Tag: Family Therapy

What is Triangulation (Psychology)?

Published on by Andrew Marshall1 Comment

Introduction

Triangulation is a term in psychology most closely associated with the work of Murray Bowen known as family therapy.

Bowen theorised that a two-person emotional system is unstable, and that when under stress it forms itself into a three-person system or triangle.

Refer to Karpman Drama Triangle.

Family Theory

In the family triangulation system, the third person can either be used as a substitute for direct communication or can be used as a messenger to carry the communication to the main party. Usually, this communication is an expressed dissatisfaction with the main party. For example, in a dysfunctional family in which there is alcoholism present, the non-drinking parent will go to a child and express dissatisfaction with the drinking parent. This includes the child in the discussion of how to solve the problem of the alcoholic parent. Sometimes the child can engage in the relationship with the parent, filling the role of the third party, and thereby being “triangulated” into the relationship. Alternatively, the child may then go to the alcoholic parent, relaying what they were told. In instances when this occurs, the child may be forced into a role of a “surrogate spouse” The reason that this occurs is that both parties are dysfunctional. Rather than communicating directly with each other, they utilise a third party. Sometimes this is because it is unsafe to go directly to the person and discuss the concerns, particularly if they are alcoholic and/or abusive.

In a triangular family relationship, the two who have aligned risk forming an enmeshed relationship.

Good versus Bad Triangulation

Triangulation can be a constructive and stabilising factor. Triangulation can also be a destructive and destabilising factor. Destabilising or “bad triangulation” can polarise communications and escalate conflict. Understanding the difference between stabilising triangulation and destabilising triangulation is helpful in avoiding destabilising situations. Triangulation may be overt, which is more commonly seen in high-conflict families, or covert.

A 2016 longitudinal study of adolescent relationship skills found that teens who were triangulated into parental conflicts more frequently used positive conflict resolution techniques with their own dating partner, but were also more likely to engage in verbally abusive behaviours.

The Perverse Triangle

The Perverse Triangle was first described in 1977 by Jay Haley as a triangle where two people who are on different hierarchical or generational levels form a coalition against a third person (e.g. “a covert alliance between a parent and a child, who band together to undermine the other parent’s power and authority”). The perverse triangle concept has been widely discussed in professional literature. Bowen called it the pathological triangle, while Minuchin called it the rigid triangle. For example, a parent and child can align against the other parent but not admit to it, to form a cross-generational coalition. These are harmful to children.

Child Development

In the field of psychology, triangulations are necessary steps in the child’s development. When a two-party relationship is opened up by a third party, a new form of relationship emerges and the child gains new mental abilities. The concept was introduced in 1971 by the Swiss psychiatrist Dr. Ernst L. Abelin, especially as ‘early triangulation’, to describe the transitions in psychoanalytic object relations theory and parent-child relationship in the age of 18 months. In this presentation, the mother is the early caregiver with a nearly “symbiotic” relationship to the child, and the father lures the child away to the outside world, resulting in the father being the third party. Abelin later developed an ‘organiser- and triangulation-model’, in which he based the whole human mental and psychic development on several steps of triangulation.

Some earlier related work, published in a 1951 paper, had been done by the German psychoanalyst Hans Loewald in the area of pre-Oedipal behaviour and dynamics. In a 1978 paper, the child psychoanalyst Dr. Selma Kramer wrote that Loewald postulated the role of the father as a positive supporting force for the pre-Oedipal child against the threat of re-engulfment by the mother which leads to an early identification with the father, preceding that of the classical Oedipus complex. This was also related to the work in Separation-Individuation theory of child development by the psychoanalyst Margaret Mahler.

Destabilising Triangulation

Destabilising triangulation occurs when a person attempts to control the flow, interpretation, and nuances of communication between two separate actors or groups of actors, thus ensuring communications flow through, and constantly relate back to them. Examples include a parent attempting to control communication between two children, or a relationship partner attempting to control communication between the other partner and the other partner’s friends and family. Another example is to put a third actor between them and someone with whom they are commonly in conflict. Rather than communicating directly with the actor with whom they are in conflict, they will send communication supporting his or her case through a third actor in an attempt to make the communication more credible.

What is an Identified Patient?

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Introduction

Identified patient (IP) is a clinical term often heard in family therapy discussion.

It describes one family member in a dysfunctional family who expresses the family’s authentic inner conflicts. Usually, the “designated patient” expresses their physical symptoms unconsciously, unaware they are making overt dysfunctional family dynamics that have been covert and which no one can talk about at home. Occasionally, the identified patient is partly conscious of why and how they have become the focus of concern in the family system.

As a family systems dynamic, the overt symptoms of identified patient draw attention away from the “elephants in the living room no one can talk about” which need to be discussed, such as a pending separation or divorce. If covert abuse occurs between family members, the overt symptoms can draw attention away from the perpetrator(s).

The identified patient is a kind of diversion and a kind of scapegoat. Often a child, this is “the split-off false carrier of a breakdown in the entire family system,” which may be a transgenerational disturbance or trauma.

In Organisational Management

The term is also used in analysing dysfunction in businesses where an individual becomes the carrier of a group problem.

Origins and Characteristics

The term emerged from the work of the Bateson Project on family homeostasis, as a way of identifying a largely unconscious pattern of behaviour whereby an excess of painful feelings in a family lead to one member being identified as the cause of all the difficulties – a scapegoating of the IP.

The IP – also called the “symptom-bearer” or “presenting problem” – may display unexplainable emotional or physical symptoms, and is often the first person to seek help, perhaps at the request of the family. However, while family members will typically express concern over the IP’s problems, they may instinctively react to any improvement on the IP’s part by attempting to reinstate the status quo.

Virginia Satir the wellspring of family systems theory, who knew Bateson, viewed the identified patient as a way of both concealing and revealing a family’s secret agendas. Conjoint family therapy stressed accordingly the importance in group therapy of bringing not only the identified patient but the extended family in which their problems arose into the therapy – with the ultimate goal of relieving the IP of the broader family feelings he or she has been carrying. In such circumstances, not only the IP but their siblings as well may end up feeling the benefits.

R.D. Laing saw the IP as a function of the family nexus: “the person who gets diagnosed is part of a wider network of extremely disturbed and disturbing patterns of communication.” Later formulations suggest that the patient may be an “emissary” of sorts from the family to the wider world, in an implicit familial call for help, as with the reading of juvenile delinquency as a coded cry for help by a child on his parents’ behalf. There may then be an element of altruism in the IP’s behaviour – ‘playing’ sick to prevent worse things happening in the family, such as a total family breakdown.

Examples

  • In a family where the parents need to assert themselves as powerful figures and caretakers, often due to their own insecurities, they may designate one or more of their children as being inadequate, unconsciously assigning to the child the role of someone who cannot cope by themselves. For example, the child may exhibit some irrational problem requiring the constant care and attention of the parents.
  • In Dibs, an account of a child therapy, Virginia Axline considered that perhaps the parents, “quite unconsciously…chose to see Dibs as a mental defective rather than as an intensified personification of their own emotional and social inadequacy”.
  • Gregory Bateson considered sometimes “the identified patient sacrifices himself to maintain the sacred illusion that what the parent says makes sense”, and that “the identified patient exhibits behaviour which is almost a caricature of that loss of identity which is characteristic of all the family members.”

Criticism

Extending the original concept of the identified patient, the anti-psychiatry movement went on to argue it is the family who is chiefly mad, rather than the individual the family identifies as ‘sick’ – positing also that the latter might in fact be the least disturbed member of the family nexus.

Literary and Biographical

  • In the play The Family Reunion, T.S. Eliot writes of the protagonist: “It is possible You are the consciousness of your unhappy family, Its bird sent flying through the purgatorial flame”.
  • Carl Jung, who viewed individual neurosis as often deriving from whole family or social groups, considered himself a case in point: “I feel very strongly I am under the influence of things or questions left incomplete and unanswered by my parents and grandparents and more distant ancestors…an impersonal karma within a family, which is passed on from parents to children”.