Family Sculpting

Another technique that serves as both assessment and intervention is that of family sculpting (Satir, 1988). Most commonly, the therapist asks one family member to place other family members in a physical pose, as if in a sculpture, to represent the way that sculptor views the family functioning. The therapist may ask for three sculpts: one from an important time in the past, one in the present, and one that shows how the family member would like to see the family functioning in the future. This exercise is often more revealing than verbal description. Each family member may get a chance, so that differing perspectives (e.g., from a married couple) may be illuminated and discussed.

For example, when asked to sculpt how the couple’s relationships is at present, Stella set herself in one corner working and her husband Bill in another. Bill’s sculpt was similar, except he was playing racquetball while Stella was at home reading. When asked how she wanted it to be, Stella sat herself and Bill side by side, very still, each staring lovingly at their interlocking hands. For his part, Bill walked the couple around a garden pointing out interesting plants and flowers. This exercise revealed the couple’s differing temperaments and goals for the relationship much more vividly than their earlier verbal descriptions.

Positively Connoting the Resistance to Change

In individual psychotherapy, the therapist works to understand what stands in the way of a patient resolving a problem. In family therapy, this same process becomes an interactional exercise as the therapist positively connotes the resistance. This positive connotation allows the patient and family to advocate for change.

With Stella and Bill, for example, the therapist posited that Stella must have good reasons for blanking out, perhaps things she didn’t want to hear or say to Bill, given their long-term love and devotion to each other. This comment led to Stella watching for her own anger just before blanking out. With Bill, the therapist commented that he must recognize the importance of expressing negative feelings in a relationship. Perhaps his feelings were so intense because he was expressing them for both members of the couple. If Stella were able to begin to express her own irritations or anger, perhaps Bill could take responsibility for expressing his in a more appropriate way. Positively connoting Bill’s behavior allowed him to take charge of his anger without inducing shame that would only result in more symptoms.

Genograms and Time Lines

Genograms and time lines are invaluable tools for the family therapist to organize the complicated data about a family’s history and relationships. These tools are often interventions in and of themselves. Posting them on easel paper allows the family to see holes in their information (such as when Diana didn’t know her biological father’s name) and patterns across generations (“I never realized how many divorces there are in my family until we put it up on the board like this”). Time lines allow families to associate important events, such as job loss, illness, or death, with the development of symptoms.

Sandy and Sean came to therapy because of Sandy’s loss of sexual desire. In the second session, the therapist suggested they draw a time line beginning with when they met, including all the important events from that time forward. Both members of the couple realized that Sandy’s sexual desire waned after the birth of their third child, which occurred soon after the death of her mother. This association allowed for a focus on unresolved grief before returning to strengthening the couple’s intimacy, both verbally and physically. Genograms and time lines also reduce the blaming that can occur in families when intimacy fails.