FAMILY TEAMS: FAMILY STRUCTURE

An often subtle form of circular dance that happens in some families involves confusing the family structure. Families run according to rules. Some of these rules are obviously stated and serve as clear guidelines for interacting with one another. Other rules are felt or assumed but not spoken out loud. Whether obvious or subtle, these rules determine how family members interact; these rules structure the family.
Healthy families have clear and sensible rules that structure the relationships within the family. Key among these rules is that the parents share more and greater varieties of intimacy with each other than either shares with any other family member. The "mother of family therapy," the late Virginia Satir, once commented, "The marital relationship is the axis around which all other family relationships are formed. The mates are the 'architects' of the family." This rule should continue to apply regardless of the ages of your children. It is certainly true and appropriate that as parents age, they may become more dependent on their grown children. However, healthy families continue to respect the rule that parents have a right to privacy and the now grown children have a right to live their own lives.
Periodically I have the delightful experience of addressing the residents of a local retirement home about the marital and family issues that are encountered during the years of senior adulthood. One of these residents bragged to me about the closeness that had developed between him and his four grown children in recent years, especially since the death of their mother five years before. When asked to share the secret of this success, he replied: "One thing my children don't do is forget about me for long periods of time. One thing I don't do is forget that my children have their own families now and that they sometimes need my encouragement to forget about me for a while." The point to underscore is that stress tends to disrupt family structure; it changes the ways family members relate to one another. These changes in relationship patterns can lead to a variety of problems.
One unhealthy pattern that is typical in families coping with illness involves two members becoming emotionally close at the expense of a third member. This pattern can be a particular problem if the two closely connected family members are from different generations in the family hierarchy; for example, a parent and a child may get close but exclude the other parent. When this happens, it almost always leads to such tension within the family that someone or some relationship is damaged. Once again, I refer to the Hinson family as an example.
Maria and Henry suffered a breakdown of marital intimacy, and everyone involved developed symptoms of stress as Maria turned primarily to her son, rather than to her husband, for emotional support. Although the excessive joining between the child and one parent in this family was well-intentioned, it confused the overall teamwork and comfort that is necessary for healthy family functioning. The Hinsons broke an important family rule, and they paid a high price. Fortunately, they changed in time to avoid bankrupting their family's emotional fortunes.
Following my session with Henry Hinson, I met with him and his wife together. I encouraged them to begin discussing with each other the same concerns that they each had shared openly with me. Fortunately, they were willing to try this different way of relating to the fears and concerns that had paralyzed their marriage since Henry's heart attack.
But they did not just talk; they found the courage to change. First, they made a list of the many responsibilities and concerns that faced them as a couple: business matters, household financial responsibilities, management of retirement funds, dealings with insurance companies and with Henry's doctors, needed areas of change in their family diet and other life-style matters, the day-to-day running of the household, and, of course, their son, John.
John accompanied them to their next counseling session and was lovingly included in planning how this family would go about changing. The therapy setting was helpful in pointing out to the Hinsons the many ways in which they had created an uncomfortable family structure, one in which Mom and Son were running Dad's life. The relief and the appreciation that this family felt toward one another as they openly discussed their life together was obvious and touching.
For several weeks, Maria and Henry grappled with various possible ways of restructuring their life. They included their son in some of these discussions, but they often expressed their thoughts, feelings, and wishes privately, as husband and wife—just like old times. The Hinsons decided that Henry would indeed remain retired from running his business. Instead of working outside the home, he would take over managing the household and family finances, his own paperwork with his medical insurance companies, and the day-to-day operations of the household. He expressed a new enthusiasm for learning to cook—a part of family life that Maria had never really enjoyed, anyway. Free of the pressures of running their home, Maria found that she could better manage the pressures of running their family business, but she admitted that she needed help in this area. This time, both Henry and Maria were clear that this help needed to come from someone other than their son. They decided to hire a business manager.
Maria and Henry emphasized to their son their sincere hope that he would return to college and finish his education. John reacted honestly: he did not feel ready or motivated to return to school, but neither did he particularly enjoy working in the family business. Instead, he opted to get a job in a company that employed several of his high-school friends. He also stated that he wanted to begin sharing an apartment with these buddies.
I do not mean to imply that the Hinsons changed easily or that they just went on to live happily ever after. Like all families, they continued to have times of struggle and disappointment. Seven years after his first operation, Henry had to undergo bypass surgery again. Maria still periodically suffers stress-related headaches, and she feels sadness and resentment because her life plan has been changed by Henry's heart illness. John never did return to complete his education, and his efforts to establish a career outside his family business have not succeeded. But these family crises and disappointments were met head-on by this couple. They are no longer stuck in attempted solutions that do not work, and they no longer mess up their family structure in facing their stressful times.
There is another troublesome family structure, one that is found in some families that operate quite differently from the way the Hinsons do. Here, family members grow accustomed to keeping excessive emotional distance from one another. They simply do not nurture or soothe one another; nor do they communicate or cooperate among themselves. Everyone lives in emotional disconnection. Such families have much difficulty feeling comfortable in reacting to crises such as illness. The obvious need for healing through intimate connections during such times makes these families uncomfortable. They tend either to flounder in awkwardness as they attempt to be more caring, or to seethe in guilt and anger over not giving or receiving more nurturance.
Family teams resist change.
Families tend to dance circular dances.
Family structures are important in determining how we relate to one another.
Bearing these factors in mind, we turn now to a closer examination of healthy and unhealthy family reactions to illness.
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