Hargrave Et Al - 2020 Transgenerational Theories and How They Evolved

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Transgenerational Theories
and How They Evolved into
Current Research and Practice
Terry D. Hargrave and Benjamin J. Houltberg
As therapists, we see and hear almost a predictable cadence come out of the voices of
our clients, couples, and families. Whether it is in the effort to describe the problem,
where they are stuck in life, or how they describe their personhoods and relationships,
we hear and see the patterns of the past and how the people we seek to help came to
know and understand themselves and relationships. As we listen, we may call the nar-
rative or story different things such as the problem saturated story, the attachment
history, or the nuclear family emotional process. The fact remains, however, most of
us in the therapeutic context will begin to ask companioning questions about the
people we help and their pasts and how they were raised as well as the essential rela-
tionships that formed and shaped identities and senses of safety. We are still curious to
know how the past and the history of relationships came to impute meaning to the
interpretations of self as well as the beliefs that shaped behaviors in relationships. It
seems fundamental to our systemic family therapy (SFT) DNA to ask questions like
“What experiences or relationships were the most important in your life?”; “Where
did you learn the beliefs you are talking about?”; and “How did you learn about being
a woman or a man in the context of your culture and family?” We are still interested
after all these years to therapeutically chase down the origins of pain, misunderstand-
ings, and impacts of behavior and relationships with our clients. We are, in other
words, all doing at least some of the work we learned in our field’s beginnings through
the transgenerational theories of family therapy.
This does not mean, however, we all do the therapy as it was first identified in the
transgenerational theories. From our viewpoint, we see how the transgenerational
theories were primarily involved in the beginnings of our family systems thinking but
then evolved into more orientations that were experiential in nature. As the impact of
neuroscience and mindfulness has grown in our field, there has been a further evolu-
tion of how to efficiently make sense of the past, capsulate the understanding through
systemic patterns, and then move clients to the work of mindfulness and practice in
order to make the changes they deem necessary and useful to solve problems and
The Handbook of Systemic Family Therapy: Volume 1, First Edition. Edited by Karen S. Wampler,
Richard B Miller, and Ryan B. Seedall.
© 2020 John Wiley & Sons Ltd. Published 2020 by John Wiley & Sons Ltd.
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318 Terry D. Hargrave and Benjamin J. Houltberg
create better relationships. In this chapter, our goal is to not only create a scaffold of
three major transgenerational theories but also trace how the experiential theories
evolved from this rich beginning and provided a further scaffolding to the more
recent evolution of current models utilizing emotional regulation, mindfulness, and
practice of new behaviors into habituation.
Transgenerational Theories
It is essential to remember that transgenerational theories themselves did not develop

in a vacuum but instead evolved themselves from the context and influence of psycho-
analytic theory. This was due to two primary factors. First, psychoanalytic theory was
by far the dominant force in psychiatry and psychology through at least the first
50 years of the twentieth century (Sander, 1998). Second, and perhaps more impor-
tantly, the founders of the transgenerational theories described here were trained and
likely influenced by psychoanalytic thinking (Framo, 1981; Goldenberg & Goldenberg,
2013). Even though these family therapy founders emerged from psychoanalytic
thinking to make their own contributions to SFT, they were influenced by certain
aspects of psychoanalysis. For instance, both Boszormenyi‐Nagy and Framo were
heavily influenced by the dynamics expressed in object relations theory (Boszormenyi‐
Nagy & Ulrich, 1981; Fairbairn, 1952; Framo, 1982).
From our observation, as the transgenerational theories evolved, there were important
aspects of psychoanalytic influences that persisted in their work. First and foremost, there
was a clear focus on the fact that early relationships—particularly with the mother and
father—were the dominant force in shaping personality as well as relational dynamics
(i.e., Erikson, 1963; Fairbairn, 1952; Freud, 1940; Giovacchini, 1987; Spitz & Wolf,
1946; Sullivan, 1953). The transgenerational theories clearly accepted as fact that the
family of origin was the essential factor in shaping and driving human behavior in rela-
tionships (Bowen, 1978), as well as having a dual effect of shaping the individual psyche
and interactions with others (Boszormenyi‐Nagy & Framo, 1965; Framo, 1981).
Second, there was a focus of these theories that these influences on the individual psyche
and relationships were the root of much of the anxiety experienced in both the individual
and the family relationships (Boszormenyi‐Nagy & Spark, 1973; Bowen, 1966; Framo,
1992). Although these theories referred to this anxiety utilizing different names such as
merging projections, irrational role assignments, or family projection process, it is clear
that these theorists were picking up the thread that psychoanalytic conflict resulted from
the unconscious forces (Freud, 1959) and the flight of fear from object relations (Klein,
1946). Finally, transgenerational approaches were influenced by the psychoanalytic per-
spective that uncovering unconscious or unrecognized influences on the individuals
could produce client insight and perhaps even change (Goldenberg & Goldenberg,
2013). Whether it was by the practice of coaching and bringing family dynamics to the
attention of the client of family (Bowen, 1978), using multidirected partiality to identify
generational loyalties and relational entitlements (Boszormenyi‐Nagy & Krasner, 1986),
or utilizing the use of insight to loosen past relational introjects to resolve current rela-
tional issues (Framo, 1992), the transgenerational theories very much carried on an
evolved belief that interpretations and insights into the family of origin produced not
only some relief for the individual psyche but also relational resolution.
Transgenerational Theories and Current Practice 319
Bowen family systems theory

Murray Bowen was the leading and most influential person in the cadre of transgen-
erational theories and perhaps the most important founder to the field of SFT. So
much of the language and vocabulary family therapists use on regular occasions—par-
ticularly in assessment and understanding of relationships—was developed or articu-
lated by Bowen (Kerr & Bowen, 1988). Although there are many contributions of
Bowen to the field, the crux of his influence of understanding the individual in con-
text of the family is found in the eight interlocking concepts (Goldenberg & Goldenberg,
2013). Bowen believed, like Freud, anxiety was an unavoidable aspect of human exist-
ence and expressed itself in the context of family relationships as members struggle to
(a) balance togetherness forces of the family and individual autonomy drives and (b)
express thoughts with rational clarity versus being swept away by emotional irrational-
ity (Bowen, 1978). This anxiety is either dealt with in a healthier manner or results in
family dysfunction. For Bowen, the eight concepts were interlocking because they
were mutually influential on one another.
Differentiation of self is the first interlocking concept and the key measure in family
assessment of the health of the individual and family. As an individual becomes more
differentiated, he or she is able to be clearly rational and make flexible and good
choices when balancing the obligations of togetherness with the autonomy drive of
individuality (Bowen, 1978). Individuals who experience a state of fusion are very
much in a state that is opposite of differentiation in that his or her emotions contami-
nate rational thinking and therefore lead to imbalance and leaning to either too much
autonomy in individuality or too much togetherness in relational demands. To lean
too much one way or another in this balance will either result in the individual being
unable to connect with important others relationally or make it difficult to maintain a
more autonomous sense of self and choice. True differentiation always means to be
able to hold the anxiety in a reasonable way and be able to connect with others with-
out fear of losing a sense of self. Bowen (1978) maintained a descriptive differentia-
tion of self scale from 0 to 100 where 0 represented a person totally fused emotionally
and rationally and unable to separate self from family influence and 100 represented a
person who was completely differentiated and able to make relational choices without
fear of losing self.
Lack of differentiation breeds confusion and emotional reactivity not only in the
family‐of‐origin system but also in the intergenerational and societal systems of rela-
tionships. Emotional triangles are largely a result of this lack of differentiation and are
the second of the interlocking concepts (Kerr & Bowen, 1988). In a two‐person sys-
tem such as a spousal relationship, two undifferentiated or emotionally fused indi-
viduals have difficulty finding balance in the relationship and therefore increase anxiety
and discomfort with one another. There is a need to diffuse the anxiety caused by this
relationship, and this fact is highly common in dyadic relationships (Bowen, 1978).
The result is often to triangulate another individual into the situation so one of the
dyadic partners has another who is “teamed” with his or her anxiety against the other
partner. A triangle most often splits the dyad and spins off a situation where there are
two insiders and one outsider. Destructive triangles tend to focus the anxiety and
problems on the outsider and away from the dyadic conflict. Triangles are common
not only in families but also occur intergenerationally and where ever there are sys-
temic relationships at work that produce anxiety. When undifferentiated parents
t riangulate a child into their emotional reactivity, the child is subject to the emotional
impairment and is likely to have difficulty maintaining any sense of differentiation in
the future (Bowen, 1978). Bowen (1972) saw clearly how he was triangulated into his
own parents’ relationship and was insightful enough to develop interventions and
clarity on how to de‐triangulate himself.
Another consequence of differentiation is the third interlocking concept called the
nuclear family emotional process. Bowen (1978) believed dyadic partners sought out
or were only able to attract others who were somewhat at equal levels of differentia-
tion. Of course, when highly differentiated partners create family, they raise children
in an environment where there is clarity of thought, flexibility in meeting relational
and individual needs, and a propensity to produce stability in the family. As a result,
the emotional process and patterns of the partners are replicated in the children to
produce adults who are differentiated individuals. When the partners, however, are
undifferentiated and have a high degree of emotional fusion, they produce the same
type of characteristics and patterns with their children. The lower the level of differ-
entiation in the dyad, the greater the likelihood that there will be family instability
through perpetual conflict, distancing, or blaming. Kerr and Bowen (1988) identified
three symptomatic patterns that often develop when partners are emotionally fused,
which include physical or emotional impairment of one of the partners, resulting in
the rest of the family being absorbed into the symptomatic behavior as the focus of all
relationships; chronic conflict in the marital dyad where partners are locked into cycles
of distanced and enmeshed behavior over the emotional anxiety that then dominates
the entire family; and emotional impairment of a child where the undifferentiated
partners band together to blame the child for the anxiety in the family.
Family projection process is the fourth interlocking concept in Bowen’s model.
Bowen (1978) believed there to be an uneven distribution of the parents’ anxiety to
children, and therefore some children would have an opportunity to be more differ-
entiated than siblings. In other words, all children are exposed to the same nuclear
family process and patterns, but not all children are triangulated or impaired in the
same way in the family. For the unlucky or only child of undifferentiated parents, the
projected on child receives an inordinate amount of focus or blame for the anxiety
that exists between the partners or the family. As a result, the overfocus on the child
puts him or her in a position of having more emotional instability and will grow up
with likely even less differentiation from the parents as he or she learns that the only
way to relate and survive is to be emotionally fused, demanding, and perpetually
immature in the same way the parents are immature (Papero, 1995).
The fifth interlocking concept is recognized as emotional cutoff and is one of the
processes that crosses clearly from the family into the intergenerational context as well
as other relationships individuals have in society. In the family projection process,
children who are unable to achieve some type of differentiation from their families
often try various strategies to exert or put forth their adulthood or autonomy. From
an undifferentiated position, however, the adult child will often make this autonomy
play by moving further away from the family of origin, creating barriers to make com-
munication with the family difficult or pretending as if everything in the family is okay
and attention is never again required. Although this may have an appearance of indi-
vidual autonomy, Bowen (1978) would consider it an emotional cutoff. This has the
unfortunate effect of creating a pseudo‐self of autonomy or pseudo‐maturity by phys-
ical or emotional distancing but does not alleviate the emotional fusion or the lack of
differentiation. As one of my professors used to say, “an emotional cutoff is like drag-
ging the family emotional umbilical cord around with you across any distance.” In
other words, the distancing leaves intact all the emotional anxiety without much pos-
sibility of resolving such lack of differentiation. Even more damaging, however, the
distancing techniques learned in this methodology are perpetuated in partner and
other relationships and makes triangulation and the family projection process even
more likely (Kerr & Bowen, 1988).
It makes sense that as a family with undifferentiated or fused parents raise children
who were triangulated, patterned in the nuclear family process, and subjected to the
family projection process, several of those children will likely be even less differenti-
ated than the original parents. These grown children will seek out partners with
equally low levels of differentiation and perpetuate the same unfortunate triangula-
tion, family process, and impairment of their own children through family projection.
The result, generation after generation, is a further deterioration of the multigenera-
tional family and the levels of differentiation among the members. Papero (1995)
reports that although the multigenerational family may stabilize for one or two gen-
erations, there is a tendency when anxiety rises in the family to return to these long‐
standing emotionally fused reactions that spiral the family into dysfunction. This
interlocking concept is called the multigenerational transmission process.
The last two interlocking concepts in the Bowen family systems theory are sibling
position and societal regression. Bowen (1978) recognized that sibling position not
only came into play as the learned interactive patterns between marital partners were
influenced by their sibling positions of being eldest, middle, or youngest but also how
lesser differentiated parents would select potential children in terms of position in the
family projection process. In societal regression, Bowen put forth the belief that
societies—just like families—faced forces of autonomy and undifferentiation. He pos-
tulated that as societal forces produced more stressful and anxiety‐producing conse-
quences, there would be more global deterioration in terms of differentiation and
clarity of thinking (Bowen, 1978).
Like psychoanalysis, Bowen family systems theory is not as interested in problem
solving or change as much as it is in helping individuals recognize and be thoughtful
about their own differentiation and relationships. Therefore, the primary goal of the
work is to improve differentiation through helping people decrease their emotional
reactive patterns and extricate themselves from the dysfunctional patterns revealed in
the eight interlocking concepts that were present in their families of origin (Kerr &
Bowen, 1988).
Although Bowen did not focus on therapeutic techniques, there are identifiable
methods the theory utilized. First and foremost, Bowen (1978) believed the thera-
peutic posture of a therapist should be one of a coach. In this manner, the therapist is
able to give direction and inform individuals about more differentiated positions and
de‐triangulating the self from the family of origin. Although Bowen would work with
families and couples occasionally, he very much preferred that the family members
learn in conversation with him directly and not by speaking directly to one another in
the beginning stages of therapy. In this way, he believed he minimized the opportu-
nity for family members to emotionally fuse and at the same time maximized his influ-
ence in coaching the family toward more differentiated behavior (Bowen, 1978). In
recognizing the family emotional process, the projection process, emotional cutoffs,
and the multigenerational transmission process becomes evident in the technique of
genograms used by many Bowen systems therapists (McGoldrick, Gerson, & Petry,
2008). Also, Bowen (1978) utilized the coaching position in helping clients practice
more differentiated behavior through improving rational thinking and communica-
tion through taking “I‐positions” and engaging in relational experiments. All of these
methods were clearly designed to help the family members and clients become
thoughtful about their processes and improve their growth by more differentiated
behaviors.
There has been some current research that has explored Bowenian concepts. For
example, Miller, Anderson, and Keals (2004) found that lower levels of differentiation
were significantly correlated with higher levels of anxiety and lower levels of marital
satisfaction. Also, Bartle‐Haring, Ferriby, and Day (2018) found that the level of dif-
ferentiation mediated the association between depressive symptoms and relationship
satisfaction. Higher levels of differentiation of self are also correlated positively with
sense of well‐being (Ross & Murdock, 2014) consistent with Bowen’s perspective of
individual and relational balance.
Contextual family therapy

Ivan Boszormenyi‐Nagy was a Hungarian psychiatrist who immigrated to the United
States after World War II. He was a leading figure in the early development of family
therapy in the 1960s, working with families and schizophrenia (Boszormenyi‐Nagy &
Framo, 1965). As his understanding of families grew, he and his colleagues directed
their work more toward transgenerational issues in the family. Contextual family therapy
was the eventual result. It is a comprehensive approach to therapy that is integrative of
several psychological and developmental theories (Boszormenyi‐Nagy & Krasner,
1986). In essence, contextual family therapy emphasizes relational healing through
growth in family commitment and trustworthiness, primarily developed through the
process of loyalty, fairness, and reciprocity. Although there have been modifications to
his theory since his death in 2006, his systemic therapy is best conceptualized by the
four dimensions of relational reality (Boszormenyi‐Nagy & Krasner, 1986):
1 Facts are the relational influences that are primarily due to existing environmen-
tal, relational, and individual realities that are objectifiable. For example, genetic
heritage, physical health, historical facts, and specific events in the family life cycle
would be a part of this dimension.
2 Individual psychology. Individual psychology is the relational dimension that
accounts for a person’s experiences and motivations. These subjective influences
are internalized to individuals as he or she strives for recognition, love, power, and
pleasure and are motivated by the forces of aggression, mastery, or ambivalence.
3 Family or systemic interactions. This dimension is delineated by relational trans-
actions, communication, and interactions. These interactions produce a family or
systemic pattern of organization that defines power, alignments, structure, and
belief systems.
4 Relational ethics. This dimension deals with the subjective balance of trustworthi-
ness, justice, loyalty, merit, and entitlement between members of relationships. As
relational members interact, they are interdependent and relational ethics requires
them to take responsibility for actions and consequences as well as to strive for
fairness in the process of relational giving and taking.
Although all four dimensions are interdependent on each other and have mutual
influence, it is the dimension of relational ethics that is the strongest and overarching
concept in the theory. Simply stated, it is the balance of fairness in the family relation-
ships between the obligations and entitlements of each member of the family. This is
instinctual to family members based on the trust that the family is committed to meet
the individual’s needs and the individual will do what it takes to perpetuate and give for
the good of the family (Boszormenyi‐Nagy & Krasner, 1986; Boszormenyi‐Nagy &
Ulrich, 1981).
When family members take part in this mutual investment of give and take—both
giving for the good of individual members and the members in turn seeking and giv-
ing to help the family survive or become stronger—a sense of trustworthiness is devel-
oped in the relationships. Trustworthiness in relationships is consistently pointed out
as the essential element in building family health and intergenerational stability
(Boszormenyi‐Nagy, Grunebaum, & Ulrich, 1991). Trust in the family process of
give and take is powerful because it allows family members to contribute and give to
one another in freedom without fear of others threatening, manipulating, or with-
drawing from them. In short, they give to each other because they trust that other
family members will give to them and meet their individual needs (Hargrave &
Pfitzer, 2003).
When there is an imbalance in this family ledger of give and take or merits and obli-
gations between family members, it is experienced by members as a violation of jus-
tice. If the injustice persists over a period of time, trustworthiness begins to deteriorate
and so does the individual freedom to give to others (Hargrave & Pfitzer, 2003). As
a result, individual members decrease or stop giving to other family members, and it
then triggers a further deterioration of trust in the family. Soon, individuals in the
family start seeking destructive ways to gain their justified entitlements that have been
neglected or ignored. Because no one in family relationships give to one another,
members begin threatening others to “make” them give what is needed, manipulating
relationships to meet their own needs, or withdrawing and giving up on the relation-
ships with the belief that people will be unable or permanently unwilling to meet their
needs. This tragic loss of trustworthiness and movement of family members to take
what they need through threat, manipulation, or withdrawal is called destructive enti-
tlement (Boszormenyi‐Nagy & Krasner, 1986).
Boszormenyi‐Nagy, of all the family‐of‐origin therapists and theorists, was most
true to the idea of a comprehensive transgenerational theory. He believed sincerely in
the idea that deficits of injustice and trustworthiness were passed along in the destruc-
tive entitlement of one generation to the next forming a revolving slate of the genera-
tional ledger (Hargrave & Pfitzer, 2003). It was this concept of the revolving slate of
the generational ledger that led Boszormenyi‐Nagy and Spark (1973) to identify the
concept of invisible loyalty. When an individual is raised in a family where there is an
unjust system where he or she is deprived of fair entitlement, the individual is likely to
carry a dysfunctional and sometimes pathological drive into the existing relationships
that can be quite destructive to both the individual and intergenerational family
(Boszormenyi‐Nagy & Krasner, 1986). For instance, as children grow in a family,
they are a part of a vertical relationship where giving from the previous generation is
asymmetrical in nature. In other words, parents give to children not because they
expect to receive giving back from the child, but because the child is fulfilled and
emotionally healthy by the love and trustworthiness given by the parents. As the child
grows up and has children of his or her own, he or she then is raising a child in this
vertical, asymmetrical relationship. This adult child now gives to his or her own chil-
dren love and trustworthiness out of the resource provided by his or her parents in the
previous generation. This healthy generational giving also raises children who are
then able to engage in sound horizontal relationships or relationships where partners
engaged in balanced give and take with one another such as siblings, friends, or
spouses (Hargrave & Pfitzer, 2003).
The unpleasant rub comes when a child is raised in a situation where he or she
does not receive the just entitlement from the previous generation. The denial of
what the child needs to be loving and trustworthy sets him or her on a destructive
entitlement drive to fulfill what is needed and will include the threatening, manipu-
lating, and withdrawing from others. Further, he or she will be indiscriminate in this
destructive entitlement expecting innocent parties such as his/her own spouse, chil-
dren, or friends to make up for the entitlement lost in the vertical relationship. The
invisible loyalty to family of origin, and more importantly the generational revolving
slate, makes the behavior of the destructive and dysfunctional person most profound
as he or she desperately tries to fulfill their own quest for entitlement. Worse still, the
partners and children of this person are impaired and cheated out of their fair love
and trustworthiness. Thus, the drumbeat of dysfunctional families proceeds in a
downward spiral through the generations (Boszormenyi‐Nagy & Krasner, 1986;
Hargrave & Pfitzer, 2003).
The crux of the therapeutic effort in contextual family therapy is multidirected par-
tiality. As Boszormenyi‐Nagy and Krasner (1986) point out, it is not simply a thera-
peutic methodology or intervention strategy, but instead is a central theme for the
therapist as he or she seeks to understand the story of all those who have a genera-
tional ledger stake in the family and be partial and trustworthy in holding parties
accountable and responsible (Hargrave & Pfitzer, 2003).
There are four primary methods used in the process of multidirected partiality
(Goldenthal, 1996). The first is empathy, and it is perhaps the most well‐recognized
methodology in the therapeutic field. When the therapist reflects empathy while lis-
tening to the client story, he or she expresses connections to the client’s loss, fear, and
pain (Goldenthal, 1996). The second methodology in multidirected partiality is cred-
iting and involves the therapist openly acknowledging the unfair violations and rela-
tional insults the client has experienced in the family. In addition, the therapist credits
the client efforts to be loving and trustworthy amidst receiving insufficient resource
from the family. In other words, recognizing the client for giving when he or she has
not received fair and just entitlement. When this is done in conjunction with empathy,
it further builds a trustworthy alliance between the therapist and the client
(Boszormenyi‐Nagy et al., 1991). Acknowledgment of efforts is the next aspect of
multidirected partiality and involves the therapist recognizing the successful loving
and trustworthy efforts not only of the client but also of the family that might have
been well meaning, but went awry because of destructive coping (Goldenthal, 1996).
For example, many times family members get angry or manipulative in relationships
in an effort to force more responsible or just behavior from others. Finally, multidi-
rected partiality involves accountability. This aspect involves the therapist holding the
client as well as the other relational parties—both present and not present in the
room—responsible for the actions and behaviors that caused damage to relationships
and resulted in violations of love and trustworthiness (Hargrave & Pfitzer, 2003).
The practice of multidirected partiality in the therapy room provides an initial infu-
sion of trustworthiness and insight to the family member or members. As this trust-
worthiness grows, members are then able to acknowledge not only the pain in other’s
stories but increasingly take responsibility for their own destructive actions. In short,
family members start making efforts toward giving to one another amidst the atmos-
phere of understanding and trustworthiness. This action creates an equally powerful
inclining spiral of love and trustworthiness as giving results in more family trustwor-
thiness and more family trustworthiness begets even more giving. The way out of
family and individual dysfunction, therefore, is utilizing multidirected partiality in
order to create ample trustworthiness to start building a legacy of health and giving
(Hargrave & Pfitzer, 2003). As such, contextual family therapy clearly acknowledges
the power of the past in shaping the inter‐ and intrapsyche of the individual and family
and builds a methodology of insight and understanding in order to promote healthier
individuals and family relationships.
Contextual therapy has less research that is not associated specifically with examples
and case studies, but there has been encouraging work in terms of identifying core
practices of the approach from observations of both Boszormenyi‐Nagy and current
practitioners (Meiden, Noordegraaf, & Ewijk, 2017, 2018). Also, Hargrave, Jennings,
and Anderson (1991) developed a Relational Ethics Scale to validate constructs in the
theory. This scale was then used to identify a positive correlation between trust and
justice in relationships and marital satisfaction (Hargrave & Bomba, 1993). Likewise,
the Relational Ethics Scale was used and was significant as a predictor of marital satis-
faction, and in turn, marital satisfaction was significantly associated with depression
and health problems (Grames, Miller, Robinson, Higgins, & Hinton, 2008). Finally,
the same scale was used in a study to measure a sense of fairness and relationship sat-
isfaction, which revealed that lower sense of fairness was correlated significantly with
lower relational satisfaction (Gangamma, Bartle‐Haring, & Glebova, 2012). All of
these findings are supportive of the constructs of contextual therapy.
Framo’s object relations/family‐of‐origin therapy

James Framo was a founder in family therapy who was hesitant to jettison what he saw
as the benefits of the psychoanalytic understanding of client intrapsychic issues. He
focused instead on efforts to balance his understanding of object relations with overt
understanding and direct interventions with individuals and couples and their families
of origin (Framo, 1981). His uniqueness in the field of SFT is his direct application
and intervention with individuals and families confronting their pasts in their families
of origins and pioneering conjoint and group meetings with family‐of‐origin
members.
Out of his work in object relations, Framo (1982) believed the bulk of anxiety and
conflict experienced by individuals spawned in the family of origin and it was these
influences that then led individuals to act out and replicate the conflict and anxiety in
current relationships. Framo (1981) was most heavily influenced by the work of
Fairbairn (1952) and believed that as a child interprets and experiences a parent who
is inattentive, rejecting, or even abandoning, the child is caught in a terrible bind. The
child is dependent upon the parent as the only one who can provide the love and care
he or she needs and therefore cannot give the parent up or reject the parent, but, at
the same time, hates the parent who has failed him or her. This love/hate r epresentation
of the child’s feelings toward the parent results in the intrapsychic conflict of splitting
(Framo, 1981).
Key to the object relations analytic perspective, these splits of the object (the par-
ent) are held by the child as introjects, or internalized objects and beliefs about the
objects held in the psyche. In the internalized psychic world of the child, the child
learns to control and deal with the conflicting splits of the internalized parent or
object (Fairbairn, 1952). Framo (1981) believed these parental introjects were among
the toughest to change in therapy, and the greater the parental neglect or rejection of
the child, the more resistant the internalized object and splits would be to change as
the child grows into an adult. Further, as the child turns to an adult and seeks a mate,
he or she does not select a partner that is desired as much as a partner that matches
the internalized objects and splits that which already exists in the psyche. In this way,
the individual seeks a pair bond that holds out the hope of the love represented in the
best of the internalized parent, but also a partner who holds some of the same reject-
ing or neglecting attitudes of the worst part of the internalized parent. The individual,
therefore, recreates their own split‐internalized representation in their current family
relationships in an effort to work out, albeit unconsciously, the desired love of the
internalized best parent and resolve or eliminate the worst characteristics of object or
parent in the context of the current relationship (Framo, 1992).
The most damaging part of this process in producing conflictual marriages is the
process of projective identification, wherein the partners project their expectations and
resentments of their internalized object parents, or the disowned part of themselves
that are much like the hated part of the internalized parent. Although this process is
evident with partners first, children of the partners are particularly vulnerable as
objects of this projections. As a result, children cannot get the projecting parent to
love him or her because the parent has projected a “bad” introject onto the child and
expects the child to somehow work this out on his or her own to provide the parent
with unconditional love. In this way, partners and children become substitutes for the
rigid introjects of the individuals past family of origin (Framo, 1981). In turn, it is
easy to see how this process is then replicated from generation to generation as inad-
equate parents produce splitting of the internalized parental object in their children
where the process is then repeated.
Therapeutically, it was not unusual for Framo to meet with the entire family first in
order to free children from carrying symptoms or responsibilities caused by the pro-
jections of the parents. Once this was achieved, the clear focus of the therapy became
about undoing the projections of the past in the partnering or marital relationship of
the parents (Framo, 1982). Framo (1992) would most often meet with partners in
conjoint sessions first to help the partners articulate and understand their frustrations
and internalizations of their objects. But very quickly in the process, Framo would
move these partners into the context of group marital therapy, most often consisting
of three couples. In addition to hearing and understanding the influences of the past
from each member and the subsequent introjects, splitting, and projections, group
members would learn from seeing the interactional patterns acted out by other cou-
ples. As a result, members would also see how the same or similar dynamics or pat-
terns were at work in their own relationship as well as seeing the insights and new
possibilities brought to light by the therapist. Couples were also encouraged to give
each other positive feedback as well as insight into certain issues the couple might be
experiencing. Besides the positive aspects of any group experience, Framo also believed
that the couple marital group then set the stage and reduced resistance in preparation
for the final stage of the treatment: the meeting of the individual with the family of
origin (Framo, 1992).
Framo (1981, 1992) clearly felt that the most powerful way to loosen the bonds
of the good/bad introjects and projections was not through the insight, understand-
ing, and comments from the therapist or others, but to deal directly with one’s family
of origin in a session with as many original family members as possible. As such,
Framo serves as an important bridge from the insight‐based transgenerational theo-
ries into more of the experience‐based approach that evolved into the experiential
therapies. In the family‐of‐origin meetings, the therapist (or co‐therapists) would
meet with one of the individuals with the couple and his or her family of origin for
usually two two‐hour sessions. The goals of the sessions were to explore how the
beliefs or perceptions formulated in the family of origin found their way into the
projections in current relationships and to have corrective experiences with the fam-
ily of origin. In many cases, individuals had misunderstandings or misperceptions of
the problems in the family of origin, and these could be addressed through the clari-
fications and explanations of the family members. Rather than being a platform for
blame, the meetings would often be a place where misunderstandings could be
cleared up overtly and messages of love and care could be expressed. But even when
this was not the case, individuals had the positive outcomes of talking out their past
beliefs and projections and came to a better understanding that the issues clearly
belonged in the relational realm of the family of origin instead of the intrapsychic
aspect of the individual (Framo, 1992).
In working with the family of origin directly, the individual had the grip of the
internalized objects loosened. As a result, the individual can then see more clearly the
reality of the family‐of‐origin parents and realize that these objects were never totally
the rigid splits that were internalized, but rather real people who are imperfect but still
able to love and connect. With this revision of the introject, the individual is finally
able to release a good part of the old projections and is free to behave and act in a
more beneficial manner toward the partner and the children (Framo, 1981). In this
way, the individual, partnering relationship, and children can have a changed experi-
ence without the unconscious introjects of the past. For the individual, the anxiety of
the split is resolved by both the insight and understanding gained in therapy and the
new liberating experiences gained in the family‐of‐origin sessions. Although imperfect
in many cases, the process of interacting in the conjoint therapy, group marital ther-
apy, and family‐of‐origin sessions is restorative and healing for the intergenerational
family (Framo, 1992).
Experiential Theories
The early transgenerational theories definitely made an impact in the psychotherapy

field as they opened up the possibilities of working in a relational way, instead of
strictly an intrapsychic manner. The experiential theories discussed here were develop-
ing along with these transgenerational approaches and shared much common ground
with those founders. First, both Whitaker and Satir felt that the best context for indi-
vidual fulfillment would come to fruition in the context of healthy relationships (Satir,
Banmen, Gerber, & Gomori, 1991; Whitaker & Bumberry, 1988). This fundamental
concept is very close to and was likely influenced by the outlook that the d
ifferentiation
of self results in the ability to practice not only autonomy but also togetherness in a
family context (Bowen, 1978). Second, there was a high stock put into clarity of
expression in the here and now among the experiential founders (Satir, 1964). Again,
this goal is consistent with the transgenerational theories to root out past loyalties and
projections in order to make more informed and clearer choices in relating. Finally,
the experiential founders placed a premium on growth and individual freedom (Satir
et al., 1991; Whitaker & Bumberry, 1988). Clearly, although the transgenerational
founders did not express it in the exact language, the therapeutic goal was to direct
change into a less dysfunctional system where healthy individuals could flourish
(Boszormenyi‐Nagy & Ulrich, 1981; Framo, 1981; Kerr & Bowen, 1988).
The experiential founders, however, expanded the framework of family therapy
from decreasing the focus on conflict and anxiety to the focus of human growth and
freedom (Satir et al., 1991; Whitaker & Keith, 1981). This was a natural outgrowth
of their phenomenological influence from focusing more on the aspects of humanistic
psychology in the tradition of Gestalt and person‐centered therapies instead of the
more traditional psychoanalytic approach (Goldenberg & Goldenberg, 2013). Still,
both Whitaker and Satir put the family of origin as the primary block to overcome in
the work to growth (Satir et al., 1991; Whitaker & Keith, 1981). As such, the family
dynamic of the past plays a central role in the systemic nature of these experiential
theories. The primary evolution of the experiential theories, therefore, was not so
much the focus of the goal of therapy but rather the way these therapists worked to
produce change and growth. Traditional transgenerational theories focused on
thought processes, understanding, and insight to interpret and clarify family‐of‐origin
dynamics to produce change. In the experiential iteration of the evolution, these
models emphasized the actual emotional experience in the therapy room as the pri-
mary methodology of change, thereby opening the opportunity for freedom and
growth in the individual (Satir, 1982). Indeed, Whitaker and Bumberry (1988)
almost held the practice of theoretically driven techniques and rational thinking as an
avenue to change in contempt and much preferred the practice of being and doing in
the room. As Whitaker said many times in a variety of settings, “Anything worth
knowing cannot be taught; therefore, anything worth knowing must be learned” (C.
Whitaker, personal communication, August 23, 1991). Clearly, the experiential evo-
lution of dealing with family of origin was driven by doing and trying new experiences
rather than clinical interpretation.
Symbolic experiential family therapy

Carl Whitaker was one of the founders of the family therapy movement who took an
extraordinary path in his therapeutic development. Initially influenced in psychoana-
lytic thought, Whitaker took on unique and daring treatment for schizophrenic
patients at the Department of Psychiatry at Emory University early in his career. He
focused on a type of play therapy with influence of therapists who acted as co‐parents
and experimented with regressive and symbolic techniques in order to reduce the
infantile effects of schizophrenia (Whitaker & Keith, 1981). After his tenure ended in
Atlanta, Whitaker eventually went to Madison, Wisconsin, to do training in psychiatry
and further adapt his model of therapy.
Symbolic experiential therapy always values the freedom and choice of the individ-
ual, and growth is seen as developing in healthy groups as a natural process of crisis
due to developmental changes. Issues of individual and family health such as clear
generational boundaries, the flexible distribution of power among members, the free-
dom to express individual beliefs and differences, and the ability to problem solve are
negotiated via the pathway of actual experiences of going through these challenges
together (Whitaker & Keith, 1981). On the other hand, family dysfunction often
presents itself when parents struggle over which family of origin of the partners is
going to govern or influence the family more, a rigid structure of rules that must be
obeyed by all members and an inability to operate outside of the homeostatic expecta-
tions. Further, all members of the family are equally affected in a pathological or
dysfunctional family. Particular members may be scapegoated, but the entire group
bears the marks of the problem behavior (Whitaker & Bumberry, 1988).
Specific issues may bring the family to therapy, but the symbolic experiential thera-
pist most often sees the symptom only in the context of helping the individuals and
family negotiate to a larger goal of freedom and growth. As such, each experience
between therapist and family is essential in formulating new opportunities for choice
and growth (Keith, 2000). The first stage of the symbolic experiential therapy process
is the battle for structure in which the family must capitulate its role to operate the way
it likes and is used to in favor of the therapist’s mode of operating. The next stage is
the battle for initiative in which the therapist is nondirective toward the family in get-
ting information or story concerning their issues. The therapist in this model makes it
clear that he or she is committed to his or her own growth in the therapy process.
While this serves as a model of responsibility, the family members are left on their own
to reveal their own processes and thoughts (Whitaker & Keith, 1981).
Experiential therapists in general, but particularly symbolic experiential therapists,
do not structure interactions or tasks or even endeavor to gain much content or his-
tory concerning the family. The focus of the therapy is clearly to confront the process
that is happening in front of the therapists during the session. Once the family mem-
bers show part of this process, symbolic experiential therapists will engage the process
using metaphor, teasing, humor, free association, fantasy, and confrontation in order to
increase the family confusion, prompting the family members to find a different way
to resolve the stress (Whitaker & Keith, 1981). For example, when a client in a family
states, “I am the black sheep of the family,” a therapist might respond, “Well, that is
fortunate for you that you don’t shear off your black wool just to become another
mindless sheep following your family. Isn’t there something about that makes you the
special one in the family?” Such a challenge forces the family into disequilibrium as
they now will likely attribute forming a coalition against the “black sheep” as being
mindlessly influenced and the “black sheep” having to reckon with the advantages of
having more freedom of choice. The point is that the family is actively challenged
through their discussions and interactions with the therapist to have to modify their
processes and move more toward family health, boundaries between generations,
adapting and balancing new ways of expressing and connecting to one another and
growing (Keith, 2000).
Although research evidence for outcomes in this approach are scant, clinically sym-
bolic experiential therapists believe that this process, experience‐based approach, has
the power to change any family with virtually any diagnosis. They maintain systemi-
cally that since causation is circular, change has the same characteristic (Whitaker &
Keith, 1981). Many times, Whitaker referred to his work as the “therapy of the
absurd” because he saw the entire family as his client and would go to any lengths—
stretching the bounds of accepted therapeutic practice—in order to invade the normal
but dysfunctional family process to produce new growth and adaptations (C. Whitaker,
personal communication August 23, 1991). He saw symptoms and anxiety as oppor-
tunities for growth and would model fantasy alternatives in order to get the family
unstuck (Whitaker & Keith, 1981). Like the transgenerational theories, Whitaker
would use the anxiety as a force to bring about change. From our perspective, he was
part shaman and part stand‐up comedian, but he certainly created experiences wherein
families and individuals were prompted to change and grow.
The Satir model

Virginia Satir was one of the founders of the family therapy movement who was an
experience in evolution herself. Through her work as a social worker, she was perhaps
the first founder to meet with families as a whole. She was attracted to the Palo Alto
Group that eventually became the Mental Research Institute in the late 1950s and
worked in the research of understanding behavioral communication and its connec-
tions with mental health. Satir (1964) published one of the first works in family ther-
apy. As she began to train therapists more, she became more influenced by humanistic
theories and began working to clarify her early communication work and combining
it with growth enhancing methodology (Satir, 1982).
Like Whitaker, Satir believed that being a part of the family as a homeostatic system
required members to take on certain roles, limitations, behaviors, and sometimes
symptoms in order to keep the family functioning the same. She interpreted these
limitations and symptoms as blocks to individual growth and well‐being. She also
believed, like Whitaker, that the experience in the therapeutic process offered the best
opportunity for family members to remake their limits and remove the blocks to the
growth and healthy functioning. Unlike Whitaker, however, who took great care to
guard against being absorbed into the family (Whitaker & Bumberry, 1988), Satir
used her charisma as a nurturing and loving mother figure to involve herself com-
pletely with the family learning experience, creating new possibilities for not only love
but also growth (Satir & Baldwin, 1983).
Satir et al. (1991) pointed to three factors as essential to therapeutic understanding
in human development. The first of these is genetic endowment. Like Boszormenyi‐
Nagy’s account of the dimension of facts in contextual family therapy, Satir also saw
how genetics play into our physical as well as some of our emotional endowment.
The second factor is that of longitudinal influences, and for many, this is the most
essential construct in determining how identity, self‐worth, and self‐esteem shape
behavior, as well as the development of blocks to growth. Satir pointed to the primary
survival triad consisting of mother, father, and the child as the main context of the
family of origin where the child experiences love and encouragement as well as poten-
tially neglect and discouragement. The elements of touch, care, tone, and nurturing
are key in the child’s development, not only in direct experience but also as the child
sees and experiences the mother and father expressing these qualities toward one
another (Satir & Baldwin, 1983). As the child experiences both constructive and
destructive messages from parents, the child learns to interpret the parental messages
and grows or declines in identity and health accordingly (Satir et al., 1991).
The final factor that plays into the Satir model is the mind–body interaction and was
represented in her work by the mind–body–feeling triad. Satir felt mind, body, and feel-
ings take on meaning to the individual, and the person either overemphasizes certain
elements of the triad because it feels comfortable or de‐emphasizes other elements
because it is neglected and disliked (Satir et al., 1991). For instance, a person who is
very strong intellectually may have a tendency to put down their body’s value or attrac-
tiveness and/or pay little attention to the emotional self. Satir would call attention to
these various parts in almost a Gestalt manner with an emphasis on encouragement and
nurturing to help individuals embrace and integrate their whole selves and recognize
the growth that occurs because of such balance (Satir & Baldwin, 1983).
One additional element that played an essential role in the Satir model was the
communication styles. Satir (1972) believes that interaction styles that individuals
take on in relationships are good representations of their feelings and identities. She
identified these styles by paying attention to the way the clients attended to them-
selves (self), the other person (others), and the situation and circumstances in the
environment (context). In turn, Satir had a sculpting stance for each style that she
would utilize in therapy to promote awareness and growth. A person well in tune with
self, others, and context would be identified as a congruent style. Individuals in touch
with others and context but not with self would likely be a placating style and be
prone to be weak, self‐condemning, and apologizing for self. Those who are in touch
with self and context but not others would have a blamer style and likely display
behaviors that were dominating, angry, and self‐justifying. Individuals only in touch
with context at the expense of self and others would be identified as having a super‐
reasonable style and would likely be out of touch with emotions while acting distant
and uninvolved. Finally, those who are out of touch with others, self, and context
would likely display a style that is irrelevant and would represent behavior that is
unable to relate and distracting in relationship (Satir, 1972).
Satir was a master therapist and extremely nurturing in the room. Her focus in ther-
apy was constantly in propelling the individuals and family members into growth of
identity and self in the here‐and‐now experience with her. Some of the techniques she
used were pointing out incongruence in the mind–body connection of the client—
often using body parts as metaphors of communication—as well as making overt family‐
of‐origin rules, power alignments, and threats people felt. She would help individuals
confront these issues with therapeutic touch and support while encouraging new behav-
iors, relational experiments, and evaluation that represented clarity and strength of self
(Satir et al., 1991). In addition, she would often utilize family sculpting and family
reconstruction in her work. In a profoundly effective family‐of‐origin application that
was experiential, she would represent the primary survival triad utilizing communica-
tion stances and styles illustrating roles of family members. She would then teach, illus-
trate, experiment, suggest, and give feedback to members to create additional possibilities
within the here‐and‐now experience and promote growth (Satir & Baldwin, 1983).
There has been very little research on the experiential approaches of Whitaker and
Satir. Outside of case studies and examples, core variables in the symbolic experiential
theory have been identified (Mitten & Connell, 2004), but little progress has been
made how these are utilized in therapy or produce change. In the Satir model, there
has been a scale developed reflecting the theory’s idea of congruence (Lee, 2002) as
well as a study that reported significant improvement in family roles and relationships
after participation in a group focused on the model (Pan, 2000).
Current state of transgenerational and experiential theories

The current discussion in the field toward evidence‐based models can highlight cur-
rent approaches and ignore the contribution of the aforementioned SFTs. This is in
part due to the lack of research that has been conducted within these transgenera-
tional and experiential theories. It is always important to remember that through
these first two iterations of theory, founders in the field were most interested in model
development, techniques, and observations of interventions that produced change in
individuals and relationships. Most written research on these approaches, therefore,
has been anecdotal and focused on case studies or examples of practices. This type of
research, albeit informal, is often quickly disregarded because it lacks the rigor of
more randomized controlled trials that are often touted as the gold standard of the
field. Ironically, there has been a push for more process research in SFTs because of
the noted challenges of conducting randomized controlled trials when trying to oper-
ationalize and measure systemic change over time (Heatherington, Friedlander, &
Greenberg, 2005). Generally, SFTs have been shown to be effective (Shadish &
Baldwin, 2003), and controlled studies comparing effectiveness between models have
yielded very little differences on outcomes (Wampold, 2001). Although evidence‐
based practices provide valuable information about the types of modalities that work
for particular clients, or diagnoses, under a particular circumstances (Patterson, Miller,
Carnes, & Wilson, 2007), there is a need for understanding how therapies work rather
than knowing what works (Heatherington et al., 2005).
However, the modest amount of research within these models beg the question: Are
the transgenerational and experiential models still being used? There is no way to know
the popularity of these models, but it seems reasonable that some of the main assump-
tions of these theories—differentiation of self, triangulation, trustworthiness, justice,
loyalty, and anxiety resulting in growth and individual congruence—are still essential to
SFT and have widespread familiarity. As we have stated before, therapists are still very
much interested in how the past issues experienced in the family‐of‐origin and essential
relationships has shown up in current individual behaviors and relationships. Perhaps it
is reasonable, however, to assume that the popularity and exclusive practice of these
theories and models have decreased with the passing of these founders. We feel, how-
ever, that the familiarity of these theories and models is still present in SFT. We also
believe that emphasizing more process‐oriented research would allow for more in‐depth
research that takes into account “local practice experience and systemic wisdom to apply
relevant therapy techniques in a relational and narrative context” (Larner, 2004, p. 33).
The Third Iteration of Theories
It is our belief that theory development is still evolving from the transgenerational and
experiential theories that represent much of our heritage in SFT. The increased focus
of contemporary research on the physiological and neurobiological aspects of emotion
regulation and benefits of mindfulness have expanded the understanding of how family
processes can shape emotions in patterned ways and introduces new possibilities for
intervention. Emotion regulation involves the modulation of the occurrence, duration,
and intensity of internal states of feeling (positive and negative) as well as physiological
processes and is critical for emotional and relational health (Morris, Criss, Silk, &
Houltberg, 2017). Much of what people learn about emotions and emotion regula-
tion derives from their family of origin and become the emotional scripts for how they
interact in current relationships. Although definitions of mindfulness may vary, there
has been mounting empirical support for the importance of cultivating practices of a
nonjudgmental, present‐moment awareness of physiological, emotional, and bodily
experiences (Shapiro & Carlson, 2009). Mindful practice increases a person’s aware-
ness of their own emotional reactivity and allows them the opportunity to respond
more intentionally rather than automatically out of patterned behaviors.
Emotionally focused therapy (EFT) (Johnson, 2004) and restoration therapy (RT)
(Hargrave & Pfitzer, 2011) are two theories that represent the evolution of transgenera-
tional and experiential theories that integrate current research from neuroscience on
understanding how the brain is shaped by systemic relationships and also has patterned
itself into preferred predictable reactions in dealing with emotional pain (Hanna, 2014).
Both of these theories are rooted in the tradition of transgenerational therapies main-
taining that the past and early attachments are key in understanding current emotions
and behaviors. Also, both theories carry on the experiential tradition of working with
these past influences in the here and now as evidenced with the therapist encouraging
relational partners interacting, using interactions and empathy to produce change, and
engaging in role play and imagery for the purpose of fostering client growth and change.
Both theories identify emotion regulation processes of pain as being the key to
break up old patterns and move into new possibilities of change (Baumeister &
Tierney, 2012; Siegel, 2015). Further, both cultivate a mindfulness practice to pro-
duce emotion awareness, flexibility, and regulation that are critical to consolidating
changes and growth both inside the therapy session and eventual habituation when
therapy ceases. In this way, both of these theories maintain insight, understanding,
and connection as part of the therapeutic practice, but explicitly identify emotion
regulation and mindful practice as being the key elements for behavioral and thera-
peutic change (Hanna, 2014; Hargrave & Pfitzer, 2011; Johnson, 2004).
EFT and RT are heavily influenced by attachment theory (Ainsworth, 1967; Bowlby,
1969) and are appreciated much in SFT in understanding how past family‐of‐origin
and attachment relationships play out in current relationships. People and especially
young children are in need of secure attachment figures that provide emotional sup-
port, encouragement, love, and predictability. When these qualities are absent in par-
ents of young children, the result leaves emotional pain in the child, resulting in
detachment, disconnection, frustration, anger, and depression (Ainsworth, 1967;
Bowlby, 1969). Without this emotionally secure base to be fostered by parents, people
grow into adults who carry this same emotional pain or attachment styles as well as
negative reactions into partnering and family relationships negatively affecting con-
nections and relational satisfaction (Johnson, 2004).
Emotion‐focused therapy and emotionally focused couple therapy

Greenberg and Johnson (1988) are key figures in recognizing that the attachment inju-
ries of the past can change as relational partners engage in new and emotionally meaning-
ful experiences in therapy. Greenberg (2002) has been particularly important in the
development of emotion‐focused therapy promoting human growth and change through
individual and couple emotional awareness through experiential opportunities in therapy.
His approach creates opportunities and a therapeutic atmosphere where there is greater
emotional expression, regulation, and understanding. Further, the approach works to

transform emotions and develop empathy as a pathway toward change. One of the most
important contributions of Greenberg has been developing an evidence‐based approach
that focuses on immediate process changes that occur in therapy in order to not only
distinguish the effectiveness of therapy but also track how intermediate and long‐term
changes with individuals and couples occur (Greenberg, 1986).
Johnson (2004) has been the leading advocate and developer of the application of
the emotion‐focused therapy to marital therapy culminating in her work on emotion-
ally focused couple therapy (EFCT). Also, she and colleagues have produced impres-
sive research on the approach not only in effectiveness of marital therapy but also with
issues of trauma and mental health. EFCT is experientially driven, meaning that
insight and healing are produced as the clients experience emotional connection,
become more secure attachment partners, and change their ways of relating (Johnson,
2004). Work is not accomplished by assignments, but rather the practice in the room.
This process is achieved through the therapist initially, but then is broadened to
include the partners in becoming more attached in their relationship as they experi-
ence safe haven with one another.
EFT identifies nine steps in the process of working the experiential process with a
couple (Johnson, 2004). First, the therapist delineates conflict issues in the core of the
struggle by joining, assessing, and being a safe haven. Second, the work turns to iden-
tifying the negative interaction with the couple. Key to EFCT is the observation of
enactment in order to find pursuer–withdrawer patterns as well as tendencies to
under‐ or overregulate emotions. Assessing the unacknowledged emotions underlying
the interactional positions is the third step in EFCT. Much of this work involves the
therapist probing the couple to not only identify the secondary emotions, which most
often have a reactive and behavioral component, but also the primary emotions, which
are more representative of the true feelings. Fourth, the therapist helps the couple by
reframing the problems in terms of negative cycles, underlying emotions, and attachment
needs. Fifth, the therapist helps the couple by making identification of disowned attach-
ment emotions, needs, and aspects of self and integrating these into relationship interac-
tions. This often involves helping the couple recognize how earlier attachment injuries
have affected the senses of identity as well as making needs and wants better known
relationally. As this discovery takes place and is shared, partners may have difficulty
with acknowledging and accepting these emotions of a spouse and move toward
established relational patterns. Therefore, the sixth step in EFCT is to promote accept-
ance of the partner’s experience and new interactional responses. Seventh, the therapist
helps the couple express needs and wants to each other and create emotional engage-
ment. Helping the couple create new solutions to old relational issues is the eighth step
in EFCT. Finally, the therapist works with the couple to consolidate new positions and
new cycles of attachment behaviors in their relationship.
Restoration therapy
RT is a relatively new model of systemic marriage and family therapy developed by
Terry Hargrave and Franz Pfitzer and is heavily influenced by contextual family ther-
apy, attachment theory, cognitive therapy, and mindfulness research. In RT, the thera-
pist sees the primary emotions as relating to identity, which is developed in the context
of how the individual was loved in relationship, and safety, which is developed by the
patterns of trustworthiness found through predictability, openness, and justice

(Hargrave & Pfitzer, 2011).
In RT approach, the therapist is careful to evaluate and assess the client in terms of
identity and safety. Because of the nature of brain function, many dis‐regulated pri-
mary emotions develop a pattern of being likely to occur frequently from childhood
into adulthood. Also, these primary emotions illicit predictable patterns of reactivity
of actions such as blame, shame, control, and escape/chaos. Although this reactivity is
rooted in behavioral actions, they do have secondary emotional artifacts (Hargrave &
Hammer, 2016). Using this framework of predictable primary emotions and resulting
reactivity during emotional dis‐regulation, the RT therapist is able to construct a cog-
nitive map for the client delineating the pain cycle (Hargrave & Pfitzer, 2011). The
focus of therapy then takes the direction of helping clients focus on a self‐regulating
emotional “truth,” or primary reality individuals feel will regulate the previously trig-
gered emotion. This focus goes beyond simple cognitive‐behavioral focus, but also
includes experiential activities, imagery, repetition of regulating emotions, and role
play demonstration with other family members (Hargrave & Pfitzer, 2011). The
intent of such work is to help individuals self‐regulate emotions associated with attach-
ment injuries and emotional pain and not to conflate vertical relationship attachment
issues into horizontal relationship. This does not mean family members or partners do
not engage in emotional and experiential intimacy in therapy; rather RT maintains
that intimacy is most likely to occur when relational partners are regulated and
engaged versus emotional co‐regulation (Hargrave & Hammer, 2016).
RT then focuses the therapy on the relational interactions using the regulating
emotions of the “truth” to promote the individuals to make choices of actions that are
not governed by reactivity, but rather a sense of peaceful choice. This process is also
delineated in a cognitive map called the peace cycle (Hargrave & Pfitzer, 2011). The
RT therapist is then able to utilize both the pain and peace cycles in a mindfulness
practice process called the four steps. In this process, first the clients are taught expe-
rientially to observe when they are emotionally dis‐regulated to slow down the pro-
cess by saying what they feel related to the pain cycle. Second, the clients will say out
loud what they normally do in terms of reactivity when they are triggered by their pain.
Third, clients are encouraged to say their self‐regulating truth out loud to gain the
benefits of previous experiential processing and emotionally regulate themselves
(Hargrave & Hammer, 2016). Finally, clients then integrate the experience by saying
and doing what they want different in terms of actions. These four steps are the mind-
fulness practice piece of RT, which occurs both in therapy and eventually into rela-
tionships and being outside of therapy (Hargrave & Pfitzer, 2011).
Conclusion
From the beginning of therapeutic processes, there has been a focus on early family‐
of‐origin relationships and how the dynamics of interactions and emotions have
shaped individuals in the transgenerational process. Here, we have tried to clearly
articulate how those processes in the transgenerational theories are indeed still alive in
present in therapy, albeit evolved through the experiential therapies and more cur-
rently in the therapies that also integrate the physical and neurobiological dimensions.
We are still focusing on the past in SFT and will do so for a long time to come.
References
Ainsworth, M. D. S. (1967). Infancy in Uganda: Infant care and the growth of love. Oxford,
England: Johns Hopkins Press.
Bartle‐Haring, S., Ferriby, M., & Day, R. (2018). Couple differentiation: Mediator or modera-
tor of depressive symptoms and relationship satisfaction? Journal of Marital and Family
Therapy, 00, 1–15. doi:10.1111/jmft.12326
Baumeister, R. F., & Tierney, J. (2012). Willpower: Rediscovering the greatest human strength.
New York, NY: Penguin.
Boszormenyi‐Nagy, I., & Framo, J. L. (1965). Intensive family therapy: Theoretical and practi-
cal aspects. New York, NY: Harper & Row.
Boszormenyi‐Nagy, I., Grunebaum, J., & Ulrich, D. (1991). Contextual therapy. In A. S.
Gurman & D. P. Kniskern (Eds.), Handbook of family therapy (Vol. II, pp. 200–238). New
York, NY: Brunner/Mazel.
Boszormenyi‐Nagy, I., & Krasner, B. R. (1986). Between give and take: A clinical guide to con-
textual therapy. New York, NY: Brunner/Mazel.
Boszormenyi‐Nagy, I., & Spark, G. M. (1973). Invisible loyalties: Reciprocity in intergenera-
tional family therapy. New York, NY: Harper & Row.
Boszormenyi‐Nagy, I., & Ulrich, D. N. (1981). Contextual family therapy. In A. S. Gurman &
D. P. Kniskern (Eds.), Handbook of family therapy (pp. 159–186). New York, NY:
Brunner/Mazel.
Bowen, M. (1966). The use of family theory in clinical practice. Comprehensive Psychiatry, 7,
345–374. doi:10.1016/s0010‐440x(66)80065‐2
Bowen, M. (1972). On the differentiation of self. In J. Framo (Ed.), Family interaction: A
dialogue between family researchers and family therapists (pp. 111–173). New York, NY:
Springer.
Bowen, M. (1978). Family therapy in clinical practice. New York, NY: Aronson.
Bowlby, J. (1969). Attachment and loss, Vol. 1. Attachment. New York, NY: Basic Books.
Erikson, E. (1963). Childhood and society. New York, NY: Norton.
Fairbairn, W. D. (1952). An object‐relations theory of the personality. New York, NY: Basic.
Framo, J. L. (1981). The integration of marital therapy with sessions with family of origin. In
A. S. Gurman & D. P. Kniskern (Eds.), Handbook of family therapy (pp. 133–158). New
York, NY: Brunner/Mazel.
Framo, J. L. (1982). Explorations in marital and family therapy: Selected papers of James L.
Framo. New York, NY: Springer.
Framo, J. L. (1992). Family‐of‐origin therapy: An intergenerational approach. New York, NY:
Brunner/Mazel.
Freud, S. (1940). An outline of psychoanalysis (Vol. 23, Standard Edition). London, UK:
Hogarth Press.
Freud, S. (1959). Fragment of an analysis of a case of hysteria. Collected papers. New York, NY:
Basic Books.
Gangamma, R., Bartle‐Haring, S., & Glebova, T. (2012). A study of contextual therapy theo-
ry’s relational ethics in couples therapy. Family Relations, 61(5), 825–835.
doi:10.1111/j.1741‐3729.2012.00732.x
Giovacchini, P. (1987). A narrative textbook of psychoanalysis. London, UK: Aronson.
Goldenberg, H., & Goldenberg, I. (2013). Family therapy: An overview. Belmont, CA:
Brooks/Cole.
Goldenthal, P. (1996). Doing contextual therapy: An integrated model for working with indi-
viduals, couples and families. New York, NY: Norton.
Grames, H. A., Miller, R. B., Robinson, W. D., Higgins, D. J., & Hinton, W. J. (2008). A test
of contextual theory: The relationship among relational ethics, marital satisfaction, health
problems, and depression. Contemporary Family Therapy, 30(4), 183–198. doi:10.1007/
s10591‐008‐9073‐3
Greenberg, L. S. (2002). Emotion‐focused therapy: Coaching clients to work through feelings.

Washington, DC: American Psychological Association.
Greenberg, L. S. (1986). Change process research. Journal of Consulting and Clinical
Psychology, 54(1), 4–9. doi:10.1037//0022‐006x.54.1.4
Greenberg, L. S., & Johnson, S. M. (1988). Emotionally focused therapy for couples. New York,
NY: Guilford.
Hanna, S. M. (2014). The transparent brain in couple and family therapy: Mindful integrations
with neuroscience. New York, NY: Routledge.
Hargrave, T. D., & Bomba, A. K. (1993). Further validation of the relational ethics scale.
Journal of Marital and Family Therapy, 19(3), 292–299. doi:10.1111/j.1752‐0606.1993.
tb00990.x
Hargrave, T. D., & Hammer, M. Y. (2016). Restoration therapy. In J. Carlson & S. Dermer
(Eds.), Encyclopedia of marriage, family and couples counseling. Thousand Oaks, CA: Sage.
doi:10.4135/9781483369532.n424
Hargrave, T. D., Jennings, G., & Anderson, W. (1991). The development of a relational ethics
scale.JournalofMaritalandFamilyTherapy,17(2), 145–158. doi:10.1111/j.1752‐0606.1991.
tb00877.x
Hargrave, T. D., & Pfitzer, F. (2003). The new contextual therapy: Guiding the power of give and
take. New York, NY: Routledge.
Hargrave, T. D., & Pfitzer, F. (2011). Restoration therapy: Understanding and guiding healing
in marriage and family therapy. New York, NY: Routledge.
Heatherington, L., Friedlander, M. L., & Greenberg, L. (2005). Change process research in
couple and family therapy: Methodological challenges and opportunities. Journal of Family
Psychology, 19, 18–27. doi:10.1037/0893‐3200.19.1.18
Johnson, S. M. (2004). The practice of emotionally focused couple therapy (2nd ed.). New York,
NY: Brunner/Routledge.
Keith, D. V. (2000). Symbolic experiential family therapy. In A. M. Horne (Ed.), Family coun-
seling and therapy (3rd ed.). Itasca, IL: Peacock.
Kerr, M. E., & Bowen, M. (1988). Family evaluation: An approach based on Bowen theory. New
York, NY: Norton.
Klein, M. (1946). Notes on some schizoid mechanisms. International Journal of Psychoanalysis,
27, 99–110. doi:10.1080/21674086.1949.11925749
Larner, G. (2004). Family therapy and the politics of evidence. Journal of Family Therapy, 26,
17–39. doi:10.1111/j.1467‐6427.2004.00265
Lee, B. K. (2002). Development of a congruence scale based on the Satir model. Contemporary
Family Therapy, 24(1), 217–239.
McGoldrick, M., Gerson, R., & Petry, S. (2008). Genograms: Assessment and intervention (3rd
ed.). New York, NY: Norton.
Meiden, J. V. D., Noordegraaf, M., & Ewijk, H. V. (2017). Applying the paradigm of relational
ethics into contextual therapy: Analyzing the practice of Ivan Boszormenyi‐Nagy. Journal
of Marital and Family Therapy, 44(3), 499–511. doi:10.1111/jmft.12262
Meiden, J. V. D., Noordegraaf, M., & Ewijk, H. V. (2018). How is contextual therapy applied
today? An analysis of the practice of current contextual therapists. Contemporary Family
Therapy, 41(1), 1–12. doi:10.1007/s10591‐018‐9467‐9
Miller, R. B., Anderson, S., & Keals, D. K. (2004). Is Bowen theory valid? A review of basic
research. Journal of Marital and Family Therapy, 30(4), 453–466.
doi:10.1111/j.1752‐0606.2004.tb01255.x
Mitten, T. J., & Connell, G. M. (2004). The core variables of Symbolic‐Experiential Therapy:
A qualitative study. Journal of Marital and Family Therapy, 30, 467–478.
doi:10.1111/j.1752‐0606.2004.tb01256.x
Morris, A. S., Criss, M. M., Silk, J. S., & Houltberg, B. J. (2017). The impact of parenting on
emotion regulation during childhood and adolescence. Child Development Perspectives, 11,
233–238. doi:10.1111/cdep.12238
Pan, P. J. D. (2000). The effectiveness of structured and semi‐structured Satir model groups on
family relationships with college students in Taiwan. The Journal for Specialists in Group
Work, 25(3), 305–318. doi:10.1080/01933920008411469
Papero, D. V. (1995). Bowen’s family systems and marriage. In N. S. Jacobson & A. S. Gurman
(Eds.), Clinical handbook of couple therapy. New York, NY: Guilford.
Patterson, J. E., Miller, R. B., Carnes, S., & Wilson, S. (2007). Evidence‐based practice for
marriage and family therapists. Journal of Marital and Family Therapy, 30, 183–195.
doi:10.1111/j.1752‐0606.2004.tb01233.x
Ross, A. S., & Murdock, N. L. (2014). Differentiation of self and well‐being: The moderating
effect of self‐construal. Contemporary Family Therapy, 36(4), 485. doi:10.1037/
e551352014‐001
Sander, F. M. (1998). Psychoanalytic couple therapy. In F. M. Dattilio (Ed.), Case studies in
couple and family therapy: Systemic and cognitive perspectives (pp. 427–429). New York,
NY: Guilford Press.
Satir, V. M. (1964). Conjoint family therapy. Palo Alto, CA: Science and Behavior Books.
Satir, V. M. (1972). Peoplemaking. Palo Alto, CA: Science and Behavior Books.
Satir, V. M. (1982). The therapist and family therapy: Process model. In A. M. Horne & M. M.
Ohlsen (Eds.), Family counseling and therapy (pp. 12–42). Itasca, IL: Peacock.
Satir, V. M., & Baldwin, M. (1983). Satir step by step: A guide to creating change in families.
Palo Alto, CA: Science and Behavior Books.
Satir, V. M., Banmen, J., Gerber, J., & Gomori, M. (1991). The Satir model: Family therapy and
beyond. Palo Alto, CA: Science and Behavior Books.
Shadish, W. R., & Baldwin, S. A. (2003). Meta‐analysis of MFT interventions. Journal of
Marital and Family Therapy, 29, 547–570.
Shapiro, S. L., & Carlson, L. (2009). The art and science of mindfulness. Washington, DC:
American Psychological Association.
Siegel, D. J. (2015). The developing mind (2nd ed.). New York, NY: Guilford Press.
Spitz, R., & Wolf, K. (1946). Anaclitic depression: An inquiry into the genesis of psychiatric
conditions early in childhood. Psychoanalytic Study of the Child, 2, 313–342. doi:10.1080
/00797308.1946.11823551
Sullivan, H. S. (1953). The interpersonal theory of psychiatry. New York, NY: Norton.
Wampold, B. E. (2001). The great psychotherapy debate: Models, methods, and findings. Mahwah,
NJ: L. Erlbaum Associates.
Whitaker, C. A., & Bumberry, W. M. (1988). Dancing with the family: A symbolic experiential
approach. New York, NY: Brunner/Mazel.
Whitaker, C. A., & Keith, D. V. (1981). Symbolic experiential family therapy. In A. S. Gurman
& D. P. Kniskern (Eds.), Handbook of family therapy (pp. 187–225). New York, NY:
Brunner/Mazel.

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14

It is essential to remember that transgenerational theories themselves did not develop

Bowen family systems theory

Contextual family therapy

Framo’s object relations/family‐of‐origin therapy

The early transgenerational theories definitely made an impact in the psychotherapy

Symbolic experiential family therapy

The Satir model

Current state of transgenerational and experiential theories

The Third Iteration of Theories

Emotion‐focused therapy and emotionally focused couple therapy

emotional expression, regulation, and understanding. Further, the approach works to

patterns of trustworthiness found through predictability, openness, and justice

Greenberg, L. S. (2002). Emotion‐focused therapy: Coaching clients to work through feelings.

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