More
Topics |
FAMILIES
They come in all sizes, shapes, and descriptions.
We call them single parent, dual career,
blended, alternative, and makeshift. We
have them, for better or for worse. With
more awareness and education, we can make
the emotional balance, from all the social
changes, tilt toward the positive. Regardless
of form, families have many ingredients
that can be cultivated to have successful
outcomes in family happiness and functioning.
A family that functions well has a direct
link to facilitating mental and physical
well-being for each person in the family.
Some original research suggesting the
connection of healthier families leading
to individual health was done by a psychiatrist,
Dr. Salvador Minuchin, and an endocrinologist,
Dr. Lester Baker ,who worked with families
whose children had diabetes. In a small
and uncontrolled study, they looked at
children with extremely “ brittle
diabetes” (labile blood sugars).
The children witnessed family conflict
through a one- way mirror, while being
hooked up to a blood sugar monitoring
device. The physical response in the children
was hyperglycemia (high blood sugars)
and ketones.
The children at risk, according to Minuchin,
were part of families characterized by
“enmeshment”-children overinvolved
in their families’ issues - overprotection
, rigidity, and a lack of skills for conflict
resolution. (Minuchin, S., Rosman, B.,
& Baker, L. (L978). Psychosomatic
Families. Cambridge , Mass: Harvard University
Press). Minuchin and Baker’s work
underscores the potential of the positive
power of the family in an individual’s
health and well-being. They address the
use of family therapy as an effective
means of treating difficult- to- control
diabetes.
My patient Nancy, a 17 year old girl
with diabetes since she was nine, lives
in a family with the same parenting styles
that Dr. Minuchin warns us about. It is
totally understandable that families begin
with patterns of overinvolvement,overprotection,
and inflexibility as their first response
to taking care of the child with diabetes.
Actually, diabetes requires these postures
in the beginning. Nancy could not bear
to see her parents upset. She was already
guilty that her diabetes had upset them
greatly. She became embroiled- "enmeshed-"
with their feelings about the diabetes-
their tears and worries, and was unable
to feel her own. She would always hear
them say they wished they could take the
diabetes from her and bear it themselves.
She actually felt sorry for them. There
was no place for her to cry out about
her sadness, fears, or anger at having
diabetes.
Growing older, she still could not face
her feelings or the behavior required
to take care of herself. Her parents had
closely watched over her and advised her,
and she had depended greatly upon them.
She was actually afraid to do anything
without them. Their overprotection, well-meaning
and natural had left her feeling as a
much younger child than she actually was.
Their initial response never diversified
into encouraging her response,before theirs,
or in encouraging her to grow up unafraid,
normal, and aspiring to exciting life
goals and diabetes management.
When I met Nancy, she never slept out
at friends, was disinterested in going
for her driver’s license, and no
control over her diabetes management.
Families, help or hindrance
...we can learn to nurture whichever direction
we want to go in. The notion of healthy
families is the sa.me for all families,with
or without a chronic illness to fit in.
Having diabetes in a family, however,
intensifies the need for a family to be
effective. There are several key components
of a highly well-balanced families. One
of the best predictors of success in your
adult family life is having experienced
a family that was highly functional in
your childhood. Next, feeling unconditionally
loved as a child is a great part of the
necessary positive framework. Unconditional
love is an ideal, not a constant state
of perfection, that is not easily or smoothly
achieved. Predictable rules and predictable
warmth, love, and closeness are also parts
of making a family work. There is a balancing
act required in accommodating the other
assets of a healthy family: autonomy and
individuality; the themes of mutual dependence
and group closeness; and the toleration
of differences and conflicts.
These themes involve the idea of boundaries,
maintaining the balance of movement to
allow the separate states of individuality
and closeness at different times. For
example, you could be close to your mother
and still be yourself, a different and
separate person. Flexibility and resilience
in feelings, behaviors, conflicts, and
tasks are also themes that run through.
|
