Alert others to inherited wounds + unawareness


A Model of Effective Service to
Troubled People, Couples, and Families

By Peter K. Gerlach, MSW
Member NSRC Experts Council

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The Web address of this article is http://sfhelp.org/pro/model.htm 

  Updated  September 30, 2015

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      This article is part of a series for human-service providers working with low-nurturance (multi-problem, dysfunctional) families and with  survivors of childhood abandonment, neglect, and abuse ("Grown Wounded Children.") This article offers...

  • perspective on why providing effective human-service to troubled people and families is challenging, and

  • a summary of a 5-part clinical model of effective clinical work with these families.

      This series is written to student and practicing counselors, life-coaches, and therapists and their instructors, consultants, employers, program managers, and evaluators. Most of the principles in this model apply to any human group, not just families.

Note - this model and series were originally designed to focus on effective clinical work with typical U.S. divorcing families and stepfamilies. It is being reorganized in 2009 to pertain to (a) all low-nurturance families, and (b) persons wounded by early-childhood trauma ("Grown Wounded Children" - GWCs). Sections of these articles still hilight keys to serving divorcing and stepfamily members well.

      This series assumes you're familiar with:

  • The intro to this nonprofit educational site and the premises underlying it

  • self-improvement Lessons 1 thru 6

  • perspective on human change

  • useful clinical and lay terms; and...

  • the intro to this series for clinicians, and these premises.

      Before continuing, pause and reflect - why are you reading this article? What do you need?

Perspective

      Families have existed in every age and culture because they are best able to fill a range of primal needs of their adults, kids, and societies. Families' ability to fill their members' daily and developmental needs (i.e. to nurture) varies from low ("dysfunctional") to high ("functional").

      Demographers estimate that almost half of recent American marriages have ended in legal divorce. Uncounted millions of other mates and their families endure psychological divorce. More millions never risk forming a family. This suggests that well over half of typical current U.S. families have a significantly low nurturance level. This has serious effects on family members, future generations, and society.

      Premise - a high percentage of typical American clinical clients and patients come from low-nurturance childhoods and current families. So do many human-service providers. Addicted, divorcing, and step families are overrepresented among them.  

      My experience as a family-systems therapist since 1979 suggests that most institutions who train and license counselors, therapists, and psychiatrists don't adequately prepare them to improve family nurturance levels. If true, this suggests that most American (and other?) human-service providers don't know what they need to know to provide fully effective service to low-nurturance families and Grown Wounded Children (GWCs).

  Test this premise by taking these quizzes and see what you learn. Then reflect and say your definition of "a healthy, functional family" out loud, as though to a first-year grad student. Then compare your definition to this.

The Challenge

      Premise - all social role and relationship "problems" stem from two interactive factors: adults' (a) psychological wounds from low-nurturance childhoods, and (b) their ignorance of basic information about personalities and relationships + effective communication + losses and healthy grief + effective parenting + (for some) stepfamily realities and hazards.  The more knowledgeable clinicians (like you) are about (a) these interrelated factors and (b) causing desired systemic change, the higher their odds of satisfying clinical outcomes.

      Providing effective counseling and therapy to typical low-nurturance families is challenging because their adults and supporters have little or no awareness of...

  • this toxic cycle of [psychological wounds + unawareness] that spreads down the generations un-less family adults admit and break it;

  • these five related hazards that will significantly stress their family members, and...

  • up to six vital topics about themselves and human relations. And typical adults are unaware of ...

  • how to make three wise, informed marital decisions, and evolve a stable, high-nurturance family together.

      The clinical model proposed here is designed to help professionals help clients to (a) become aware of the [wounds + unawareness] cycle and (b) break it, to protect their descendents from its toxic effects. The model includes special application to

An Overview of the Model

      This unique clinical model has five parts:

  • Theoretical  foundations, including a definition of effective clinical service;

  • The client-family + professional metasystem (system of systems);

  • An experience-based set of interrelated premises about...

    • personalities, human development and behavior, change, and relationship problems;

    • traits of typical high and low-nurturance family systems and wounded people;

    • six psychological wounds contracted by average survivors of low-nurturance childhoods;

    • five epidemic, interactive family stressors and how to avoid or reduce them

    • personal and professional requisites for effective clinicians; 

    • essential knowledge for lay people and clinicians;

    • typical divorcing-family and stepfamily system dynamics, problems, and solutions; and...

    • a system of clinical assessment and intervention options and errors; and...

  • a practical three-step proposal for preventing family stress and divorce; and...

  • Relevant resources for clinicians, clinical organizations, and clients.

      Here is brief perspective and links to more detail on each of these elements.

1) Theoretical Foundations

      My clinical (MSW) training and experience since 1979 has integrated the work of four groups of respected  theoreticians and veteran human-service professionals into this clinical model:

  • Human-development and family-system pioneers, principally Erik Erickson, Virginia Satir, Murray Bowen, Carl Rogers, Jay Haley, Patricia Papp, Salvador Minuchin, Carl Rogers, Carl Whitaker, John Gardner, Nathaniel Branden, Celia Falacov, Judith Wallerstein, Steven Covey, Froma Walsh, and the "Milan Group" - Palazzoli, Boscolo, Checchin, and Prata; 

  • Intrapsychic, communication, and clinical-hypnosis pioneers, including Abraham Maslow, Gregory Bateson, Milton Erickson, Francis Barber, Paul Watzlawick, John Weakland, Richard Fish, Eric Berne, Claude Steiner, Neale Walsch, Anne Moir, Jeffery Zeig, Thomas Harris, Hal and Sidra Stone, Alexander Lowen, Larry Dossey, John Masterson, Fritz Perls, Steven Gilligan, Harville Hendrix, Roberto Assagioli, John Rowan, Deborah Tannen, Robert Bolton, and many others; 

  • Childhood-trauma recovery pioneers, including Bill Wilson et. al., Claudia Black, John Bradshaw, Sharon Wegsheider-Cruse, Janet Woititz, Charles Whitfield, John and Linda Friel, Rokelle Lerner, Alice Miller, Jane Middleton-Moz, Robert Ackerman, Anne Smith, Richard Schwartz, John Rowan, James Masterson, Mary Jo Barrett, Patricia O'Gorman, Philip Oliver-Diaz, Anne Wilson Shaef, Julia Cameron, Robert Subby, Charles Whitfield, Pia Melody, and many others; and...

  • Pioneer stepfamily sociologists, researchers and clinicians, including Andrew Cherlin, A. J. Norton,  Larry Bumpass, Jeffrey Larson, Paul Glick, J. A. Sweet, Esther Wald, John and Emily Visher, Cliff Sager et. al, Kay Pasley, Marilyn Ihinger-Tallman, and more recently John Bray, Margaret Newman, Elizabeth Einstein, Patricia Papernow, and many others.

      The five-element model proposed here is based on (a) a mosaic of ideas from these scores of wise practitioners, theoreticians, and researchers; and (b) my experience at integrating and selectively using my version of their ideas in my clinical practice with over 1,000 self-referred persons and couples since 1981.

Note that except for Richard Schwartz, none of the experts above incorporated ideas on normal personality subselves and wounds into their paradigms.

      The second element of this clinical model is a group of interrelated premises about...

Clinical Requisites

      A vital component of this clinical metasystem is the degree to which each human-service provider involved with a given client family meets these four requirements:

  • Special didactic and experiential knowledge; and...

  • Key personal traits, including...

    • their true Self steadily guiding their "inner family" of personality subselves, and...

    • clear self-awareness and process-awareness; and

    • key attitudes about the these complex client family systems and clinical work with them; and...

    • unique (vs. basic) clinical skills, and...

  • A high-nurturance, well-informed work environment, and...

  • Special professional and client resources.

For more detail on each factor, follow the links.

      The next element in this clinical model has three parts: (a) basic traits of these client families, (b) a three-level framework of common family stressors, and (c) a multi-modal framework for effective assessment, intervention, and case supervision with these family systems.

Model, Part 3) Premises on a Range of Related Factors

.       For links to detail on the premises (theories) that comprise this model, see this.

Model, Part 4)  Stress and Divorce Prevention

      Read this overview of the [wounds + unawareness] cycle. Then read about three steps that anyone (like you) can take to to help prevent inadequate family nurturance and potential divorce trauma in their community, state, or nation:

  • acquire didactic knowledge of...

    • the [wounds + unawareness] cycle and its effects,

    • assessing for and recovering from psychological wounds, and...

    • some of or all of these vital topics. Then...

    • patiently use this knowledge in your own life to validate these concepts and gain experiential awareness. Then...

  • choose a local, state, or national target group, and devise a strategy to alert them to how this knowledge can help them maintain high-nurturance relationships and avoid major stress and illness; Then...

  • patiently implement your plan with or without help, within your limits, priorities, and other responsibilities, and enjoy the satisfaction of having made a significant difference in the world.

      A keystone requisite for implementing these steps is that you work toward having your Higher Power  and true Self guide and support you along the way - and then encourage others to do the same. This series of prevention articles includes specific suggestions tailored to different human-service professions.

      The last component of this clinical model is a collection of...

5) Lay and Professional Resources

      This nonprofit, divorce-prevention site offers many practical resources for clients and clinicians to help (a) improve family nurturance levels and clinical outcomes, (b) break the ancestral [wounds + unawareness] cycle, and (c) prevent family stress and divorce trauma. The resources include...

  • A unique self-improvement course designed to avoid and reduce these five hazards.  The  course has evolved over 27 years of professional research and over 17,000 hours of clinical practice and classroom experience with hundreds of clients and students. Key topics are inner-wound assessment and recovery (Lesson 1), and effective-communication (Lesson 2) and grieving (Lesson 3) basics.

      Each Lesson is composed of a sequence of specific steps and options. Together, the Lessons provide a practical way for motivated adults to...

  • make wise commitment choices,

  • patiently evolve a high-nurturance family together, and

  • protect their descen-dents from the toxic effects of the [wounds + unawareness] cycle.

These Lessons also underlie this model's frameworks for clinical assessments and interventions with typical divorcing-family and stepfamily clients.

  • Hundreds of informational popups thruout this site to provide brief perspective specific concepts and links to more detail.

  • Lay and professional glossaries to help people understand these Projects, and promote clear thinking and effective communication.

  • Six guidebooks explaining and illustrating the 12 Projects in detail, and providing practical suggestions and resources for implementing them. The books integrate the key articles in this nonprofit Web site.

  • Basic-knowledge quizzes, and a collection of free worksheets and checklists to help co-parents and professionals assess their current knowledge and learn what they need to learn. Many Web articles here also include "status checks" to help with this.

  • Key questions client co-parents and clinicians should ask, summary answers, and links to more detail and practical options.

  • Over 90 lay articles on typical surface problems (symptoms) in these complex families, and practical options for reducing common intermediate and problems that cause them;

  • Suggestions, materials, and resources for a comprehensive clinical self-education and in-service training program based on this model.

  • A free modular self-improvement course for courting couples with and without prior kids from earlier unions. . The course can be tailored for use by human-service interns and professionals.

  • An experience-based framework for starting and maintaining an effective co-parent support group.

  • Description and illustrations of two powerful assessment and teaching tools - (step)family genograms and structural maps.

  • A menu of other relevant resources for clients and clinicians.

These lay and professional articles and resources are free to download, copy, and distribute, with these conditions.

Options  

      I suspect that this model is significantly different from the paradigm you normally use with your family and typical multi-problem clients. The attitude of your dominant subselves toward trying parts of this model will range from enthusiasm and curiosity (a typical true-Self reaction), to (protective) cynicism and skepticism, to rejection, to procrastination, to numbness and indifference. Which of these best describes your attitude now?

      If the model is very different from yours, exploring its validity and utility may seem daunting, like satisfying the graduation requirements for a higher-education degree. As you decide what to do with this scheme (if anything), note that it's modular - i.e. you can progressively evaluate parts of the model, not all of it at once. For perspective, it has taken me 26 adult years and over 17,000 hours of client contact with hundreds of different clients to evolve and validate this model - and I'm still learning!

      You may do nothing with this model (now), or you can choose among action-options like those below. As you decide, wonder if you were one of your clients, what would you want your clinician to do?:

  • Compare your current definition of "effective clinical work" to this, and decide if you're open to shift anything. Option - on a scale of one (consistently very ineffective) to ten (consistently very effective), use your definition to assess your work with a variety of clients in the recent past - e.g. the last six months.

  • Perhaps with objective supervision or another informed colleague, assess yourself honestly for these four requisites. With your Self (capital "S") in charge, decide if you wish to invest time and effort in gaining any missing requisites, within your situational limits. If you (subjectively) conclude you're working in a significantly low-nurturance setting, meditate on how that affects your professional morale and productivity.

  • Accept that to evaluate parts or all of this clinical model fairly, you'll need...

    • most of the requisites, and...

    • a steady willingness to change some significant current attitudes, priorities, and clinical practices to see how that effects your outcomes; and...

    • a patient expectation that it will take many months of experimenting and evaluating to evolve an organic decision on whether to adopt parts or all of this model in your work and workplace.

  • Review these three stress-prevention steps, and - with your Self in charge - decide if you're willing to act on at least the first two of them for your and your family's long-term good. Picture any children or grandchildren you care about as you do this. Option - explain the steps to your primary partner (if any), and see if s/he (a) is guided by her/his true Self, and (b) is motivated to do the steps with you now. If s/he's dominated by a false self, review these options.

  • Assess yourself honestly for significant psychological wounds, and use your experience to decide whether to study this "inner family" concept further. If you find the concept credible, then begin to assess your individual, marital, and family clients for false-self dominance and wounds, experiment with Lesson-1 interventions like these, and see what you learn. If a false-self dominates you, those well-meaning subselves may sabotage your efforts to try this model. And/or...

  • Use this example of win-win problem-solving and this summary of common communication blocks to assess the communication effectiveness of several client couples or families. If you become convinced, as I have, that most people aren't aware of their options to improve communication effectiveness, then commit to (a) studying and modeling the Lesson-2 basics and skills here, and (b) motivating your clients to study and use them. Then objectively track the results with anh open mind, and see what you and they learn.

      More options toward evaluating and/or adopting parts or all of this clinical model...

  • Ground yourself thoroughly in the three-level grieving basics proposed here, and begin to assess (a) your personal and your family's grieving policies, and clients' (b) knowledge of these basics, (c) their personal and family grieving policies, and (d) symptoms of blocked grief. Look for trends among a range of clients. Experiment with appropriate Lesson-3 interventions, and see what you learn. And/or you can...

  • Assess several client couples for (a) low-nurturance ancestry, (b) significant false-self dominance and wounds, and (c) unawareness of effective-communication basics, blocks, and options, regardless of their presenting problems. Look for common trends. Then in the context of your clients' presenting (surface) problems, experiment with Project-8 interventions like these, and see what you all learn.

  • With an open mind and your Self in charge, study the basic concepts of (a) the [wounds + unawareness] cycle and (b) stepfamily basics, hazards, and these 12 projects, and then experiment with Lesson 7, 4, 9, and 10 interventions with several stepfamily clients regardless of their developmental stage.

      If you wish to discuss the model and/or action-options like these with me via email or over the phone , I'm glad to do so while my health permits. I'm interested in your view of and experience with it.

Recap

      This and related articles for clinicians exist because there currently seems to be no comprehensive experience-based model of effective service to typical divorcing-family and stepfamily clients available. This article (a) summarizes why clinical work with these complex multi-problem families is more complex than with average intact biofamilies, and (b) outlines five elements of a unique systemic model of effective clinical service to these families. The model has evolved over 27 years' didactic study and clinical experience with hundreds of these clients.

      The five elements of this model are...

  • Theoretical  foundations, including a definition of effective clinical service;

  • A definition of a clinical metasystem (system of systems), including the client family system;

  • An experience-based framework of (a) traits of typical divorcing-family and stepfamily systems, (b) three levels of common client-family "problems," and (c) an integrated, multi-modal framework of clinical assessment and Intervention options and errors; and...

  • a three-step proposal for preventing family stress and divorce; and...

  • A collection of resources for clinicians, clinical organizations, and clients.

Links lead to more perspective and detail on each of these elements.

      Key factors that will determine whether this model is credible and useful to you is whether (a) your true Self governs your personality, and whether you (b) are open to evaluating and accepting the pervasive [wounds + unawareness] cycle that appears to stress most families and organizations in our culture. Another key factor is how receptive you are to studying and applying these basic topics and teaching them to your clients, as part of your clinical goals and strategies.

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Updated September 30, 2015