Psychotherapy and Family History
Many individuals decide to attend psychotherapy for a number of reasons: anxiety, depression, sexual and emotional affairs, divorce, sexual abuse, physical abuse, conflicts in family or at work, self-esteem issues, codependency, eating disorders, the list goes on. While psychotherapy has become more accepted and known in our society, specific aspects of psychotherapy and what actually goes on in a session is still left unknown. While psychotherapy sessions and therapeutic styles differ among psychotherapists, there is one area that sometimes new clients are reluctant about: the past. Many clients wonder what is the connection between family history and the present.
People who don’t want their past (family history) to be part of their therapy (psychotherapy), may opt for a behavioral therapist or short term or solution focused therapy. Such types of therapy deal with the here and now, rather than the “where do you think that comes from?” approach.
People who are really stuck therapeutically, or have never thought about where they come from will benefit from the more traditional family history work. A client’s family history and significant past events are crucial for gathering a full assessment of a new client, but most importantly it is crucial in attaining therapeutic goals. A common response from new clients when they are asked about childhood memories, or family history: “But what does that have to do with what’s going on now?As mentioned earlier, most clients will enter psychotherapy with an intention, an area to address, a specific problem to confront, and with many of these intentions comes goals. Almost everyone who decides to see a psychotherapist has a goal for the future, or a hope for something different. In order to attain the goals you have in mind, going back into our history is necessary. Here’s why: There’s a lot to factor in when learning to understand why a client behaves and sees the world as he/she sees it. Some of the basics include: whether or not you had siblings and what was the birth order, how you were raised by your parents, did you have both parents, and did were they both “hands on” with you as a child?
Family background (psychotherapy and family history)
In gathering history it’s always important to go back to the beginning and start with the basics, your childhood. This is a main area of focus when exploring the family history, especially your relationship with your parents. Your mother was the first person you ever came in contact with, this is most likely your first relationship, this set the tone for how you interacted with others. The little details of your family background give a therapist so much insight, or at least a guess about the dynamic in your family growing up. Things that you probably don’t think about on the daily basis is what we therapists go for: How did your parents meet? What were their ages when they met/gave birth to you? Were/are your parents married? Right there, these 3 questions give a therapist an idea of the kind of environment you born into, and what that must have been like for a child. There is so much more to ask to understand your relationships with your parents: did you grow up with both parents? Were they both hands on? Were you closer to one parent more than another, and why? These types of questions open the door to finding out about so much: parents’ personalities, your feelings towards your parents, how their parenting impacted you, and more.
Other important family questions to consider: Did you have siblings and if so what’s the birth order? These 2 questions alone tell a lot about the roles you had as a child, and how you interacted with your siblings (best friends, arch enemies, very distant, far apart in age, or did a sibling take on a parent role, etc.) Other family history basics include how was discipline modeled in your family? This tells the therapist whether or not you grew up with structure and consistency, or was disciplined with fear of corporal punishment, or if you parents disciplined at all, or simply avoided conflict. Having this information then helps us understand you better in how you view things like discipline, shaming others, and consistency.
What was communication like for you growing up? Was there open communication or were certain topics (sex, money, family conflict, etc) not discussed? This helps the client and therapist understand why you view and approach communication the way you do today. Perhaps you avoid conflict today because conflict was something to stay away from and not discuss in your family? Or maybe you’re the type of person that has to confront conflict the minute it occurs, because that’s how your mother communicated with you growing up. The more questions about communication the more we can learn: were you raised to avoid arguments at all cost, or did you grow up in a house full of “yellers?” Were there any family secrets that you were aware of?
Another important area is affection. What did you see growing up? Were your parents openly affectionate with each other (hugging, hand-holding, kissing hello and goodbye)? Were they openly affectionate with you, and if so what type of affection are you comfortable with and not comfortable with?
Relationships overall is an important area to cover when gathering a client’s history. Not just a client’s relationship within his or her family or with friends from school, but more intimate relationships. It may feel a bit intrusive, but information such as when you lost your virginity, or how many long term relationships you have can say a lot about your relationship patterns, and how you view sex, love, and partnership. There’s many more areas that a therapist can cover when asking about romantic relationships: why did relationships end, how much time did you allow yourself to be single in between relationships, what do you look for in a partner, etc.
Keep in mind this is barely the tip of the iceberg as far as the categories and type of questions a therapist will explore when gathering the family history. Regardless of which specific questions are asked, these are all helpful questions in letting a therapist know what factors and what events shaped you the most.
I often tell my clients the first 2-3 sessions is like putting pieces of a puzzle together in terms of getting to know you as a client and understanding you in order to work best with you and help you get what you want. The history provides the most pieces of the puzzle of all for me.
How you were treated by others during your childhood affected you, and impacts how you interact with others today. A common saying about children is that “their brains are like sponges, they soak up everything they see.” As children we are picking up messages through sight, sound, and emotion: How we see our parents treat each other, how they talk to us, what we see in school, what consequences we experiences. These are just a few examples of what shapes our worldview and behaviors. So if you are coming into therapy for anger, addiction, or couples therapy to address issues like trust and communication, this is a great opportunity to learn how your past plays a role in your overall functioning.
For more information about psychotherapy and family history, or to simply schedule an appointment with a therapist call 267 - 324-9564.