How Does Family Therapy Work?
Family therapy works quite a bit like couples therapy, except with more patients in the room, more interpersonal dynamics, and more "knots" to untangle. We recommend you read our essay on "How Does Couples Therapy Work?" to understand more of what we mean by this statement. Couples, families, and groups of any kind become a kind of unconscious living system, and the more individuals that comprise that system, the more infinitely complicated the dynamics of the system become.
All of which leads us to a somewhat distasteful paradox: the more complicated the system (i.e., the more patients there are in the therapy office), the more superficial the therapy becomes. Therapists who have devoted their working lives to family and group therapy might want to kill us for such a statement, but we feel it's true in a very specific way. To wit: the more patients there are in the room, the more the therapy has to focus on communication skills and boundary issues, and the less it can focus on the resolution and removal of unconscious inhibitors to success. There is nothing wrong with a therapy that focuses on communication and boundaries, but that kind of therapy may remain incomplete if certain individuals' unconscious dynamics remain unaddressed.
The best method to address an individual's unconscious dynamics is in individual psychodynamic developmental psychotherapy, not family therapy, nor even couples' therapy.
Don't despair! Family therapy is a great starting point for lots of people. It is "safer" and more benign than other forms of treatment, and many people find that the educational aspects of learning about communication and boundaries are invaluable. Many families have left our offices feeling and functioning much better than when they came in, sometimes even in a very short period of time.
A best case scenario for many courses of family therapy is that the family gains some immediate, palpable relief from its struggles, as well as an increased sense of curiosity about "what lies beneath" the communication and boundary confusions. Previous participants in family therapy may then transfer or resume their earlier therapy experience into an individual therapy one, where a deeper sense of completion can be gained via increased insight into the reasons behind the development of the troublesome family symptoms in the first place.
Different modalities of therapy can often be used as effective stepping stones in helping this process along. Individual therapy, couples therapy, and family therapy are each valuable in the larger picture of a family system.