaks on behalf of everyone. In each of these cases, the psychotherapist, while carrying out the connection, maintains the presented structure of roles until its completion.

2. Formulating a therapeutic request S As a rule, the initiator of the appeal presents the psychotherapist with a manipulative request for the following reason: “My child has a symptom (bad student, disobedient). Make it different." This formulation allows the initiator of the appeal to distance himself from the unconscious or conscious feeling of guilt, relieve himself of responsibility for what is happening in the family and transfer it to the child and the psychotherapist.

/ Meta-modeling techniques and psychotherapeutic metaphors make it possible to transfer the request from a superficial manipulative level to the level of parents’ awareness of their ineffectiveness in the parental role.

/ Family members' examination of themselves as unsuccessful parents allows them to move to an awareness of their ineffectiveness as spouses.

S In parallel with formulating the request, the psychotherapist examines the resource states of individual family members and the family system as a whole: “Was there a moment in your life when you were successful together? How did you do it?

Thus, we have developed a technology for formulating a therapeutic request, which we called: XR-> YR-> ZR, Where: X- level of manipulative request; U - level of self-awareness as ineffective parents; Z - level of awareness of their incompetence as spouses; R- resource states of the family system and individual family members. At the stage of formulating a therapeutic request, it is also important to determine the goals that are set by each family member and which they want to achieve during psychotherapy. At this moment, it is important to transfer psychotherapeutic work from the plane of studying the past to the plane of “here and now.” Excursions into the past are made only to search for resource states among family members. The formulation of the goals of each family member led to the formation of the goals of the family as a single psychological organism.

3. Reconstruction of family relationships

S The work of a psychotherapist helps to establish boundaries between subsystems, strengthening the functioning of some and the reciprocally associated weakening of others. For example, spouses used to spend most of their time unconsciously mixing parental and marital contexts. And this, on the one hand, led them to dissatisfaction with the marriage, and on the other, it caused the appearance of problems or symptoms in the child. Separating the parental and marital contexts during psychotherapy contributed to the clients' effectiveness as both spouses and parents. The ancestors learned to recognize the boundaries of their subsystem, the quality of its functioning and the motives for which they inconsistently crossed internal boundaries.

■S Throughout family psychotherapy, the same techniques are used that are used in the group psychotherapy model we developed:

a) balance in the study of negative and positive experiences;

b) use of two-level feedback;

c) psychosculpture, family psychodrama.

4. Termination of psychotherapy and disconnection

The following facts indicated the completion of psychotherapy:

/ Achieving stated goals.

/ Compliance with the agreed time context. After the joining stage, which usually took 1-2 sessions lasting 2 hours, psychotherapy participants negotiate the boundaries of the time context necessary to achieve psychotherapeutic changes. The minimum time for reconstruction of family relationships is 8 hours - 4 sessions, and the maximum time for family psychotherapy is 16 hours - 8 sessions.

■/ Environmental audit - family members creating an image of their future. In the last lesson, in a number of cases, we invite participants to imagine themselves in a segment of the future - how they interact there, what works for them and what doesn’t work out for them. Discussion of such work allows us to determine the most successful ways to use these states. Our experience has also shown the high effectiveness of the nonverbal procedure we developed, “joint drawing of family happiness,” with which we often complete family psychotherapy. Each participant draws with their non-dominant hand eyes closed your idea of ​​happiness. After that, everyone puts the fragments together into a complete picture and discusses what happened.

4.5. An example of the use of systemic family psychotherapy

As an illustration, we present a fragment of the transcript of a session of systemic family psychotherapy (psychotherapist - N.V. Aleksandrova).

■ Fragment of the transcript of a session of systemic family psychotherapy

A father, mother and 6-year-old daughter are present at the session.

Complaints made by the mother: the girl’s whims, unwillingness to sleep in her own bed.

Psychotherapist (P.) (after meeting all family members): Who will tell you what brought you to consultation? (During the conversation with the parents, the second psychotherapist is drawing with the girl.)

Mother (M.): My daughter is six years old, she is capricious, everything is wrong for her, and because of her I lost my job, that’s all I do, and at night she doesn’t want to sleep at home, she tries to sleep with her father...

P.: Please tell us how your family lives, how it works?

M.: We have a separate apartment, three rooms. In one room I and my daughter, or rather, her bed, in another - my husband, the third - the living room.

P: What does it mean that the husband is in the other room?

M.: Daughter with early age restless, and he had to go to work early, so it happened...

P.: Who was the initiator of this division into rooms?

M.: I don’t remember, probably both...

P. (addressing mother): May I turn to your husband, perhaps he can add something to your words? M.: Yes, please.

P. (addressing father): You heard what your wife said, what can you say about this?

Father (O.): We should probably start from the beginning... My wife, having learned about the pregnancy, didn’t really want to leave her, I insisted... She wanted to write a dissertation. Difficult pregnancy, difficult childbirth. When she returned from the maternity hospital, it was difficult for her, her daughter was restless, she ate and slept poorly, and somehow it just happened that I went to another room... P.: And how did things turn out for you after giving birth? intimate relationships? O.: Yes, perhaps not at all...

P.: (addressing his wife): What do you say about what you heard? M.: Yes, I had no time for that... And in general, he worked, met with people, and I was within four walls with my screaming daughter... But the dissertation was not finished... But he defended himself and found a good job. ..

P. (addresses mother): Who would you say is the daughter in your life? M.: I love her, I put so much effort into it, sometimes she gets sick, sometimes she doesn’t sleep, sometimes she doesn’t eat, but she has grown up and keeps clinging to her father: as soon as his doorbell rings, she immediately runs, throws herself around her neck, shows off her dress... I tell her that the dress doesn’t suit her, put on another one, and he kisses her, says: “You’re my beauty,” and she’s melted. In the evening I can’t even get her to sleep, she keeps trying to run to him, and at night I wake up and she’s already with him...

ABOUT. (barely waiting for the end of the mother’s words): So you keep nagging her and nagging her - it’s not like that, it’s not like that, so she’s running towards me...

P. (addressing father): When your daughter greets you like this, what happens to you?

O.: So only she keeps me with her (nods at his wife), so I would probably leave...

P. (to father): How do you understand why your daughter comes running to you at night?

O.: Yes, she wants warmth and affection... She’ll hear enough comments for the whole day....

P. (addressing mother): What happens to you when you discover that your daughter

M.: I’m angry, I’m offended - I gave everything to her, and she took everything to her daddy... It’s easy for him to be affectionate... I would try to listen to her whims all day - I won’t go to a speech therapist, I won’t study English... I tell her: “You’ll grow up to be a fool, you won’t become anyone, no one will marry you”...

P: How do you feel as a wife?

M.: Well, someone has to feed him... Yes, and she loves him... and I... what?., somehow...

P: Is it possible to assume that your daughter’s behavior and your not entirely satisfactory marital relationship have a certain connection?

The parents thought about it. They look at each other and at their daughter, who at this time was also distracted from her work and is looking at them.