Magazine article Family Therapy Networker

CASE STUDIES; the Pizza War: Finding the Fit between Cognitive-Behavioral and Family Therapy

Magazine article Family Therapy Networker

CASE STUDIES; the Pizza War: Finding the Fit between Cognitive-Behavioral and Family Therapy

Article excerpt

OFTEN, THE HARDEST THING to change in any client are the beliefs that underlie rigid family relationships. One of the goals of cognitive-behavior therapy (CBT) is to help family members identify distortions in their own thinking, which then expands their perspectives on new possibilities in their relationships. Cognitive-behavioral interventions are particularly effective with difficult cases such as the one below, in which the impulsivity and combustibility of the family members could have easily overwhelmed and derailed the therapy.

It is not unusual for couples to come to therapy because they are contemplating divorce, but this was the first time I had been approached by two teenage children who wanted a divorce from their parents. While they weren't accusing their parents of abuse or of any terrible crime, Rollie and Janice Steigerwalt, ages 15 and 17 respectively, told me, "We're sick of them telling us what to do, and we would just as soon live somewhere else divorced from them!" The parents, silent through this declamation, gave me the distinct impression that this was not the first time this song had been sung in the Steigerwalt household.

Robert, a 44-year-old draftsman, worked for a large, national automation firm, a job that had moved the family around quite a bit during the course of his 19-year marriage. His wife, Carole, a 43-year-old administrator at a nursing home, described how she resented the moves, particularly in light of Robert's failure to be promoted or given a significant salary increase. The Steigerwalts reported having had a tense, distant marriage up until three years ago, when they went through intense marital therapy. I asked the family what it had been like before the couple had attended conjoint therapy. As their disagreements worsened, Carole spent more time with the children, with whom she had a close relationship. When Robert, who often traveled for his job, came home, he was the odd man out. "This was when he became nasty to everyone and began to verbally abuse us," said Carole. Since they had completed therapy, however, the only real conflicts the couple continued to experience centered Robert's occasional verbal attacks on her and the children. But Mr. and Mrs. Steigerwalt were at a loss to explain why their kids were so unhappy.

The children's dissatisfaction with their parents apparently began around the time that Robert and Carole started working on their marriage. The problem, Rollie and Janice explained to me, was that although they were good kids, their parents treated them badly. For example, they told me, their parents kept changing their minds, giving them permission to go away with friends for the weekend, but later making it conditional, saying, "Well, you can go only if you do this or that first." Both kids complained that this and other examples of inconsistency were terribly unfair and selfish on their parents' part.

It was family therapy pioneer Virginia Satir who said, "The marital relationship is the axis around which all other family relationships are formed the mates are the architects of the family." When there is a major shift in a couple's relationship, the whole family system changes, and I suspected this was at the root of the children's rebellion. Both parents agreed that prior to the marital therapy they had been lax with discipline and setting-boundaries. The children chimed in to tell me their parents had never agreed on anything in the past and now all of a sudden they had become extremely strict, even though they maintained no set rules in the house and simply made tilings up as they went along. "Our lives really suck," said Janice. The parents acknowledged that they often "shoot from the hip."

Carole remarked that when she and her husband had been having marital problems, they were more divided around parenting. She was the one in the children's "camp" and Robert was in his own "camp." Since clients eventually act out their family dynamic right in the office, I soon had the chance to see the Steigerwalts in their battle mode. …

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