ABSTRACT
All psychoanalysts and psychodynamically inclined therapists have a deep interest, I assume, in the understanding of family relationships. Ever since Freud described the family constellation in terms of the oedipal situation, the psychoanalytic process has included as one of its central tasks the untangling of the web of current and past family relationships. In individual psychoanalytic and psychotherapeutic treatment, the primary concern is, however, with the internalized, intrapsychic representations of the patient's family relationships, rather than with the direct observation and study of actual, ongoing family transactions. In this chapter, I shall consider some of the circumstances under which direct psychotherapeutic work with family units seen conjointly may be indicated or, on the other hand, contraindicated.1 The problem I raise is not whether
290 INTENSIVE FAMILY THERAPY
I approach this problem with an investigative spirit, not with the intent of making doctrinaire pronouncements or promulgating an ideologic, family-therapy party line. Let me state at the outset that I do not regard family therapy as a psychiatric panacea, but as a valuable addition to our psychiatric repertory. On the one hand, I consider family therapy as the treatment of choice under certain conditions, which I shall attempt to specify. On the other hand, certain limitations, some of which are intrinsic to family therapy and others of which are imposed by external, practical considerations, restrict the range of problems for which this treatment approach is appropriate. Comparable considerations apply to every form of psychiatric treatment; through exploration of the especially advantageous and disadvantageous conditions for using each approach, we may eventually be able to become both more ~pecific and more comprehensive in making treatment recommendations than is presently possible.
