Family therapy can be dangerous. As practitioners we are exposed to deep sadness, fear and impotence and there are sessions where this touches us to our core. Early models of family therapy which ascribed to ideas of first order cybernetics drew a boundary around the family with the practitioner characterized as operating like the mechanic who ‘fixes’ the faulty motor and is themselves unaffected and unchanged. With the adoption of Heinz von Forster’s second order cybernetics or the cybernetics of cybernetics, therapy was understood as a process of mutual influence where therapist and family affect each other. Whatever our theoretical position we have always known this.
Emotions and the Therapeutic Alliance
In a recent edition of Family Process, Peter Rober directly addresses the threat to the therapeutic alliance from the practitioner’s emotions. Alliance is central to positive outcomes for all therapeutic practice, but meta-analyses suggest that this may be even more critical for family therapy than individual work. It is also more complex, with the practitioner required to build trust with all family members while also enhancing trust between them so processes of self-protection, including silence, attack or sarcasm do not prevent effective work.
The Therapist’s Emotions
While the therapist’s emotions are important and instructive, there are occasions where strong emotions conflict with the goals of empathic listening, authenticity, and hopefulness. Unacknowledged sexual attraction, boredom, anger, fear, and irritation leaves the practitioner at risk of unwittingly acting them out while expressing these in the session can be inappropriate and detrimental to the therapeutic relationship. Where feelings of sexual attraction, love or anger arise, it is advisable for the practitioner to seek supervision as soon as they are aware of these feelings.
Regulation of Emotion
Rober (2023) suggests there are three key reasons why therapists should manage their emotions in sessions. This includes allowing them to remain in their therapeutic role of empathy and acceptance, using emotions to help understand the family’s experience and information to guide the process of designing interventions. At times family members may also, unknowingly, help regulate the therapist’s emotions when they step in to comfort, reassure or contain another in a way the therapist would like to have done.
Five Strategies for Self- Regulation
Rober identifies five strategies practitioners adopt to manage emotions in sessions, three of which involve avoidance of troubling feelings and are less useful. These include sidestepping topics that may resonate with one’s own current difficulties, or which may produce strong emotions in family members or not letting themselves experience the emotion while in the session by focusing on something else. More useful strategies are self-supervision or self-talk where the practitioner consciously attends to relaxing and calming themselves and reappraisal or reframing which attaches a more positive or hopeful perspective on the family’s situation. The latter can also be used as an intervention with the family but only if the therapist has genuinely adopted it.
How Can We Use Our Emotional Response?
Rober recommends that practitioners adopt three steps in using their emotional response in sessions. First, one must focus, experience, and identify the feeling, next, reflect on the possible link with the family dynamic and finally, consider how this understanding can be used to promote the therapeutic dialogue.
In Conclusion
Affect is a key element of pattern, between family members in the development and maintenance of problems and in the therapeutic dialogue. Embracing this and working with strong affect rather than denying or avoiding will enrich and protect clinical practice.
Rober, P. (2023). Emotion regulation of the family therapist. Family Process, 62, 1307–1321. https://doi.org/10.1111/famp.12937