Pioneers in Medical Family Therapy

 
 
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Some of the early pioneers of the field include Gregory Bateson, Lyman Wynne, Carl Whitaker, Murray Bowen, Salvador Minuchin, and Edgar Auerswald. Other prominent names include Don Jackson, Richard Fisch, Paul Watzlawick, Virgina Satir, Ivan Boszormenyi-Nagy, Insoo Kimberg and Steve de Shazer. Each of these authors struggled to birth variations of systems thinking that helped to explain family dynamics, structure, communication patterns, how we talk about problems vs. solutions and how to preserve the identity of individual psychology while treating the family context. The themes from these visionaries form the backdrop of applying family systems thinking in various medical settings, giving rise to Medical Family Therapy.

 

Gregory Bateson helped to develop the term homeostasis, which explained symptoms within the family system (Hodgson, 2014). His concepts suggested that illnesses, health, and recovery patterns might be associated with the communication styles within families. Bateson, Jackson, Fisch, Watzlawick, and the researchers at the Mental Research Institute (MRI) in Palo Alto, CA created a framework to understand how family systems (set of relationships and communication patterns) contributes to the development and maintenance of the problem vs. the traditional view of how the problem contributes to the dysfunction of the team. The idea that relationships shape our social, psychological, and spiritual life is a vibrant concept in Medical Family Therapy. Medical Family Therapist highly value the voice of the patient, the family, the members of the interdisciplinary team (e.g., physician, medical assistant, nurse) and the administrators in their work.

 

Lyman Wynne coined the terms pseudomutuality, pseudohostility, and Rubber Fence (Hodgson, 2014). His terms helped to establish individual symptoms rooted in systemic issues and believed that the family should be a part of treatment for individuals with schizophrenia. Carl Whitaker also worked with patients who were diagnosed with schizophrenia and their families. Murray Bowen specialized in working with families who had a member diagnosed with schizophrenia and is best known for hospitalizing the whole family (Hodgson, 2014). This whole family approach was innovative for family therapy treatment because traditionally only the individual diagnosed with schizophrenia would be hospitalized. Bowen believed that wellness for one member included the entire system as a part of treatment. Salvador Minuchin coined the term psychosomatic families, which means to have physical manifestations that are caused by psychosocial stressors (Hodgson, 2014). This idea helped to link the psychosocial element of family therapy with the biological illnesses that people experienced. Today, the practice of Medical Family Therapy is intimately tied to the biopsychosocial model - a critique of medicines’ biomedical framework that encourages reductionistic thinking – championed by George Engel. Edgar Auerswald used an ecological model to research and provide care to inner city youth through mental and physical health care. The ecological model applied to family therapy and healthcare continues to be at the core of the theoretical foundation of Medical Family Therapy. The common thread among these pioneers was that they believed in the value of incorporating family therapy with mental and physical health care (Hodgson, 2014).