Social Issues and Family Life

When a family walks into a therapist's office seeking help for a troubled family member, most traditional family therapists would say that the whole family, not just the individual, has problems. Family therapy emphasizes the family unit as well as the individual. A process-oriented family therapist sees not only an individual or family as having problems, but also views families as microcosms of social issues. Process-oriented therapy includes the individual, family dynamics, and, most recently, the social forces of the world in which a person lives. These social forces include the current struggles of any given culture.

This article examines how both current social problems and past historical events impact the family. I will discuss how family interactions and struggles reflect cultural tensions such as race, gender, religion, sexual identity and class issues. How the individual and family deal with these situations has tremendous social and political importance, as well as implications for whether or not the individual "gets better."

A family that is able to come to grips with how social issues impact them may then choose to go out and do something about issues in the world. At the time the family moves into the realm of social action, the actions of this family have political implications. I use the term "social issues" to refer to problems a society is struggling with, and "political issues" to refer to the realm of government. Social forces and family life

We frequently see the phrase "family values" in the news, indicating that family dynamics have become a hot political issue. In the United States, different political groups have widely varying definitions of family. Right wing political groups usually use the term family to refer to a white

heterosexual nuclear family with children, often with the women and men in traditional home-maker and breadwinner roles. Groups more on the left tend to have a looser definition of family which includes single parents and gay, lesbian or bisexual relationships.

A family for the purpose of this article is any unit that identifies itself as a family, whether through emotional, blood, or marriage ties. Family refers to people of all colors, religions and sexual orientations. Family structures may be with or without children, nuclear, expanded, and alternative. By accepting diversity in families, I am identifying with one of many different trends in family life. As a process-oriented family therapist, I believe in supporting the direction a family is trying to move in, whether this be completely traditional, totally alternative, or anything in between. During one day at work I might find myself supporting one family trying to keep their traditional structure together and another family trying to relate in a new and experimental way.

Viewing our daily family dramas not only as personal, but also as pieces of the world family drama, is another way of bringing social issues into family work. For instance, the family that comes to therapy trying to figure out how to deal with the pressures of both parents working while raising children think of this as just their problem. Most families don't consider this problem as both personal and social. Actually, each family, along with millions of other families, takes part in finding solutions to social problems. Every family has its pieces of the puzzle to work on.

What happens in our families is greatly influenced by our culture. Many difficulties that family therapists have labeled relationship problems are also cultural problems manifesting in a

relationship. While it may look like June and Jim are working on who takes out the garbage as a relationship issue, they may actually be trying to address the underlying sexism that organizes housework. Child care battles may look exclusively like communication issues between the parents, but such battles are full of issues around sexism. Racism, classism, homophobia, ageism-all the issues our culture struggles to come to grips with play themselves out, with our living rooms serving as the stage. Process-oriented family therapy

Process-oriented family therapy shifts perspective. Instead of viewing the family or individual as outside a norm, it considers the family's troubles as potentially useful. Family difficulties may be meaningful not only for the family, but for the culture. Disturbances are the parts of ourselves, our families, and our culture that we are prejudiced against and put down. One family says feelings aren't good. One splits off anger but says depression is fine. Another says no to sex and another no to God and spirituality. One culture values silence and goes against expression; another culture values expression and puts down introversion. Many cultures devalue women. Racial and religious discrimination are almost universal. All of these prejudices mean that certain parts of our development go forward and others are repressed.

All parts of the individual, family, group and world are important and need to be valued. Problems arise when certain parts are embraced and others cast off. This creates internal relationship problems in one's own psyche, and corresponding problems in the family and the world. Parts may need work to be useful, but they can't just be thrown away because they persist and re-emerge in different forms.

For example, many individuals, families, religions, cultures and nations have tried to eliminate anger, but our world is more violent than ever. Anger needs to be worked with consciously. It is like a force of nature that can't simply be suppressed. When utilized consciously, anger can protect, create boundaries, clarify, and be useful in many other ways. Split off parts, if not worked with consciously, come back to haunt us in our dreams, family difficulties, body symptoms and world problems. Working with these disturbances may lead to a direction of growth for the family. What is happening in a family is not only that one individual is troubled or the whole family has

problems, but also that the world itself is trying to change and express itself through the family scene.

Family work must be seen in the context of the world's struggles, its history, and its current social and political realities. Families are deeply effected by both current political issues and past historical events. Because these powerful outside influences are not overt, they create a background atmosphere, or mood, in the family.

These unacknowledged forces may originate both from the family and/or from the larger society. A family may feel haunted by its unique family history. For example, let's say grandmother or grandfather was a tremendously successful person who has been dead for years. The living members of the family always feel like failures. The successful grandparent's presence looms in the air, and people compare themselves to this person. Unacknowledged family influences may also include emotions felt in the atmosphere but not represented, like fear or anger, or serious problems like alcoholism or abuse that are present and felt but never talked about.

I have worked with families where an alcoholic parent was passing out regularly at home in front of everyone, but talking about alcohol problems was forbidden. This problem therefore becomes a mood that hangs in the air. Its invisibility severely cripples the family's ability to face the problem. Because alcoholism is a forbidden topic, no one can say, "Let's have a family meeting to discuss what to do about dad's alcohol problem.'' Pain or fear about bringing up this reality is often so great that outside assistance is needed to bring up and focus on the topic. The pain of the individual, the family members and the collective pain over the alcoholism need to be addressed, as well as political issues that are rarely considered.

In some rural areas where I work, boredom with one's job is a huge problem. Many people have manufacturing jobs that involve little of their creativity or autonomy. One of the unfortunate side effects of this amount of boredom in the job is very high rates of alcohol and amphetamine addiction. Alcohol often numbs the pain and bored feelings, while amphetamines can create inner excitement and give people the temporary energy to be productive. In my experience, getting families to communicate with an addicted family member is very difficult, so the problem often remains hidden. Denial, in some ways, is

less painful than risking confrontation. Once the family comes to therapy, bringing up a forbidden topic is usually not difficult, but getting the substance-abusing person to attend the session is.

Many families don't feel safe working on core issues such as addiction, especially since there is often so much shame and pain involved. The process behind addictions, not the addictions themselves, need to be supported in ways that are useful to the individual, family, and culture. In addiction work the family therapist has a difficult job. His or her task is to bring forward the background atmosphere and to deal with it in a way that doesn't shame or destroy the basic integrity of the family unit. Simultaneously, it may be vital to assist in stopping the harmful addictions.

In one very driven family, the father drank after work. When we unfolded the impulse behind the addiction, it turned out that the alcohol gave him a break from the demands of his job and large family. My goal in this case was to help the relaxation, which was trying to happen through alcohol, transform the driven nature of the family. It turned out that this man had fascinating hobbies he had put aside. He began to get back in touch with those hobbies, which also connected him with his family in new ways. Cultural moods and atmospheres

Societal atmospheres tend to manifest in two distinct but related ways, historical and social. Families are followed by history—past events live on in the minds of family members, but are not actively brought up and felt. The holocaust and slavery are two historical events that haunt many families. Not only individual families but the culture that people live in tends to block out and forget certain historical realities. While these historical periods have passed, the impact on our families lives on in our dreams and greatly effects our daily lives and interactions.

Societal atmospheres arise out of social forces that impact our lives. Issues of race, gender, class, sexual identity and religion are crucial issues in today's culture. When these cultural pressures manifest in a family scene, most families assume they are personal problems and fail to see the collective aspect. As a family therapist, I often see the family as an arena in which society attempts to work out its problems. Social trends and family growth

Over the years, I have worked with a number of traditional families where one parent has

decided to begin exploring their bisexuality. When this happens, many cultural issues emerge, such as: how will the children tell their friends that dad is now living with another man or mom with a woman. The parents grapple with the choice of living out the changes they are making personally or turning their backs on their own sexual identities to protect their children from potential harassment by their peers. The family struggles with social as well as personal forces. These social forces have political implications. For example, members of the family may eventually be effected by ballot measures that discriminate against gays, lesbians and bisexuals. At this point the original family issue, which is also a social issue, becomes political.

Here is an example. A family comes to my office in a small town. The focus is on the children and their increasing school problems. I ask the parents if they are having any problems in their relationship. Mom says she is going to try harder to be a good mother, but it is very difficult because dad is never around—he works, goes to the bar, and then hunts on the weekend. The closer mom gets to the children and the more distant dad becomes, the more the children act up. For a family therapist trained in structural family therapy, this looks like a mother who is too involved and a father who is too disengaged. With some restructuring the mom could pull back and the father come closer. A process-oriented family therapist would explore with the family to discover if this is the direction of their development. Even if the family is interested in changing, such change is not so easy—both mom and dad are caught in a small town culture spinning in change.

Traditional male and female roles are in the midst of a revolution. For Dad to become more involved would mean his going against the tide of his peer group, feeling more of his feelings, and facing his own emotional needs. Who will support him in this? Mom would like to be more involved in other parts of her life but is still closely tied to her mother and grandmother and their definitions of a woman who should be home for her children. What will it mean for the political climate of the small town if people start acting more free to be themselves in their relationships? Without addressing the cultural and political issues of changing gender roles for both men and women, it is highly unlikely that any restructur-

ing will work. Social pressures will force people to stay the same, and new political changes won't emerge.

Once a family realizes they are in the midst of a huge cultural transition, pursuing different options becomes important. Reading books on the women's or men's movement might help. Forming a support group of men or women or couples going through similar transitions could ease feelings of isolation. Talking to the family about cultural pressures that keep them stuck and having them address these pressures directly might be helpful. I might say to the father, "I am the voice of your culture that says raising kids is women's work and a real man will be out with the boys hunting and fishing," and then have the family react to this pressure. I might say, "I am the force of culture that says a good mom stays home all the time," and then see what the family thinks about this idea. Does this definition still work for this family, or does anyone see this lack of options as sexist? If people feel they want to change, they may need to change other aspects of their worlds. Change may need to happen at work, in the schools, and in other community arenas.

I often find myself providing a resource just by telling people what I observe about social trends in my practice. Here is another example I have seen repeatedly. Many families split up due to sexual difficulties between the adults. Working with the adult couple alone is an important part of family therapy. Many couples assume they are sexually incompatible if they are too tired to make love the three times a week which popular magazines claim as the national average. Extreme fatigue from overworking often eliminates the energy for a sex life. This is a problem of epidemic proportions. When I tell people that their sexual problems are part of an epidemic and are not just because they no longer bring each other flowers, they often feel relieved. The subject has shifted from their personal and relationship problems to an important discussion of cultural values and social issues—how do they feel about the change of pace in their lives? Has their relationship shifted from the times when closeness came automatically? Does intimacy now require effort? Each couple and family must decide if the collective shift towards production is right for them, or if they are swept up by a social trend they may need to fight against and help transform.

When one couple I work with came back from a trip that they had taken without their children, they said it was very intimate, including sexually, because it was the first time in years they spent quality time together. This family may not be aware that they are part of a huge debate about how much to stress productivity over the value of intimate time; how to integrate productivity and intimacy, and how to balance our natural selves and the demands society places on us. This issue is both personal and collective. The danger for us as family therapists focusing on the family alone as the source of the problems is that we may fail to create a climate in which culture can develop. Many attempts at change fail not because families don't want to change or are resistant to therapy, but because they return to the same old world with its pressures to conform. Personal growth and social change often go hand in hand. I must change so my world can change, but then my world needs to change to support my development.

I have had many experiences with clients where world change leads to rapid personal change. This leads me to believe even more strongly in the importance of outside influences on the family. I have worked with several clients who were suicidal. When their abusive bosses suddenly quit, their work environment became humane, and suddenly their suicidal states disappeared.

We as therapists make an error of serious consequence if we continue to help our clients get better without helping them make the changes they can in their world. Therapists can easily eliminate much of the motivation to work on world problems. Let's say we teach a factory worker stress reduction methods, and help him improve his relationship at home. We can consider this important individual and family therapy. The person feels much better. Let's say he feels happy enough to put aside the issue of worker boredom and dissatisfaction. A great opportunity has been missed. Perhaps this person could really have made an impact on a problem that causes suffering in millions. Perhaps he could have joined with others to promote social change. Another possibility is that he could have learned a great deal about oppression and developed more compassion and solidarity for other oppressed people. The possibilities are not mutually exclu-

sive. Personal happiness could increase world awareness which could lead to political change.

Worker dissatisfaction that leads to depression is not just a psychological issue, but a political one. The medical model keeps looking for causes of depression under the microscope, but fails to look at oppression at work, sexism, and other obvious causes of depression. Every time a new study blames depression on genes, we let society and the way we live off the hook. For some depressed workers, just being aware of how the world impacts them is enough. For others, feeling better depends on attempting to change, or actually succeeding in changing, the world. Historical influences

My own family of origin has a strong history. I am the grandchild of a family that lost many members to the gas chambers of the Holocaust. I remember as a child never quite understanding why my family divided people into us, the family, and them, the rest of the world. The lines were so clear. People on the outside were never let in or trusted the way the close family was let in. We didn't talk much about the Holocaust. We just knew that one side of the family was full of great aunts and uncles, and distant cousins, and on the other side, the side that still spoke broken English, there were only a few people—the rest had disappeared. This history was something I had to work on to survive in the outside world away from my family.

I have lived far from my immediate family for over twenty years, but my siblings all live within a few miles of my parents. Family gatherings happen non-stop. If someone marries into the family, their family may be added to the circle. I hitchhiked around British Columbia in my late teens to see what the world of non-family was like. I didn't really understand this walled-off attitude until I went to Venice, Italy and experienced the first European Jewish ghetto preserved as it used to be. I saw the physical walls that kept Jews separate from the rest of the world. When I traveled to Eastern Europe and learned more directly of the horrors of the Holocaust, I began to understand my family's mistrust of outsiders. When I went into a synagogue in Prague and saw my family name on the walls honoring those murdered, I knew where part of my family's lack of trust came from. After your neighbors kill your family members, it takes time, personal work and cultural change to heal this betrayal.

I have often heard white politicians say to Native or African-American groups that the past is the past and not relevant. For instance, in recent arguments about affirmative action, politicians claimed that 130 years after slavery the government has done enough to make up for a wrong. But in terms of history, even a few hundred years is a short time. Aspects of history continue in the existence of slavery-like conditions today. When a Southern state recently reintroduced chain gangs for prisoners, some of the prisoners said clearly that trouble would come. They remembered their families' history as slaves. Anti-semitism is rampant and growing. Native American lands are still stolen and environments poisoned for profit.

We can't forget history because in many ways it has not changed. In the United States, people want to put slavery behind us. In European countries, surveys show large numbers of people doubting the existence of the holocaust. When we work with a family where these kinds of issues are present and fail to bring them up as therapists, we join society in trying to silence people. Family therapy in transition

Family therapy is making a transition towards being able to address social issues. Feminist therapists first challenged traditional family therapy about ignoring social issues, saying that family therapy reinforced the patriarchy. Recently Narrative Therapy, and its main founder Michael White, has started working with cultural issues. White has said that the voices schizophrenics hear "bear an uncanny resemblance to common negative cultural stereotyping" (in Sykes Wylie, 1994). Sykes Wylie says:

For White, the personal is, and must be, deeply embedded in the political. The stories of the people he sees—John, Mary, Jane—are of personal struggle and transcendence no doubt, but in White's eyes they are also unmistakable tales of power politics, the "politics of local relationship" as well as the larger social politics of gender, class, professional and institutional dominance. (1994: 44)

Process Work not only talks about cultural forces, but represents them and encourages interaction. Acknowledging that a family member is a victim of sexism is one step. Actually representing the forces of sexism right in the family session is yet another. Saying as a therapist, "I represent the voice of culture that says this and that about

women," allows controlling voices to come to the foreground where they can be challenged and addressed.

Internal social issues of the family also need to be addressed. Outer social issues manifest in the family in the form of rank and hierarchies within the family's power structure (Mindell, 1995). Each family has its own set of power dynamics. Family styles run the spectrum from authoritarian to democratic. Even in more democratically run families different people have different amounts of power. Power in all these styles tend to be largely unconscious. Many family battles, especially with teenagers, center around challenging the power set up. Here is a typical struggle. A teenager begins to show more and more rebellion, violating curfews, having problems at school, coming home drunk. Often the teenager challenges and taunts the parent, "You can't control me, I'll run away." Traditional views of this behavior are that the teenager has problems or the family is dysfunctional.

Another way to look at this situation is as a transition time. The old style of governing is being challenged by a person who has had a lower rank in the power hierarchy, but is moving up as they grow older. One way to short-cut the battles and escalating trouble is to bring out the power differential directly instead of having the challenge made indirectly. The family therapist can encourage the parents to stand for and own their power and then have the teenager react to this. I have seen many different reactions. Many teens at this point back down and say, "I actually needed clear guidelines, needed you as parents to be interested enough to have this talk with me." Other teens will react and say this power is unfair. This is the beginning of a negotiation process. Even though this kind of negotiating and processing is difficult, it is easier in the long run than the family openly going to war or tensely waiting for the next bombshell to drop.

Teenagers' power also needs to be recognized. From early childhood on, parents tend not to recognize their children's power. Young children often hit their parents; parents tend to punish this behavior, and the hitting often escalates. Sometimes just saying how strong the child is will short-circuit the hitting. Teenagers also need recognition for the power they have—they may have more energy or emotional power than the parents. They may have a more supportive peer

group. All of this needs to be acknowledged directly. I have worked with families where scenes between the parents and the teenager had escalated to the point that the police were called in. In such situations, direct negotiation often helps rapidly.

One other concept that relates both to politics and the family is oppression and revenge. We see this in nations where revolution occurs—the side that was oppressed goes after the oppressors and seeks retribution and justice. This revenge cycle is often behind the escalation that occurs in families with teens. The cycle can be broken by helping both sides realize the cycle they are in, and to ask both sides if they are in favor of continuing escalation. By processing past and present hurts, the cycle can shift.

I once worked with a family where the father had physically abused his daughter. He became concerned about some of her defiant withdrawn behavior, which could have been seen as her getting back at him for the abuse. He brought the whole family into therapy. The parents were able to talk openly about what they had done and about each of their roles in the abuse. The child was able to bring out feelings that she had been frightened to say. This was an alternative to her spending years getting even for the abusive behavior, possibly in ways that could have been self-destructive.

These political struggles in a family also have implications for people's physical bodies. Many children suffer from chronic physical conditions that reflect the political make up of the family. Families treat values like political parties. Some values prevail. Others have limited power, and some are totally cast out and disenfranchised. For instance, in families that exclusively value intellect and verbal skills, it is not unusual to see a child develop movement related disorders—dizziness, weakness in the limbs, seizures, and other movement problems. Being physically active becomes an unsupported minority position. I have worked with people where a child couldn't move much or even stand up. When the child's style of movement was supported, they were able to get up and wrestle or dance wildly. These were not just medical problems, but people struggling with the politics of experience in a family system where certain ways of being are disavowed by the family and usually by the culture.

I am in the process of searching for hard data on the great differences in the rate of certain diseases, particularly cancers, in different racial groups. I believe scientific data eventually will verify the relationship between cultural oppression and higher disease rates. Much of my current data is from my own experiences. When I talk about cultural issues affecting health with health care workers, I see them nodding in agreement. The relationship between society and physical symptoms deserves much more attention. I mention it here to alert therapists to the social aspect of physical diseases in families. Disease is not just the result of microscopic forces, but may often be a reaction to the long term pain and suffering of societal oppression. Conclusion

Process-oriented family therapy may help individuals and families discover social components of what look like individual problems. Sustainable change in families means that social issues, as well as personal and relationship issues, must be addressed. Unaddressed social issues can lead to escalating conflicts, physical symptoms and other problems that are difficult to resolve. Unaddressed issues act like ghosts in the atmosphere-people don't know what is causing their problems. Addressing issues directly allows the family to heal and also means the world's problems receive attention.

As our families grow, there is a good chance of family members turning their own healing into social action. This can lead to world change. The myth of the wounded healer, who helps others through healing his or her own problems, needs

to be expanded to families. Often, the healer becomes an expert in the specific area they were wounded. That healing then becomes a gift for the community. Families who work on themselves may develop insights, powers and gifts that can benefit the whole culture. I have particularly seen this in small towns, where it is easier to see the impact one changed family can have on a range of people. For example, one family concentrates on cleaning up their drug problems, then helps other families and organizes community efforts. Soon the whole environment improves.

The work all of us do with our own and other families may automatically benefit the world. In other cases, therapists can recommend to families that they share their growth with the larger community. In this way the family becomes a vehicle for addressing social problems. Historically, the family unit was expected to help enforce the status quo of society. In this new view, the family unit develops its own inner freedom and helps expand this to the culture as a whole. References

Mindell, Arnold. Sitting in the Fire: Large Group Transformation Using Conflict and Diversity. Portland,

OR: Lao Tse Press, 1995. Sykes Wylie, Mary. "Panning for Gold." The Family

Therapy Networker Nov./Dec. 1994.

Gary Reiss is a licensed clinical social worker and diplo-mate in Process Work He has more than 20 years experience working with families and currently practices in Eugene, Cottage Grove, and Portland, Oregon. Gary teaches Process Work throughout the world. He is currendy writing about both process-oriented family therapy and integrating personal growth and political action.