Including your family in therapy can benefit your personal progress

Mental health and relationships are influenced by your family and society–so how can you feel better if they don’t support you? We are each a member of our family–which in turn is a sub-unit of society–and this makes up the family system. Couples and family therapy assumes that if this system is healthy, then all the family members will be well adjusted too.

Everyone usually agrees that their families influenced their personalities, either in a positive or negative way. If you were lucky enough to come from a healthy, supportive Family Of Origin (FOO), then the idea is that you will be a better adjusted individual and your future relationships will also be healthy and balanced. Unfortunately, if you come from a troubled childhood and a difficult family background this can often create a lasting effect on your future relationships as well.

What isn’t initially obvious is how difficult it is to change some of those old patterns of behaviors and feelings that we may fall into. We can highlight some of these challenges using a case example:

Client Ramesh comes in for counselling because  he feels tired all  the time. He suspects that he may be depressed and wanted to speak to a therapist. After further exploration in the therapy room, it’s revealed that he’s recently married and Ramesh and his new wife are living in a joint family with his parents and brother. Ramesh was the eldest child and felt he was the responsible one, helping out his family financially, if necessary. His mother doted on him and would cook all of his favorite meals, while his father and younger brother would not get the same treatment. Ramesh’s mother would talk to her son about problems that she and his father were having and he enjoyed the closeness he shared with his mother. Ramesh’s understanding of marriage was that he would gain a partner who could help him carry the responsibility of his family and be a support to his mother as well.

After the wedding, things became uncomfortable. While the honeymoon was fun, there were some minor conflicts at home. When asked, Ramesh described that his wife would make sarcastic comments about how his favourite foods were always cooked at home and she would question the amount of time Ramesh spent talking to his mother after work. Ramesh felt guilty about not spending enough time with his mother, and while his mother never said anything directly, Ramesh understood that his mother needed him more. If he wasn’t there for his mother, who would be?

This caused conflict in his new marriage–there was no peace at home. His wife was threatening to leave and go back to her parents–and if that did happen what would people think? Meanwhile things at work were also stressful after the leave he had to take for his wedding and honeymoon. He was feeling guilty about not doing enough there as well.

From Ramesh’s perspective, he’s doing everything he could do keep everyone else happy but still there is no happiness. He would have assumed that these kinds of issues shouldn’t arise and as long as he does what is ‘right’, things should work out. Unfortunately, when individuals come in for counseling there is often conflict at home. The therapist could work with Ramesh and help him see some of the patterns he tends to fall into:  He feels guilty quite often even when he is trying to do the ‘right thing’. He feels responsible at home for his parents, his relationship with his wife and his role at work. He also feels social pressure regarding what others think about his family.

The problem with individual therapy is that it doesn’t address the family at home that may be perpetuating these problems. When Ramesh spends time with his mother rather than with his wife, she may be feeling lonely or jealous. Instead of expressing those feelings she may instead respond with sarcasm or anger, which in Ramesh’s case may cause more anger or guilt. Even after counseling, Ramesh still needs to go home to his family which may not respond well to the fact that Ramesh has changed and may think about things differently.

Family or couples’ therapists tend to look at these issues from a different perspective. In this example, this family could be helped by looking at Ramesh’s parents and their relationship and how this plays out in the family. It may have been fine when the sons were younger, but now that they are adults can they be expected to fulfill their parents’ needs in the same way as before? The family isn’t able to change to accommodate this growth. Both Ramesh and his brother could be asked how they feel regarding the situation to illuminate the family dynamics. Just because his brother may not express the same level of conflict, it does not mean he is not affected. In family therapy feelings like guilt serve a purpose. In this case guilt and distress may be Ramesh’s indicator that things are not well with the whole family. Ramesh and his wife could look at improving their communication with each other to build closeness.

In this way, family therapy can help to fix the root cause of Ramesh’s guilt and depressive feelings. While things may have been functioning fine before his significant life change (his marriage), the problems  started creeping in later. Families often are not able to adapt and change in response to situations when needed, and so get stuck in interactional patterns that can be painful. Family therapy can be a more efficient way of dealing with these issues.

There is a movement in the West to address as many problems using family therapy. Interventions regarding at-risk children and teenagers in particular are conducted in a family environment with the hope that it will quickly address the system that is producing the problem. Employment Assistance Programmes (EAPs) abroad also tend to encourage seeing the couple with the hope that the individual’s problems will be addressed efficiently. From our perspective almost every problem can be seen as a systemic issue that can be best addressed from that perspective. In India we are even more connected to our families and communities than abroad. While this has benefits like support, if the system is not able to adapt and change it can cause more distress than otherwise. Couples and family therapy addresses this from a holistic perspective.

The vignette presented here has been used for the purpose of illustration and does not represent actual clients.  

Shabari Bhattacharya is counselor and trainer with Parivarthan Counseling Training and Research Centre.