This video is a re-enactment of an actual Intensive Structural Therapy session.
The first section, from the waiting room CCTV, has no audio.
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Dr H. Charles Fishman MD is a general, child, and adolescent psychiatrist with over 50 years of experience treating families, adolescents, and patients with eating disorders.
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In his 2013 book, Dr Charles Fishman reveals 3 powerful tools to help your family successfully navigate the 8 critical ages, stages & things that cause rages.
He shows families how to resolve common conflicts in a way that keeps them healthy, happy and together.
Great re-enactment. The four dimensional model useful here. Off the top of my head and typing fast here….
1. Contemporary Developmental Pressures – destabilizing factors in place a) father working / studying mother working / attending meetings after work b) pre adolescent transition
2. Hx of the system – more detail required but wld like to hear more about parental hx re: family of origin attitudes towards discipline. Whether parents hv discussed their ideas re: disciplining their children. Curious re: father’s management of frustration / anger. Mother’s comments re: not following through with discipline in public spaces.
3. Structure – What constitutes this family. Im feeling grandmother’s absence here. Pre adolescent (Shelly – if I heard name correctly) is transitioning … My thoughts: Are there any cross overs of developmental events in this family? Father appears appropriately aligned with younger daughter but relationship between father and Shelly fraught. Is this a change? Mother and Father not acting as a “management team” to support Shelly through her transition challenges. Mother and Father in disagreement over many things including attending therapy. Parental subsystem in crises. Query : Hx of family violence in families of origin.
4. Process -I liked how the therapist was able to remain calm while focussing on observation rather than feeling compelled to direct the traffic and join with family too soon. So the therapist is attending to her own response to the system in what I think is a very appropriate manner. Using a IST lens as a therapist I am observing a family struggling with poor parental alignment / divided loyalties (father with youngest daughter)/ oldest daughter’s developmental journey / mother’s difficulties in consistently following through with discipline / father’s use of raised voice, intimidating behaviours.
So….what are the forces at work that keeping this family stuck????? What are this families barriers to moving forward???????????????????
Dear Lisa,
Thanks for your questions. Let me address them one by one:
In this model, we look at three domains of development: the child, adult and family development. These are universal – like a child entering adolescence or losing a parent. The issues you mention are important but not universal.
We look at the structure of the system and how it affects the issues you mention. For example, what is crucial is not just their ideas in disicplining the kids but how they are manifested – are they together? The crucial effective dynamic is are they acting as a unit? Also, the goal is to see these patterns of behaviour. In the video, the child is misbehaving to the extent that the parents are not together. At one point, in the real video – these are actors in this version, one moment when mom supports dad, the girl behaves. In my experience, that is the cruicial dynamic.
I believe in Occam’s razor – the simplist, most effective explanation is best. It is the parental split, which we can see, that is the problem which needs to be addressed and fixed. It’s important for the the therapist to focus on crucial strucural issues. I agree, it would be good to have grandma in a session, but we work with the family members who are available.
I agree with you. In the real session, the therapist was a beginner and overwhelmed by what transpired. There was no supervisor behind the mirror. She kept her cool beautifully.
This is another very important question. I see the barriers as the dysfunctional structure.
Many thanks again for you thoughtful queries.
Charles
The link to the video is not working. Is there a way to still access this? Thank you!