Dysfunctional Family Health Article

Dysfunctional Family

A family whose interrelationships serve to detract from, rather than promote, the emotional and physical health and well-being of its members.

Although this term is used casually in popular culture, health care professionals define dysfunctional family as one where the relationships among family members are not conducive to emotional and physical health. Sexual or physical abuse, alcohol and drug addictions, delinquency and behavior problems, eating disorders, and extreme aggression are some conditions commonly associated with dysfunctional family relationships.

The concept of the dysfunctional family is based on a systems approach to mental health diagnosis and treatment, where the individual's symptoms are seen in the context of relationships with other individuals and groups, rather than as problems unique to the client. There is no strict definition of a "dysfunctional family," and especially in popular usage the term tends to be a catchall for many different relational disorders that take place within the family system and its subsystems (parents, children). Mental health care providers and institutions increasingly recognize family and couples therapy as effective methods of treating diverse mental health disorders, especially where children are involved.

Some of the characteristics of dysfunctional family systems are as follows:

• Blaming; failure to take responsibility for personal actions and feelings; and invalidation of other family members' feelings.
• Boundaries between family members that are either too loose or too rigid. For example, the parent may depend excessively on the child for emotional support (loose boundaries) or prevent the child from developing autonomy by making all the decisions for the child (rigid boundaries).
• Boundaries between the family as a whole and the outside world may also be too loose or too rigid.
• A tendency for family members to enact set roles—caregiver, hero, scapegoat, saint, bad girl or boy, little prince or princess—that serve to restrict feelings, experience, and self-expression.
• A tendency to have an "identified patient"—one family member who is recognized as mentally unhealthy, who may or may not be in treatment, but whose symptoms are a sign of the inner family conflict. Often the identified patient's problems function to disguise the larger family issues. For example, a child may be regarded as a bully and a troublemaker in school and labeled a "problem child," when he may in fact be expressing conflicts and problems, such as abuse from home, by acting out and being "bad."

Family therapists, like other therapists, take many different treatment approaches—psychodynamic, behavioral, cognitive, or a combination of these therapies. They may talk to members individually, together, and in subgroups. They may ask family members to reenact situations, or to do "homework" by modifying elements of their behavior and responses. As with individual therapy, one of the goals of family counseling is to reframe problems so that family members can see specific events and behaviors more clearly in a broader systems perspective.