Protection, Paradox, and Pretending

Abstract

This paper proposes that psychopathology in children can be the result of an incongruity in the hierarchical organization of the family. The parents are in a superior position to the child by the fact of being parents, and yet the problem child assumes a superior position to the parents by protecting them through symptomatic behavior that often expresses metaphorically the parents' difficulties. The paper describes three paradoxical strategies for arranging that the parents solve the presenting problem of the child and the incongruity in the family hierarchy. The therapeutic techniques described are characterized by the use of communication modalities, such as dramatizations, pretending, and make-believe, that are appropriate to children.

Systemic change in limited family therapy

“…During the interview held for the purpose of referring this family for therapy, three consistent behaviour patterns were apparent as maintaining Mrs M.'s communication behaviour: ( I ) (Madanes, 1980) reflects the linear explanation the family had made, and explains why everyone in the family except Mrs M. periodically exhibited interpersonal or psychological symptoms severe enough to attract outside intervention. Symptoms of other family members were serving a protective function surrounding the individual whom the family had identified as the weak one, protecting homeostasis and preventing change but leaving them all very unhappy with this 'solution'.…”

“…His actions and decisions typically dictated what the rest of the family did, including the parents who seldom acted in a parental capacity. Matthew had earned his power in the context of being the identified patient (Madanes, 1980). Five family therapy sessions were held, over a period of ten weeks.…”

Family Sculpting: I. Some doubts and some possibilities

“…Madanes and Haley's (1977) review of approaches to family therapy and their division between those based on psychoanalysis and those based on communications theory may be useful as a form of simplification.…”

'Paradox: a pivotal point in therapy'

“…Apart from those quoted in the text, the following references are suggested : Ackerman (1977), Cade (1979a, b), Cade and Southgate (1979), Haley (1963Haley ( , 1973Haley ( , 1976, Hoffman (1979), Jessee and L'Abate (1980), and Madanes (1980). Finally, a slim and entertaining volume by Hughes and Brecht (1978) considers, without any therapeutic axe to grind, the ways in which paradox invades our everyday lives through art, philosophy, logic, humour and literature.…”

“…Coupled to the overt behavioural problems, there appeared to be a significant degree of psychosomatic illness, centred mainly on the father. I t seemed to me then that neither I nor my colleague had sufficient professional status and skill, nor the agency resources, to attempt an open approach in dealing with conflict in this family, as described by Minuchin (1965). I chose an alternative technique for dealing with conflict with which I had experience, that allowed battle to be joined and won without loss of face in the family.…”