Affect and Attachment in the Family: A Family-Based Treatment of Major Psychiatric Disorder

By Jeri A. Doane; Diana Diamond | Go to book overview

CHAPTER 7
Treatment of the
High-Intensity Family: A Model of
Teaching Affect Regulation

THE LABEL "high-intensity" was chosen for this group of families because it captures both the families' volatile style of affective relating and the overall feeling evoked in family therapists as they work with such families. Typically, the therapist becomes rapidly absorbed in the family's affect and may feel intensely engaged with the parents almost immediately. At the end of the initial contact, family therapists typically feel exhausted and drained by the intensity of the emotional reactions of the parents and the patient. A mutually engaging affect spiral seems to operate in these families. However, high-intensity families can display very different kinds of affect, even within one family. A verbal, demanding mother might be matched with a rigidly closed and silently angry son. Or, an angry, accusatory father might have a disorganized, psychotic son who is intrusive, inappropriate, and agitated. Another family might be characterized by a bizarre and verbally overwhelming schizophrenic daughter and a mother who is frozen in disorganized silence but reacts to every syllable spoken by the daughter.

In thinking about treatment for these kinds of families, we might first ask what underlying matrix of dynamics would drive the intense affective family interaction. Our research data provided us with some insight into family dynamics and allowed us to generate some hypotheses about what drives these systems. First, regardless of the type of negative affective displays they might exhibit in interactions with their disturbed child, the parents in these families have an attachment to their disturbed child that is neither negative nor attenuated. The inevitable stresses and strains of

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