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-The base of all of the therapeutic work
that I do is based out of family systems,
which really looks
at not just the individual, but all of the relationships.
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-Relationships.
Everybody's got them,
whether they be romantic, familial,
platonic, or something else.
Each relationship brings its own unique dynamics.
In this episode, we delve into the profound realm
of relational therapy,
a discipline that expands the approach
to traditional therapeutic methods.
As historical stigmas continue to fade and more people
recognize the benefits of therapy,
a positive embracement of the role of connections
and relationships builds.
Whether you're a seasoned advocate of therapy
or just beginning to explore its potential,
prepare yourself for a journey of discovery,
empathy, and connection.
Welcome, as we look at the ever-evolving
world of therapy
and a job you could have in the field.
At its most stereotypical level,
misconceptions around therapy often involve the idea
that a therapist fixes what's going on
in a client's life,
usually while the client is lying on a couch.
That notion doesn't begin to capture the actual work
being done in and around the therapy space.
A better comparison might be to think of a therapist
as a teacher, a coach, and a supporter who's providing
tools rooted in evidence-based study to help a client navigate
the challenges they may face.
A marriage and family therapist adds a layer
to that with training in group dynamics
that helps not only individuals, but couples and families
understand the root of their conflicts
and build healthier relationships
moving forward.
-Therapy in itself is the process of helping
an individual create some type of change.
Usually, that change is an emotional
or a behavioral change.
-That's Dr. Deborah Moore.
She is a licensed marriage and family therapist
in New York City.
-Relational therapy, on the other hand,
is when you're taking two or more individuals
and you're trying to help them create that change,
whether it be a couple or a family.
-Using the example of a couple, an MFT would work with them
to understand their unique relationship
and dynamic by understanding how they function both
as individuals
and together.
Licensed marriage and family therapist,
Shelby Riley,
has practiced relational therapy for years and helped
numerous couples and individuals.
-Most marriage and family therapists
are trained in family systems.
The base of all of the therapeutic work
that I do is based out of family systems,
which really looks at not just the individual,
but all of the relationships.
-Marriage and family therapists are able to consider
the various types of relationships
in someone's life,
whether that be families, couples,
friendships, or working environments.
-Even if I just have one person in the room,
I'm considering who they're living with.
I'm considering the relationships
that they're in in their home.
I'm considering the relationships
they're in at work.
I'm considering the relationships
that they're in in their families of origin.
What are the dynamics we need to be aware
of that are contributing
to maybe some of the difficulties
and that can contribute to some of the positive change?
What we want to do is make changes that benefit
the entire system
and not just the one person that you might happen to have
in the room with you.
-Just like a spiderweb, families consist of overlapping
relationships.
A family of five, for example, has more
than 20 different relationships
between different members of the family.
It becomes an even higher number when taking
into consideration someone's relationship
with themself.
Michael Chafin is an MFT
and former president of the American Association
for Marriage and Family Therapy.
-Relational therapy
doesn't identify
the symptom.
It focuses on the context of the family system
and the work systems and the systems that surround
the individual.
It doesn't just treat mental illness
as if mental illness resides somehow
in your bloodstream.
-Marriage and family therapists use a holistic approach
to treatment,
focusing on fostering positive change in both
the individual and the system in which they live.
-Let's say, for example, I started my career
by seeing teenagers and their families.
When you work with a teenage girl
who has anorexia nervosa and her weight gets
to be too low
and they seek out therapy
and the therapist says, "Your medical situation
is so dire that I think you need to go inpatient."
They'll do a week or sometimes even 30 days
at a hospital
to get their weight up and to receive
treatment.
Let's say
this teenager gets out of the hospital
and she goes back home.
If the home environment and the family system
isn't engaged in the treatment process,
then the teenager will revert back to the original symptoms.
We've known for a long time that the family system needs
to change along with the treatment
of the individual.
-MFTs acutely understand the impact our relationships
and broader environment have on our emotional well-being.
An essential goal for therapy is guiding clients toward
a deeper understanding of themselves that integrates
a holistic perspective.
-As a relational therapist, you're trying to help
one individual
perhaps empathize with another individual
and vice versa.
When a relational therapist looks at an individual,
they look at it from a systemic or a holistic perspective.
They often take into consideration
a biopsychosocial perspective.
They're going to look at the biology,
is there anything going on medically
that may be affecting this partner?
Is there anything social that's going
on or are there any other psychological issues?
They're looking at it
from a very holistic perspective.
-Coming up.
-There are a thousand ways to have
a good romantic relationship.
There are a thousand ways to parent children
well.
Really what you want to look at is how is it working
for this particular family.
-Earlier, we met the therapists who are dedicating themselves
to the field of marriage and family therapy.
They discussed the importance of relational therapy,
which focuses on the connections between members of a group.
Let's take a look at what those connections
can mean.
Let's take a family of four, for example.
Two parents, mom and dad, one child,
junior, and one grandparent.
Let's call this one grandma, who is the father's mother.
Each of these individual family members
have a different relationship with each other family member.
Mom and Dad have a romantic and co-parenting relationship.
Each of the parents has
a different parent-child relationship
with Junior.
Grandma has a different relationship
with her son than she does with her daughter-in-law.
Junior and grandma also have a relationship that is unique
to the rest.
We can begin to see how this web of relationships
can become messy,
particularly when we begin to look
at cross-generational communication
and the power dynamics that may exist in this family.
When even one relationship is out of whack,
it can affect the entire web.
Problems that might seem small to some can snowball
into larger issues,
threatening the well-being of every other relationship.
That's where marriage and family therapy comes in.
-There are three broad categories of stress.
You may have physical stress.
Physical stress could be anything from injuries,
accidents, falls.
You can have chemical stressors, which can be viruses,
blood sugar levels, bacteria, heavy metals,
toxins in the body.
You can have psychosocial stressors,
which could be poverty, unemployment,
single parenting.
You need to understand as a therapist
how these different types of stressors
are not only impacting one partner
but how it's impacting their partner or their family.
-When it comes to support,
one of the most important elements
is privileging relationships.
This means prioritizing the time you spend
with certain people because they mean more to you.
-I think about a few clients that I've had.
where work is so stressful,
that they're putting so much time
and attention on how to do a good job
in one area of their life, that they maybe take
their partner and their children for granted,
and they go, "Well they love me, they get it.
If I don't see them,
they know that the work I'm doing is for them,"
and so therefore, they can just go be over there.
What I will say to them is that it sounds like work
has felt like crisis after crisis after crisis,
that you have to prioritize in order to keep your job,
but right now, what we really need
to do at this juncture,
is make your relationships the crisis.
This is where you need to put your time and attention
because if we keep just assuming they're going to stick
around as you put out all these fires over here,
they're telling us very clearly that they're hurt,
and they're lonely, and they need you.
-One of the most famous social experiments,
the Harvard study,
was a lifelong study that followed
children throughout their lives from birth.
While many of its participants are deceased,
the study continues,
tracking the next generation of children
that emerged from the first set of babies
in 1937.
-This longitudinal study basically says
that human satisfaction
and people thrive
based upon the quality of their human relationships.
It basically says
that the better quality family relationships you have,
marital relationships, work relationships,
that the relationships are so important
that most people find more happiness
from their relationships than they do anything else.
-MFTs are unique in their approach
because they understand clients
within the context of their situations,
which can improve the client's likelihood
to achieve desired outcomes.
Much like the Harvard study, MFTs attempt to understand
all the factors that contribute to a client's behaviors.
-There are a thousand ways to have
a good romantic relationship.
There are a thousand ways to parent children well.
Really what you want to look at is how is it working
for this particular family.
-Shelby remembers two cases she had
at the same time with similar situations.
The context, however, led her to handle
these cases so differently.
-One was a newer romantic relationship,
and one partner was from a family culture
that really prioritized family time.
Three times a week, they were expected
to be over at the parents' house.
All the siblings were there.
They would do these big family dinners.
There was all of this dynamic.
The new partners had an issue with how much time
was expected of them in this larger family system.
Another different client
had
a mother-daughter relationship.
The woman in this relationship had a mother
where they had been really, really enmeshed
their whole lives.
The mom had a very tight hold on her adult daughter
and really needed a lot from her.
The daughter felt very guilty not being
with her mom so much.
We're going to treat these two things differently.
Although they are all about boundaries,
they're all about navigating time
and attention and which relationship
do you prioritize.
Because of the context where one is very deeply embedded
in culture, we want to approach that a little bit differently
than we might a sort of more dysfunctional
mother-daughter relationship
that might need a little bit more boundary
and attention
in certain ways. -Dr. Moore recounts working
with her own client,
a young woman in a relationship who struggled
with emotional outbursts.
-She wants to elevate her relationship
with her partner.
Every time she has talks with her partner,
it doesn't go well.
We went over different techniques
that she could do in order to control or regulate
her responses.
We did mental rehearsal.
We did visualization where I had her visualize
and mentally rehearse what is that conversation
going to look like that you're going to have
with your significant other.
Then the second piece of that was what
is that going to feel like when you're having
this conversation with your partner?
She was able to do that, and the partner agreed
that maybe they should become exclusive
and take their relationship to the next level.
-The tools Dr. Moore provided her client
were broadly applicable to many other situations.
-She came back into session, and she told me how she used
the mental rehearsal, visualization,
and the elevated feelings to be able to have
a talk with her boss.
She was working in an environment where she felt
that she wasn't being appreciated
and that she deserved the promotion.
She had this hard conversation with her boss,
and they were able to understand each other.
Subsequently, she did get a promotion.
When a client comes up each week,
and they are showing up, they are doing the work,
and they're able to take what they're learning in session
to the outside world, to me, I know they got it.
They're transforming.
-Coming up.
-It's up to the younger generation
to pull up to school,
pull up a seat at the desk, and say,
"Listen, this is going to impact my generation.
It's going to impact generations beyond me.
How can I make a difference?"
-In relational therapy, challenges are not barriers,
but opportunities for growth.
Each knot of conflict is a tapestry waiting
to be unraveled,
revealing threads that bind clients to their past,
to themselves, and to each other.
For our dedicated therapists, they step into the arena
armed not with tools,
but with empathy and open hearts.
Just like any profession, marriage and family therapists
have to deal
with their profession's unique challenges.
-The field is challenging because you're taking
two individuals or more sometimes,
and you're trying to get them on the same page.
Sometimes it's not even the same page.
We need to get them in the same book
because their realities are so different.
I often say that some people are addicted
to emotions.
What does that mean?
Just like you can have an addiction to shopping,
the internet, sex, food,
gambling.
There are some couples and some people
that are just addicted to emotions,
their emotional responses.
They are still holding on
to emotions that were 10 or 15 years ago.
Trying to help them lessen these emotional responses can be
a challenge as a relational therapist.
-While Deborah discusses challenges with clients,
Shelby recounts a time where work bled
into her personal life.
-Living in a small town and working
in the same small town can provide
some of those unique situations where I end up missing out
on some things that I might really like to do.
I've been, like say, in a book club
and it's just me and some community people
and some friends.
Then new members come in and one of them is
my client.
Then it's that situation where you're like,
I love this book club.
It's been super fun for me.
That we can't really be in book club together
because it really changes the dynamic of our relationship.
We have really, really strict ethical guidelines
about outside relationships and dual relationships.
It really is my responsibility to probably leave that book club
so that my client can enjoy it.
-Outside of the challenges within their practice
and professional lives,
many therapists are also small business owners
and must manage the day-to-day functions
that keep the lights running.
-A lot of therapists don't become therapists
because they're interested in owning their own businesses.
They really have to learn how to do that.
Personally, I balance it by spending as much time
on my business as I do working in the business.
If you see 20 clients a week,
for therapy,
I make sure that I spend another 15 or 20 hours
in the week focused on the practice
and the business side.
That way I can balance not only the workload
but make sure I tend to the business.
-It is a lot to be a therapist and a business owner
and to support a team of therapists.
I take that role really seriously.
I am really passionate about supporting therapists
and providing therapists with a lot of support
and structure so that they can do
their best work.
We also meet together for group supervision
once a month.
We go to trainings together.
When we sort of see changes
in the landscape of what families
are dealing with,
we make sure that we go and we get trained together
on these new issues
and these new ways of approaching things.
I also do quite a bit of oversight when it comes
to like their clinical paperwork and making sure
that they know what they are charting properly
and getting paid properly.
-Like most healthcare and wellness professions,
marriage and family therapy requires a love
for continuous education,
something Deborah knows a lot about.
-For me, it's not about work.
It's about doing what I love.
I can say one of the highlights of my career
is being in academia.
I do teach.
Just to be able to prepare the younger generation
for the field is something that has been
a great reward.
I think it's so ever important that younger people do enter
into this field so that way they can have
a say-so in terms of how the future of relations
will impact them.
We're going through such a tremendous social shift
right now in our society.
Why wouldn't you want the younger people
in there studying?
Why wouldn't you want them looking
at some of the theories
that may have been around for 50 or 60 years and saying,
"You know what?
This is no longer supporting our needs.
Maybe we need to do things a little bit differently."
I think it's up to the younger generation
to pull up to school,
pull up a seat at the desk, and say,
"Listen, this is going to impact my generation.
It's going to impact generations beyond me.
How can I make a difference?"
-Deborah predicts that the future of marriage
and family therapy will see therapists expanding
the reach of their services.
-Within the next few years, you're going to find MFTs
working alongside psychologists, psychiatrists.
You're going to find them working
in the government.
You're going to find them working
with veterans.
If you have a forensic case where you have two parents
who are having custody battles over a child,
who better to evaluate that child than an MFT?
-Shelby's love for her career gives her the ability
to wear many hats.
-It is really the most gratifying thing
in the whole entire world to be invited
into somebody's personal life.
When they have mental health issues
like depression, anxiety, mood disorder,
or trauma, it can be really sensitive
and it can be really scary.
For them to trust you is really one of the highest honors.
Then to get to do this work and to see that change,
it is the most amazing thing to know
that you have been allowed to be a part of people
actually feeling and functioning in a much better way.
-Like a fine-tuned ecosystem, thriving relationships are key
to diverse and vibrant individuals
whose presence beautifies and contributes to the whole.
Marriage and family therapists remediate these environments
to reach their potentials.
Thanks for watching.
I'm your host, Kristin Marand, and we'll see you
on the next episode as we explore
the jobs of tomorrow.
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