The Importance of POWER in Relationship

The Importance of POWER in Relationship

Being a systemic therapist requires ongoing analysis of the ways in which power dynamics organize and shape the life-long relational dances in couples and families.  Experiences of privilege and marginalization in the cultural landscape are critical to the daily lived experience of our clients, and impact their relationships in profound ways.

In working with our Psychiatry residents at Penn, I welcome writing that fosters clarity about the influence of these complex, often silenced, aspects of power.

Once again, my friend and colleague Ken Dolan-DelVecchio has provided a map.  He distinguishes between two types of power:  power over, which is the right to dominate, and power with, the responsibility for shared success.

He states:

Power with, the alternative to power over, sees power not as the opportunity to dominate and control but, instead, as the responsibility to bring about good things for everybody involved. It is the essence of great leadership, partnering, parenting, and friendship. Indeed, power with is the essence of love.

I invite you to read his article Radical Self Awareness #1: The Importance of Power.

In doing so, you’ll access this “essence of love,” and better, help couples and families learn to  “bring about good things for everybody involved.”

After all, isn’t that, quite simply,  what we’re all working toward?

 

Matters of the Heart

As a family therapy clinician and teacher, I am constantly talking about the importance of relationships.  I’m thus thrilled when those outside of my specialty acknowledge that as well – especially when it comes from my colleagues and collaborators in the medical community.

In “Why Your Cardiologist should ask about your Love Life,” Dr. Sandeep Jauhar discusses the link between heart health and our emotional and relational worlds:

We have learned, for example, that fear and grief can cause serious cardiac injury. During emotional distress, the nerves that control the heartbeat can set off a maladaptive “fight or flight” response that causes blood vessels to constrict, the heart to gallop and blood pressure to rise, resulting in damage to the body.

Those of us who are present daily to the intensity of marital strife can certainly attest to this fact. What is more tender to the heart than being hurt by someone we love?

It is becoming a known fact that the importance of relationship, and the quality of relationship, directly impact one’s health and well being.  Researchers here at Penn Medicine have examined the impact of marital status upon the recovery from cardiac surgery, as well as the involvement of family and friends in improving healthcare outcomes.

For example, colleagues at The Center for Healthcare Innovation studied how to engineer social incentives for health, and suggested that more of our healthcare delivery system take advantage of the highly influential nature of social relationships.

Other research focused on the connection between marital status and recovery from cardiac surgery, and found that married people may fare better than those who are divorced, separated or widowed.  Although there is a lot more to examine relative to this connection, it is heartening to see the significance of relationship included as a key factor in promoting health and well being – yes, even in recovery from cardiac surgery.

Indeed, cardiologist Sandeep Juahar suggests we deploy a paradigm shift away from the individualized mode of thinking:

We will need to shift to a new paradigm for heart problems, one focused on prevention, to continue to make the kind of progress to which patients and doctors have become accustomed. In this paradigm, psychosocial factors will need to be front and center. Treating our hearts optimally will require treating our minds, too.

Thank you, Dr.  Jauhar.  I could not have said that better myself.

Holiday Tips from a Family Therapist

Fir Branch With Pine Cone And Snow Flakes

 

Each year around this time, conversations with clients turn to the predictable stress of time with family over the holidays.

Like ghosts in the night, old issues, long dormant, reappear at holiday time. How is it that an adult with partner and children can walk into their parents’ home and instantly feel 10 years old again? The anticipation of a holiday encounter can lead any adult to feel slightly unhinged in a way that few other situations do.

Let’s face it, no one can upset you like a family member.

Here are some ideas to try on this holiday season. They are born of basic tenets of family therapy theory and are utterly applicable to a variety of anticipated holiday situations:


1. Plan and be strategic. 

It’s always a good idea to warn someone that you are going to make a change before you actually do:

“I was thinking about the holiday, and this year I might do something a bit different.”

You don’t even have to be sure of what specific change you’re going to make, the point is to warn others first. That way, you can attempt to avoid their shock and surprise when you decide not to follow the family script – you know, ‘the way it’s always been and everyone (but you) wants to continue’.

This can be particularly useful when, for example, you have young children and want to begin to create your own traditions around the holidays. Perhaps you feel the stress of traveling with small children in an effort to please everyone, or because ‘you’ve done it every year, and they’re counting on you.’ So let people know in advance and find allies to support your change.

Which brings me to the next point.

2. Expect a reaction.

It is true that relationships have much in common with physics: for every action there is a reaction. Families attempt to maintain a homeostasis – a state of balance, maintained by familiar patterns and expectations. Think of the tremendous impact it has upon relationships when a family member joins or leaves the system; these points of normative developmental crises, birth, adolescence, marriage, or death, each require a renegotiation of previous roles and rules in the family system. Holiday traditions are valued as markers of continuity, so changes, however minor, can feel disruptive and unsettling.

3. Focus on yourself.  

You can change only your behavior, not the behavior of others.

Admittedly, this is a tough one. It’s the balancing act between giving up the dream of what can be, and accepting what is. There is much integrity in changing one’s own behaviors in a respectful and compassionate way, and it’s sad to realize that, for now, others may just not be who you want them to be.

Developing a curiosity about yourself may help. This might be a good time to entertain the questions:  Why does this person still hold so much power over me?  Why do I still need my mother/father/sibling to compliment or recognize me? How is it that I have come to this place in my life carrying that old wound?

4. There’s always next year.

Your opportunities to practice being different in your family are boundless. Try to think of this as one of many steps toward change. It will most likely take more than one conversation and there can be complicating factors: addiction, trauma, divorce, remarriage. Relationships take time, so keep in mind the long term; families are full of surprises and unpredictability as the family life cycle inevitably moves into the future.

When I hear a person in their 20’s or 30’s say “I’ll never have a relationship with my brother, I respond, “Well, let’s think about this for a moment. If you both live until you’re 80, are you telling me nothing will happen over the next 50 years? Most likely, your parents will predecease you, and you and he will together become the oldest living generation in the family. You may each partner with someone, and perhaps become aunt and uncle to each other’s children.”

There are endless circumstances that create opportunities for us to evolve in our family system.

Lastly, I try to remember at this time of abundance and giving thanks, that to even think about the quality of relationship is, of itself,  both a blessing and a privilege.

With all my best to you and yours during this special season,

Jacqueline Hudak

 

 

Engaging Family Supports: Free Online Videoconference

 

Join us for the next CPSP
“Community Psychiatry Forum*”
In Collaboration with
The American Association of Community Psychiatrists

Engaging Family Supports

Learning Objectives – Participants will be better able to:

  • Identify strategies and barriers to engage family members as supportive members of recovery team
  • Enable people in recovery to identify and connect with potential sources of support in the community
  • Describe issues commonly concerning family members and other natural supports and potential approaches for addressing them

CME: You can earn 1.25 CME credits

When: Thursday, April 21, 2016
11:45 am – 1:00 pm EDT

Course Directors: Wesley Sowers, MD
Robert Marin, MD

Guest Experts:

Ellen Berman, MD, Clinical Professor of Psychiatry, Perelman School of Medicine, and Founder and Director of Training, Center for Couples and Adult Families, Department of Psychiatry, University of Pennsylvania, Philadelphia, PA

John Sargent, MD, Director, Division of Child and Adolescent Psychiatry, Tufts Medical Center and Professor of Psychiatry and Pediatrics, Tufts University School of Medicine, Boston, MA


*Community Psychiatry Forum: Free online videoconference offered twice each month. Continuing Medical Education credits

Dr. Ellen Berman with Marty Moss-Coane and Ron Lieber: “Families and Money”

326aMoskowStudio    CCAF Founder, Dr. Ellen Berman was a guest on WHYY’s Fresh Air  with author Ron Lieber yesterday.  They had a lively and informative conversation about Families and Money.  Ellen and Ron  answer some of the more vexing questions about this important, delicate, and often very difficult to discuss topic.

“Money is all about values,” says Dr. Berman, who draws upon 30+ years of clinical experience with couples and families.  She talks specifically about the cultural shifts that impact ‘adult’ children, and offers clear, specific advice about how to avoid pitfalls and seize opportunities when dealing with the thorny issue of money and the family.

 

 

Welcome to our new CCAF Clinical Faculty Member, Michelle Jackson, MSS, LCSW

Welcome to our new CCAF Clinical Faculty Member, Michelle Jackson, MSS, LCSW

The Center for Couples and Adult Families extends a warm welcome to Michelle Jackson, a seasoned Couple and Family therapist who joined our Clinical Faculty last month.

There are many reasons I’m thrilled to have Ms. Jackson aboard, not the least of which is our ability to serve more couples and families at CCAF. Her arrival is evidence of our growth; clearly the word is out that there is couple and family therapy available at Penn.

Ms. Jackson’s sensitivity to issues of diversity in clinical work is in concert with the CCAF mission, as well as our curriculum in Culture and the Family that takes place across all four years of residency training in psychiatry.

Ms. Jackson’s life trajectory informs her fluency with individuals who have chosen or invisible identities, or who are part of biracial/bicultural couples, and multi-racial families. Her work provides a context in which to normalize alternative developmental pathways and strengthen resilience in the absence of cultural validation.

Welcome to CCAF, Michelle!

I’m so happy to have you as part of our team, and know that couples and families will be enriched through their work with you.  I look forward to a long collaboration together at CCAF.

To schedule a meeting with Ms. Jackson, please call Bryn Farrelly, 215-746-5900.

Read Ms. Jackson’s full bio

New Research: Family Psychoeducation Crucial in the Treatment of Schizophrenia

A landmark, government funded study finds that schizophrenic patients who received a combination of drugs, talk therapy and family support made greater strides in the first 2 years of treatment than patients who just received drug therapy.

Featured on the front page of yesterday’s NY Times, the report made clear that  family involvement and “talk therapy” are vital in the treatment of schizophrenia, and this combined approach provided more symptom relief to patients (and thus families) and capacity for higher functioning at the end of 2 years.  The study will be published in The American Journal of Psychiatry, and the article can be found here:

http://www.nytimes.com/2015/10/20/health/talk-therapy-found-to-ease-schizophrenia.html?_r=0

At CCAF we are well aware of the importance of family inclusion and family psychoeducation around certain illness, particularly those that strike in early adulthood.  We collaborate with Dr. Claudia Baldassano and her team of psychiatry residents to facilitate multifamily Bipolar Psychoeducation groups.  We have developed a series of 4 – 90 minute family group sessions during which:

  • information about the illness is presented, and families invited to ask questions,
  • families tell their story about how the diagnosis was made,   
  • families discuss the process of coming to terms with the illness,
  • we discuss how to handle relapse and emergencies, and
  • anything else the family wants to talk about.

The Center for Couples and Adult Families is fortunate to be situated within the Department of Psychiatry here at Penn.  We look forward to further collaboration to develop similar groups for families of schizophrenic patients.