Ethical and Practical Implications of Intergenerational Family Therapy
Authors: Ivan Boszormenyi-Nagy
Journal: Psychotherapy and Psychosomatics (1974)

Family therapy and its basis – relationship theory – constitute a new outlook rather than another method for psychotherapy. The new outlook originates as much from a state of bankruptcy of the value base of traditional psychotherapy as from the accumulating experience of therapists who work with whole families as relational gestalts. The essence of family therapy itself lies in the therapist's commitment to all members of the family relationship system. In the advocacy model of individual psychotherapy the offering of confidential alliance to one family member implicitly denies the right for the other members and their aspirations to be considered by the therapist, even when the 'patient' behaves in a patently exploitative manner toward the other. The realization that when close relationships end, they can become intermitently mutually exploitative, leads the family therapist to a reciprocally balanced commitment, based on 'multidirectional partiality', empathizing with now one, then another family member, according to the issue at hand. Rather than refusing to concern himself with the members' convictions about exploitation, the therapist should welcome the family members' active search for justice as a potentially good prognostic sign. Not every family has a capacity for facing and working through the difficult, value-laden implications of close relationships. This reorientation toward the dynamics of balance versus imbalance in relationships radically alters the values and goals of psychotherapy, whether members are treated individually or conjointly. As a result, traditional, non-dialectical psychotherapeutic values of assertiveness, adjustment, effectiveness, genital competence, increased consciousness through insight, self-actualization, health, etc., become limited goals which have to be integrated into a balanced multipersonal and even multigenerational context of loyalty, fairness, and mutuality. Facing the multigenerational ledgers of obligations and designing corresponding action strategies become the deeper dimensions of intergenerational family therapy. It is the revaluation of the merits of instinct, pleasure, self-actualization and power models that builds the bridge toward the social systems model of psychotherapy in general and family therapy in particular. Instead of being a congeries of discrete, simultaneously struggling, self-assertive individuals, the social network emerges then as a system held together by visible and invisible loyalties and put under strain by inevitable structural exploit-ativeness. Aside from its profound effect on therapeutic goals, the shift in value orientation has fundamental implications for community mental health practices and a wide variety of social functions. To mention only one example, law and court functions obtain a thoroughly different meaning when viewed in the light of the recently discovered, unconsciously collusive relational structures, instead of the traditional individual based framework. Ultimately, relationship theory and intergenerational family therapy will offer a renewed definition of both health and prevention in the field of mental function.