When you get your Masters the very first thing people ask is, “When are you going to get your doctorate?”
Seriously? I just completed a level of education that some people don’t even have the luxury of dreaming about and you’re asking me when I’m going to do MORE? Why can’t you just be happy for me, MOM?
Just kidding. My mom NEVER pressured me about school. Ever.
After being asked when I would become Dr. McKinney (no Oates at the time) enough times I started saying, “Actually, I’m just going to stop here. At my Masters. Because who really wants to be Dr. McKinney when they can be MASTER McKinney?”
In all seriousness, I was going to stop at Masters no matter what because the idea of more school honestly makes me want to puke. And not in the good way.
I don’t talk tons about having a masters for two reasons:
1) It wasn’t THAT hard. And I don’t mean that in a condescending, gosh it’s hard to be so smart way. I mean it in a Master’s of Marriage and Family Therapy really isn’t the hardest thing in the world to get through. It wasn’t easy, but it just never felt like something to brag about.
2) I have no clue if it’s Masters or Master’s. This makes me insecure. I told you getting a masters is not an indication of my smartness.
Well, this Friday I’m taking an exam that I call the MFT exam when really it’s the “Lots of Letters I don’t remember” Exam. Basically, it’s the national test that I have to take if I want to be licensed.
I’ve been studying for this test for the past month and have really gotten serious in the last week or so. No, I’m not freaking out about ‘procrastinating’ and I really do think I’ll do fine.
What’s amazing, though, is that in reviewing all the different theories of therapy I am realizing that I was supposed to learned a whole heck of a lot of stuff!
One of the best ways for me to learn is to talk about something, or teach it to others. I should probably try to teach it to Mark, but, Dudes, these are therapy techniques. Ways to bring about change in others. If I teach him what I know I will lose all my power in this relationship. Not an option.
So I’m going to put it in the best hiding place I know when it comes to Mark. The McKinney-Oates Cereal Blog. And you, dear reader, will be my pupil. If you want a recap of what I’ve been studying read below…
First, marriage and family therapy is different from other therapies because we view behavior and dysfunction and health as a system. Our behaviors do not exist in vacuums. Everything is in the context of a system. “Marriage and family” is more a description of the lens we look through rather than a description of who we work with (in other words, a marriage and family therapist is more than able to work with an individual despite what the name says).
Murray Bowen is the father of this theory. His goal is to help a client achieve differentiation of self. Differentiation of self is primarily the ability to separate our thoughts from our feelings. Essentially, it’s the ability to be objective about a situation no matter your emotional state. It is also the ability to think and act for yourself. A therapist working out of the transgenerational model is going to look for the ways you are emotionally connected to your family of origin. Some of us are fused to members of our family and depend on them for acceptance, love, value, etc. Others of us are emotionally cut-off from family members and give off the appearance of “not needing anyone” or “not caring about what others think”. Being fused and cut-off are both ways to manage anxiety in our relationships. Anxiety is at the heart of Bowen’s theory because it’s what he’s trying to help individuals minimize in healthy ways. Our anxiety is at the core of most of our ‘bad behavior’. Another big part of this theory is triangulation. Any time anxiety becomes unmanageable between two people a third person is brought in (the triangle) to share the burden. This is seen in affairs (the love triangle) and in parents focusing on the child’s problems (it’s easier to deal with Susie wetting the bed than it is to deal with the loneliness in a marriage).The Bowenian therapist takes the stance of a coach guiding you towards differentiation.
(Anyone who is a fan of Carlos from Owl Sparks would be a fan of this theory and should read Edwin Friedman’s book A Failure of Nerve: Leadership in the age of the quick fix.)
If you’ve ever viewed love as a bank account with “withdrawals” and “deposits” this theory will make lots of sense to you. Basically, we all have a subconscious ledger running when it comes to our relationships. If someone is taking too much we become distrustful and our sense of justice and fairness is threatened. We each have entitlements that let us know what we are “owed” in a relationship. So a child inherently knows that they are entitled to being taken care of and loved because they are not the adult in a relationship. When we don’t get what we feel is due to us our behavior turns into destructive entitlements, or the constant feeling that the world owes us something. How able are you to trust another person to meet your needs? A high ability to trust results in a healthy relationship, a low level of trust results in an unhealthy one. This theory also includes the piece about loyalty to one’s family of origin. Because we are cared for by our parents we end up indebted to them (this is not a bad thing) and we show this indebtedness by being loyal to our roots. An interesting case where the therapist used contextual therapy was where a child was being raised by her father and her mother had bailed on her at an early age. Her father told the daughter stories about how her mother was flighty, unreliable and selfish and this was all the daughter knew about her mother. As the daughter goes into adolescence she becomes increasingly flighty and unreliable. The therapist uncovers her loyalty to the only image of a woman in her family the daughter has, the picture her father has painted. The father is then able to paint a more complete picture of her mother that includes her positive traits so now the daughter can be loyal to those traits as well.
(The book The 5 Love Languages by Gary Chapman is not based in the contextual theory, but it does operate on the similar idea of withdrawals/deposits and empty/full love tanks.)
This theory is very “to the point” and does not waste time wondering how you feel about your mother. It is almost as “pure” systemic as you can get. Problems are not a sign of deficiency in a relationship, problems are simply one point in a communication pattern. Brief therapy focuses on alleviating the problem by breaking positive feedback loops that amplify a deviation (or problem). An example of this is a woman feeling alone and hurt because she was stood up for dinner. She communicates this hurt by telling her partner that he is a scum bag who doesn’t deserve her love. He responds by staying at work later and later in an attempt to avoid further abuse. His avoidance further reinforces (or amplifies) her feelings of loneliness. The problem is maintained by this communication pattern, or viscious cycle.
The interventions in MRI Brief therapy are fascinating, in my opinion. These people are the kings of what is commonly referred to as “reverse psychology”. Reframing is defining the problem in a new way that makes it easier to see a way to change the communication pattern. Prescribing the symptom is the coolest intervention ever. Let’s say you’re anxious about taking pictures. A brief therapist would tell you to be as nervous as possible every 5 minutes. If you defy the idea then you’re going to be calm because that’s the opposite of being nervous. If you attempt to follow the directive then you’ll soon realize that you have more control than you thought and will be able to contain your nervousness.
This theory is very similar to MRI Brief but it not only wants to change the interactions between individuals but also the hierachies that exist in family systems. Problematic hierarchies, or family organization, include triangulation and coalitions. Triangulation is a structural misalignment where two individuals form a coalition against another family member. A coalition is the teaming up of two family members and is particularly dysfunctional when it includes a child because it raises the child to a superior or equal level of an adult. Haley is known for using directives and ordeals which are directives that make it harder to keep the symptom than give it up. Madanes moved to a more Experiential form of therapy.
Milan Systemic was created by Italian therapists and is very similar to the strategic and brief therapies. The differences include positive connotation which is similar to reframing but takes out the blaming aspect. Most diagnoses approach a client from the stance of blaming and positive connotation tries to get rid of this element by simply pointing out the positive value that each family member is working out of. Milan Systemic does not believe that a family necessarily gets anything out of bad behavior and instead has simply grown used to the patterns that are in place. Power games that include parents and children are at the root of dysfunction. Their interventions were based on hypothesizing (inviting the family to investigate the roles everyone plays in a problem), circular questioning (having family members describe their perception of family relationships) and neutrality (or curiosity which is the stance the therapist takes when helping the family).
(These three theories are all really similar and I always get them confused. There really aren’t any great books that show this theory at work since most seem to have abandoned it and it’s simply the foundation of many other theories.)
There are tons more, but I think these are the most important ones. And I’m sure none of you got this far because OH MY GOSH how boring, right? Yeah.