Helping to See the Part a Person Plays in Patterns Around their Problem

circular-patterns3618The value of exploring patterns of relationships

A helper is interested in assisting another to discover what part they play in problem patterns.

When I first met Ahmed he explained the distress of being a father to a young adult daughter with a long history of eating disorders and impulsive behaviours. He and his wife Lina had supported many years of various treatments for their daughter Samira. Their focus had been trying to understand her diagnosis and finding a treatment that would fix her distressing symptoms.  I conveyed to Ahmed that I was willing to meet with him to lend a hand to his efforts to assist his daughter. His wife was also welcome to come to our sessions if she wanted to. It wasn’t necessary for Samira to attend. This was a great surprise and relief to him, particularly as his daughter was resistant to seeing yet another helping professional. His surprise was that I thought that just one family member, who is not the symptomatic person, can utilise help for themselves that can benefit the whole family. Ahmed and Lina started coming to meetings and piecing together patterns of relationships around their daughter. We worked like a research team examining descriptions of interactions and seeing what clues emerged to how interpersonal reactions had contributed to generating and maintaining their daughter’s difficulties. Over time Lina came to see how much she had focussed on assisting her daughter to cope with life challenges throughout her school years. She had been very sensitive to her daughter’s upsets and had taken on the responsibility of smoothing things over for her. Over the years she could see that Samira had become increasingly needy as well as entitled. She also saw that her well-meaning efforts to relieve Samira of any distress had left her daughter with little capacity for managing her own strong emotions. For Ahmed, the exploration of the relationship dance around Samira and Lina revealed that he had become passive and resentful as a parent. He was anxious not to impinge on his wife’s management of Samira and would only assist when Lina was at her wits end. At other times he stayed distant but was silently critical of what he judged as Lina’s overly soft approach. When he stepped up in response to Lina’s requests he would be excessively stern as a corrective to his view of his wife’s parenting. He and Samira would then get caught in conflict and Lina would step in to mediate. This left Samira caught in a confusing triangle with her parents. The pattern that was uncovered revealed that Samira had become accustomed to being rescued by her mother and dismissive towards her father’s reactive attempts at limit setting.

Questions that explore interaction

It took a number of sessions to clarify these repeating patterns between Lina, Ahmed and Samira. Questions were asked each session that focussed on how each person responded to each other. “How did you respond to Samira’s distress? What was her response? Then what happened? Who was involved in these upsets? How? What effect could you observe? How were you affected? What was your response? How did this impact your parenting partnership? How did this play out between you? What differences could you notice in how Samira responded to each of you? What do you notice is different in your response to your son when he’s stressed?” We rarely talked in detail about Samira’s individual symptoms. Rather we reflected on longstanding patterns of relating and how these patterns shed some light on ways Samira was struggling to mature and manage her life without depending on or opposing others. Ahmed and Lina could begin to see that their daughter was so caught in reacting to and leaning on her parents that she had not developed enough capacity to independently manage stress. Her symptoms revealed the overflow of her anxious self in her family.

Questions also focussed on important events in the family’s history and considered how these contributed to more anxious ways of relating. For example: What was going on in the family around Samira’s birth and early years? When did the family immigrate? Where was extended family during the early childrearing years? What were the circumstances of each grandparent’s health issues and the death of both grandfathers? When did Lina lose her job? What changed in family responsibilities with this loss of income? Every significant change in the family over time revealed a parallel of increased sensitivity to Samira and her struggles to cope at school. It was interesting to compare this investment in Samira with her older brother who had not been viewed as so vulnerable. Ahmed and Lina began to see that their son had developed more life coping capacities for himself without his parents trying to be overly helpful.

Broadening the view past individual diagnosis

Unlike previous treatment, which focussed on treating Samira’s symptoms with new medications and individual therapies, this helping process broadened the picture to viewing the family as a single system. If one person can change the way they are interacting, then others will make compensatory changes. Ahmed adjusted his reactionary parenting. He stopped trying to be the tough parent when Lina was struggling and instead worked to have a separate and consistent relationship with his daughter. His efforts were often clumsy and based on ongoing trial and error but he was keen to learn from each interaction about how he could better contribute to the well-being of his family. Lina determined to reduce how much attention she gave Samira during her struggles and to say “no” to her when she became excessively demanding. Every step was a challenge for both parents. They valued the opportunity in our meetings to review what they observed and experienced as they endeavoured to respond differently. Both parents were working on the part they had discovered they were playing in fuelling a regressive pattern with their daughter and each other. Samira had her part in it all as did her brother but the parents were helped to just focus on observing and modifying their part in the dance. A helping relationship that focuses on patterns or process is pivotal to enabling this. If the helper continues to ask about the content of opinions, symptoms and criticisms the parents would have remained blinkered in a narrower view of the problem without discovering pathways to bringing their best to their daughter, their marriage and their other important relationships.

From trying to change others to changing self

Ahmed had commenced counselling thinking that his wife and daughter needed to change. After exploring how each of them affected each other he appreciated that he had a contribution to the family problem. Rather than experience a sense of blame he felt a sense of agency as he had discovered something constructive to work on. It was important to him and Lina that they figured their own way through their problem patterns instead of being instructed to change. Both parents described feeling ‘back in the driving seat’ as parents. They could see gradual improvements in their daughter’s impulsivity which gave them hope that they could make a difference by being less reactive and having clearer positions as parents. Additionally they became interested in the influences of their families of origin and the sensitivities they had brought into their marriage and parenting.

A systems lens guides the helper

The focus on patterns is different to conventional ideas of helping that involve advice giving, interpretations or education about individual’s symptoms. I do need family systems theory as a road map to lead me in this questioning process about relating process. Questions are guided by an ability to identify common patterns of triangles, over and under responsibility and reactive conflict and distance. I have found the shift to asking questions starting with: Who, When, Where, What and How, is liberating as a helper. It reduces my responsibility to solve other’s problems. It keeps me from taking sides around people’s opinions. It prevents me from looking for a singular cause to a complex problem. It allows me to collaborate with others in learning about their particular ways of dealing with tensions in their life and relationships.

Even for the non-professional helper it is worthwhile to ask questions about how the other person is managing their difficulty and how this is played out in their relationships. For example when a friend wants to talk through a problem with a person at work, rather than ask about their view about this other person, ask about how they have been responding to the situation. When does it happen? Who is involved? How do they each get involved? What has been helpful in their efforts to deal with the challenge, what hasn’t been helpful? This can be of greater assistance to another than asking them to vent about their problem and speculate about cause. It can provide a person with an opportunity to think more broadly about their difficulty and gain perspective on how they can address what is within their control.

‘Helping to See the Part a Person Plays in Patterns Around their Problem’ – Jenny Brown


Side Taking or Triangling in a Helping Relationship

parent-blame-triangleGetting caught in becoming a third party detour is a central pitfall of any helping relationship (professional, family, friendships, congregations, work). Any struggling person will feel better when they find an empathic listening ear to their problems within another relationship.

Daniel is a committed helping professional in adolescent mental health services. He engages with young people well and is skilled at drawing them out to discuss the issues that are troubling them. One of the most common complaints he hears from his young clients is that parents or step parents just don’t understand them. They are too pushy and always on their back. They expect too much, they are disapproving of friends, they don’t convey trust, they set impossible limits, and they are intrusive. In hearing about the negatives of the adolescents’ adult carers Daniel would invite his clients to talk in more detail about the effects of these experiences of their parents. He asked about what they needed to feel better supported and conveyed that he appreciated what they were up against. He affirmed their strengths and sought to build their self-esteem as well as suggesting techniques for reducing negative thoughts and anxiety symptoms.

The problems arose for Daniel when he invited parents to counselling sessions. Having already conveyed assent for the young person’s criticisms of the parent he found that he was immediately biased towards parent blame. He worked to convey warmth towards the parent in order to engage them in exploring their relationship with the child but he was quick to be annoyed by what he perceived as their invalidating approach to their adolescent. Any slight gesture of negative body language from a parent would push Daniel’s emotional buttons of defence for his young client. Daniels focus would be on trying to help the parent see what their adolescent needed from them. There was little curiosity for what the parent was up against in relating to their adolescent or for the many years invested by the parent in trying to help their child. All he could see was the current conflict in the relationship and how this seemed to be causing emotional distress for the young person. Daniel was caught in a common helper’s triangle. He was on the side of his client and was unable to see the broader patterns of interaction as part of a complex backdrop to the adolescent’s current symptoms. Daniel genuinely believed in conveying warmth and respect for the parent but his side taking meant that the parent sensed that they were the focus of a blame and change effort. In turn the parent would be edgy with Daniel which gave him further confirmation of his biased view of their dismissive parenting style.

You may be wondering if it is ever possible to counsel one person without forming an alliance with their view of things. Without an understanding of relationship systems it is very difficult to avoid side taking. In particular, without an appreciation of the invitation to triangle, a helper inevitably falls into validating one person while blaming others – sometimes in subtle ways. A triangle is when a third party is used as a detour for dealing with an issue in the relationship between two people. When we are upset with another it is comforting to find a third party who will listen to our distress. The act of telling an outsider about our worry effectively calms us down. The predicament however is that the person is not working on their problem in the relationship in which it belongs. Additionally the third party now has a different view of the person who has been complained about. This infects a negative tone to the way they now relate to this person, as was happening with Daniel in his stance with his client’s parents.

When we construct our picture of a problem through the complaints and distress of an individual, it is natural that our focus will be helping them recover from what we perceive others have inflicted upon them. This forms the basis of the common helping triangle. Such side taking or triangling can be averted when the problem is explored through descriptions of patterns of interaction and how these relationships have adjusted to pressures of adverse circumstances over time. Exploring patterns of how each person has affected each other’s way of relating enables us to appreciate that every family member (or group member) has played a part in constructing current dynamics. Rather than draw out more details of a person’s complaint the helper asks: when does this happens, who is involved, how do they each respond, what is the effect of this?

Daniel was concerned about the blocks he experienced in working with parents of troubled adolescents. He knew their relationship with the young person was important to the adolescent recovering their wellbeing. As he came to see how he was getting caught in a triangle with the parents on the outside of his alliance with their child he began to work out ways to prevent this occurring. Rather than ask his young client to expand on their feelings of angst about their parents he would explore what they were doing to deal with their frustrations in their relationship. He tracked carefully the interactions the young person was regularly part of when conflicts or symptomatic behaviours escalated. As he saw a more objective view of parent-child relationships over time he began to appreciate how important it was to include parents in his counselling right up front. When parents expressed their grievances about the child (or the other parent) in counselling, he discovered that he could draw out how they were trying to address this in the relationship. This replaced his previous approach that provided a platform for making a case that another was the problem.

Getting caught in becoming a third party detour is a central pitfall of any helping relationship (professional, family, friendships, congregations, work). Any struggling person will feel better when they find an empathic listening ear to their problems within another relationship. The helper can also feel competent as they sense appreciation for providing positive validations that are missing from an important relationship. The short term relief of this alliance can easily give way to a helping impasse. While the upset person wants to feel supported, they have not been assisted to work their difficulty out in the important relationship in their life. When a helper shifts from encouraging venting about others, to identifying patterns in relationship with others, they can become a valuable resource for a person’s change process. They still convey respect and concern for the weight of the difficulty but they resist the invitation to side taking.

‘Side Taking or Triangling in a Helping Relationship’ – Jenny Brown

The One Up, One Down Pattern: A recipe for burn out and dependency

counselling-handsI am feeling close to burn out in my work. I provide my clients with lots of affirmation, good listening and suggestions from my training on the best ways to improve their situation or reduce their symptoms. After about 6 sessions I often feel stuck and frustrated.
What are the key pitfalls in offering help and counsel to others? Most problems in helping efforts occur in the ‘one up, one down’ relationship pattern. In my last blog I mentioned how I developed the ‘one up’ position in my family of origin and how this fuelled some unhelpful patterns in my early counselling work. I have also written about this pattern in the chapters in my book [Growing Yourself Up] on understanding family of origin, marriage, parenting and workplace. It is such a central relationship dynamic to any group that it deserves a bit more elaboration. Dr Bowen called this the over- under functioning reciprocity. This is where one person responds to the distress in another with increasing support, while the other responds to the support with reduced responsibility. It happens in a circular back and forth pattern that can start on either side of the relationship. People who feel most secure and affirmed being helpful to others find themselves connected to people who are most comfortable when others are paying them attention in a caretaking manner. In many ways the conventional counselling relationship is set up in this way.
So what’s the problem with this? I recall speaking to an experienced counsellor, Fiona, who came to me for supervision saying:
I am feeling close to burn out in my work. I provide my clients with lots of affirmation, good listening and suggestions from my training on the best ways to improve their situation or reduce their symptoms. After about 6 sessions I often feel stuck and frustrated. My clients say they get so much out of coming to talk to me but they don’t seem to be making any progress in between our sessions.
Fiona and I teased out her pattern in her counselling relationships. She could see how much her clients liked coming to see her because of her warmth and attentiveness. On the other hand she could also appreciate that she was helping in a way that was inadvertently fostering dependency. On behalf of her clients she was doing most of the work to sooth their insecurities and think of ways to address their difficulties. Her clients always felt buoyed after a counselling session and they liked the advice they heard, however because they hadn’t come up with their own solutions they couldn’t find the inner resolve to implement or stick with Fiona’s suggestions. As we explored this approach to counselling and the varied ways it took over a client’s own responsibilities Fiona could appreciate how this fed into her exhaustion and confusion. Increasingly she found herself referring her clients on for more intense therapy or for psychiatric assessment. Previously unbeknown to her, she had been playing a significant part in her clients reduced progress.
Fiona began to see that her position in her family had contributed to her tendency to be so helpful. Her younger sister had many symptoms during their school years and she had learned ways to reduce her parent’s stress by taking on some of the caretaking. She would spend many hours with her sister distracting her when she was depressed and would include her in her social activities. Fiona found it helpful to see how her caretaking posture was so well honed in her family. Her counselling training had acted to consolidate this pattern.
Fiona’s effort went into reducing her support for her clients. This seemed so counterintuitive and yet she understood that she did not want to continually promote dependency. She retained her commitment to good listening and conveying a tone of warm respect. Interestingly she did report her effort to reduce her tone of concerned compassion as she could see that it fed into her client’s perception that she was more on their side than any member of their own family. She began to increase the time gap between her sessions to communicate that she wanted to give people adequate time to observe and experiment with ideas in their real world and to use counselling as a place to review instead of a place to be changed. Rather than give advice she asked questions about the clients own problem solving efforts – what had they learned about what was helpful and what wasn’t? She became more careful about sharing information from professional training. We talked a good deal in supervision about when she would ascertain the appropriate timing for sharing information. Her new rule of thumb became to ensure her client had explored their own patterns of coping thoroughly before she would convey relevant professional knowledge. She would select carefully the information to share that matched her client’s own descriptions. For example when a woman she was working with said that she always did better when she slowed things down, Fiona opened up a conversation about ways to reduce the physiological effects of stress and anxiety. She was able to add some ideas for temporary stress reduction in a non-authoritative manner. Her key message in sharing information was: “This may or may not be helpful for you but might add to the ideas you are trialling.” As a professional helper Fiona was learning to collaborate with her clients, jointly investigating their patterns for dealing with their symptoms or challenges in their important relationship contexts. This more equal posture was very different to the previous ‘one up, one down’. It was providing Fiona with a new way to view her helping efforts and provided a platform for a sustainable counselling career.

Next blog: a story of triangling/side taking in a helping relationship

‘The One Up, One Down Pattern‘ – Jenny Brown