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had to be modified to first destructure the family’s rigid patterns, and then restructure them in order to permit greater flexibility. In the process, therapeutic efforts were directed not only at changing the structure of relationships within the family but also at helping the family develop clearer boundaries, learn to negotiate for desired changes, and deal more directly with hidden, underlying conflicts. According to Colapinto (1991), the Minuchin team’s family-focused success in treating anorexia nervosa—which, unlike diabetes or asthma, has no physiological basis—drew many family therapists to the structural model.

STRUCTURAL FAMILY THEORY

As Minuchin (1974) describes his viewpoint:

In essence, the structural approach to families is based on the concept that a family is more than the individual biopsychodynamics of its members. Family members relate according to certain arrangements, which govern their transactions. These arrangements, though usually not explicitly stated or even recognized, form a whole—the structure of the family. The reality of the structure is of a different order from the reality of the individual members. (p. 89)

Like most systems theorists, the structuralists are interested in how the components of a system interact, how balance or homeostasis is achieved, how family feedback mechanisms operate, how dysfunctional communication patterns develop, and so forth. Consistent with Minuchin’s background in child psychiatry, he influenced his associates to observe too how families cope with developmental tasks as the family matures, and particularly how families, as complex systems, make adaptive changes during periods of transition. Structuralists pay special attention to family transactional patterns because these offer clues to the family’s structure, the permeability of the family’s subsystem boundaries, and the existence of alignments or coalitions—all of which ultimately affect the family’s ability to achieve a delicate balance between stability and change. Before an individual’s symptoms can be reduced or extinguished, according to this model, structural changes must first occur within the family.

Family Structure

Just as is the case with all adapting organisms, families need some form of internal organization that dictates how, when, and to whom to relate; the subsequent transactional patterns make up the structure of the family (Colapinto, 1991). Put another way, a family’s structure is the invisible or covert set of functional demands or codes that organizes the way family members interact with one another (Minuchin, 1974). In essence, the structure represents the sum of the operational rules the family has evolved for carrying out its important functions. It provides a framework for understanding those consistent, repetitive, and enduring patterns that reveal how a particular family organizes itself in order to maintain its stability and, under a changing set of environmental conditions, to seek adaptive alternatives. Typically, once established, such patterns are self-perpetuating and resistant to change. They are unlikely to change until a family’s changing circumstances cause tensions and imbalance within the system.

For example, an interactive routine may evolve in a family whereby the young son refuses to comply with his mother’s pleading to clean up his room, but will submit to his father’s request without hesitation. Repeated over time, and in a variety of situations, a basic family structure may emerge in which the father is seen in the family as

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the ultimate authority and the mother as possessing insufficient power or clout to be obeyed.

Subsequent transactional patterns between family members are likely to reflect this now-established interactive blueprint. These patterns serve to arrange or organize the family’s component subunits into more or less constant relationships (Umbarger, 1983) and thus regulate the family’s day-to-day functioning. However, structure in and of itself should not necessarily be thought of as static or fixed. On the contrary, certain temporary structures (a mother-son coalition in which the father is kept in the dark, say, about erratic school attendance or a bad grade) may occur but not persist beyond a brief arrangement, and thus must be considered to be dynamic. It’s the structural therapist’s task to watch for any repeatable family processes in action during therapy sessions, because they lead to detecting faulty or problematic or ineffective patterns that together reveal where the family’s need for restructuring exists.

A family’s transactional patterns regulate the behavior of its members, and are maintained by two sets of constraints: generic or universal rules, and idiosyncratic or individualized rules (Minuchin, 1974). With regard to the former, structuralists contend that all well-functioning families should be hierarchically organized, with the parents exercising more authority and power than the children, and the older children having more responsibilities as well as more privileges than their younger siblings.

In addition, there must be complementarity of functions—the husband and wife, for example, operate as a team and accept their interdependency. The degree to which the needs and abilities of both spouses dovetail and reciprocal role relations provide satisfaction are key factors in harmonious family functioning. In some cases, family balance is achieved by different family members’ being assigned complementary roles or functions (good child–bad child; tender mother–tough father). Thus, complementarity or reciprocity between family roles provides a generic restraint on family structure, allowing the family to carry out its tasks while maintaining family equilibrium. Complementarity takes the form of teamwork in well-functioning families. Idiosyncratic constraints apply to specific families, and involve the mutual presumptions of particular family members regarding their behavior toward one another.

While the origin of certain expectations may no longer be clear to the persons involved, buried in years of implicit and explicit negotiations, their pattern of mutual accommodation, and thus functional effectiveness, is maintained (Minuchin, 1974). The evolved rules and subsequent behavioral patterns of a particular family’s game become a part of the family’s structure, ensuring that the system will maintain itself.

Here some feminists take exception to Minuchin’s insistence on family hierarchies, claiming that they run the risk of reinforcing sex role stereotypes. Luepnitz (1988) argues that Minuchin bases many of his ideas regarding family organization on the work of the influential functional sociologist Talcott Parsons (Parsons & Bales, 1955), who saw normal family life neatly organized according to gender roles, family functions, and hierarchical power. Parsons maintained that adaptation to society requires that husbands perform an“instrumental”role (e.g., making managerial decisions) in the family, and that wives perform “expressive”roles (caring for the family’s emotional needs). Hare-Mustin, as quoted by Simon (1984), believes Minuchin himself models the male executive functions while working with families, in effect demanding that the father resume control of the family and exert leadership much as Minuchin leads and directs the therapeutic session.

Colapinto (1991) contends that the stereotypic division of instrumental vs. expressive roles is not held up as an ideal by Minuchin, but rather that Minuchin believes all

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families need some kind of structure, some form of hierarchy, and some degree of differentiation between subsystems. Thus, a family will try to maintain preferred patterns— its present structure—as long as possible. While alternate patterns may be considered, any deviation from established rules that goes too far too fast will be met with resistance, as the family seeks to reestablish equilibrium. On the other hand, the family must be able to adapt to changing circumstances (a child grows into a young adult; mother goes to work outside the home; grandmother comes to live with them). It must have a sufficient range of patterns (including alternatives to call upon whenever necessary) and must be flexible enough to mobilize these new patterns in the face of impending change, if members are to continue to exist as a family unit. The family must be able to transform itself in ways that meet new circumstances, while at the same time taking care not to lose the continuity that provides a frame of reference for its members.

Family Subsystems

As we pointed out in Chapter 4, families carry out their basic functions in part by organizing themselves into coexisting subsystems, often arranged in hierarchical order. Typically, family subsystem divisions are made according to gender (male/female), generation (parents/children), common interests (intellectual/social), or function (who is responsible for what chores). Beyond these more obvious patterns, various possibilities (older children vs. younger; boys vs. girls; parents vs. teenagers) spring up in most families. All families contain a number of coexisting but separate subsystems.

Subsystems, then, are components of a family’s structure; they exist to carry out various family tasks necessary for the functioning of the overall family system. Each member may belong to several subgroups at the same time, and families are capable of organizing themselves into a limitless number of such units. Each person may have a differing level of power within different subgroups, may play different roles, may exercise different skills, and may engage in different interactions with members of other subsystems within the family. Complementarity of roles (Ackerman’s influence again) is a key here— as Minuchin (1974) points out, a child has to act like a son so his father can act like a father, but he may take on executive powers when he is alone with his younger brother.

Subsystems are defined by interpersonal boundaries and rules for membership; in effect, they regulate the amount of contact with other subsystems. Such boundaries determine who participates and what roles those participants will have in dealing with one another and with outsiders who are not included in the subsystem. They may be based on temporary alliances (mother and daughter go shopping together on Saturday afternoon) and may have rules concerning exclusion (fathers and brothers are unwelcome). Or they may be more enduring (based on generational differences in roles and interests between parents and children) with clearly defined boundaries separating the two generations (one watches public television documentaries, the other MTV). Subsystem organization within a family provides valuable training in developing a sense of self, in the process of honing interpersonal skills at different levels.

The spousal, parental, and sibling subsystems are the most prominent and important subsystems in the family. The strength and durability of the spousal subsystem in particular offers a key regarding family stability. How husband and wife learn to negotiate differences and eventually accommodate to one another’s needs and develop complementary roles tells us a great deal about the likelihood of family stability and flexibility to adapt to changing circumstances.

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While the arrival of children forces the couple to transform their system to now become a parental subsystem grappling with new responsibilities, complementarity of roles remains essential, as the couple negotiates differences in parenting attitudes and styles. Those accommodations to one another’s individual perspectives are apt to continue and get renegotiated as children grow and require different parental responses at different stages of their lives. It is crucial at the start and throughout parenting that, whatever the demands of child rearing and the efforts expended toward the evolvement of an effective parental subsystem, the parents continue to work at maintaining and strengthening their spousal subsystem, which is fundamental to family well-being.

The sibling subsystem offers the first experience of being part of a peer group and learning to support, cooperate, and protect (along with compete, fight with, and negotiate differences). Together, the children comprising this subsystem learn to deal with the parental subsystem in order to work out relationship changes commensurate with the developmental changes they are going through. In a well-functioning family, all three subsystems operate in an integrated way to protect the differentiation, and thus the integrity, of the family system.

Boundary Permeability

The specific composition of any subsystem is not nearly as important as the clarity of its boundaries. Put another way, boundaries within a family vary in their flexibility or permeability, and that degree of accessibility helps determine the nature and frequency of contact between family members. Clearly defined boundaries between subsystems within a family help maintain separateness and at the same time emphasize belongingness to the overall family system. In an ideal arrangement, the clarity enhances the family’s overall well-being by providing support and easy access for communication and negotiation between subsystems whenever needed, while simultaneously encouraging independence and the freedom to experiment by the members of the separate subsystems. The autonomy of members is not sacrificed, but at the same time the boundaries remain flexible enough so that care, support, and involvement are available as needed. An important benefit of such clarity becomes apparent whenever the family attempts to make structural changes over time to accommodate to changing life circumstances.

Excessively rigid or inflexible boundaries lead to impermeable barriers between subsystems. In this case, the worlds of parents and children—the generational hierarchy— are separate and distinct; the members of neither subsystem are willing or able to enter into the other’s world. With parents and children unable to alter or cross subsystem boundaries when necessary, autonomy may be maintained, but nurturance, involvement, and the easy exchange of affection with one another are typically missing. While the child in such a family may gain a sense of independence, it often comes at the price of feeling isolated from others and unsupported during critical times.

Diffuse boundaries are excessively blurred and indistinct, and thus easily intruded upon by other family members. Here, parents are too accessible, and contact with their children may take the form of hovering and the invasion of privacy. Children run the risk of becoming too involved with their parents, in the process failing to develop independent thinking and behaving or to learn the necessary skills for developing relationships outside the family. Because there is no clear generational hierarchy, adults and children may exchange roles easily, and a member’s sense of self or personal identity becomes hard to establish for later adulthood. Here children may feel

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supported and cared for by parents, but it is often at the expense of feeling free to take independent (and possibly disapproved of ) actions.

In a well-functioning family, clear boundaries give each member a sense of“I-ness” along with a group sense of “we”or“us.” That is, each member retains his or her individuality but not at the expense of losing the feeling of belonging to a family. Most family systems fall somewhere along the continuum between enmeshment (diffuse boundaries) and disengagement (rigid boundaries); see Minuchin et al., 1967. Most families are neither totally enmeshed nor totally disengaged, although they may contain enmeshed or disengaged subsystems. Minuchin and Nichols (1993) describe a familiar, if troubled, middle-class family pattern in which a disengaged father is preoccupied with work and neglectful of his wife and children, and an enmeshed mother is overinvolved with her children, her closeness to them serving as a substitute for closeness in the marriage.

Enmeshment refers to an extreme form of proximity and intensity in family interactions in which members are overconcerned and overinvolved in each other’s lives. In extreme cases, the family’s lack of differentiation between subsystems makes separation from the family an act of betrayal. Belonging to the family dominates all experiences at the expense of each member’s self-development. Whatever is happening to one family member reverberates throughout the system: a child sneezes, his sister runs for the tissues, his mother reaches for the thermometer, and his father becomes anxious about sickness in the family.

Subsystem boundaries in enmeshed families are poorly differentiated, weak, and easily crossed. Children may act like parents, and parental control may be ineffective. Excessive togetherness and sharing leads to a lack of separateness; members, overly alert and responsive to signs of distress, intrude on each other’s thoughts and feelings. Members of enmeshed families place too high a value on family cohesiveness, to the extent that they yield autonomy and have little inclination to explore and master problems outside the safety of the family. As we indicated earlier in this chapter, enmeshment is common in psychosomatic families.

At the other extreme, members of disengaged families may function separately and autonomously but with little sense of family loyalty. Interpersonal distance is great, the members frequently lacking the capacity to be interdependent or to request support from others when needed. Communication in such families is strained and guarded, and the family’s protective functions are limited. When an individual family member is under stress, the enmeshed family responds with excessive speed and intensity, while the disengaged family hardly seems to look up, offer emotional support, or even respond at all. As Minuchin (1974) illustrates, the parents in an enmeshed family may become enormously upset if a child does not eat dessert, while in a disengaged family they may feel unconcerned about the child’s hatred of school.

Alignments, Power, and Coalitions

While boundaries are defined by how a family is organized, alignments are defined by the way family members join together or oppose one another in carrying out a family activity.

Power within a family has to do with both authority (who is the decision maker) and responsibility (who carries out the decision). Thus, alignments refer to the emotional or psychological connections family members make with one another. Power, on the other hand, speaks to the relative influence of each family member on an operation’s outcome.

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must function properly or individuals will cross generational boundaries—go to Grandmother for permission if Mother says no—to get what they want.

Family Dysfunction

Rosenberg (1983) summarizes the structural position succinctly when he concludes that “when a family runs into difficulty, one can assume that it is operating within a dysfunctional structure”(p. 160). Perhaps the family, proceeding along normal developmental lines, has hit a snag in entering a new developmental stage or in negotiating a particular life cycle crisis such as the birth of another child, children leaving for college, or retirement.

Perhaps the family members have become overinvolved or enmeshed with each other (parental behavior that seems supportive and loving to a preadolescent is experienced as suffocating and intrusive by a teenager). Or, at the other end of the continuum, perhaps we are dealing with the dilemma of disengagement (parents’detachment permits growth and encourages children’s resourcefulness, but at the same time represents parents’ unavailability and lack of support in time of crisis). Dysfunction suggests that the covert rules that govern family transactions have become (perhaps temporarily) inoperative or inappropriate and require renegotiation.

A dysfunctional family by definition has failed to fulfill its purpose of nurturing the growth of its members (Colapinto, 1991). In the Wiltwyck families (Minuchin et al., 1967), typically burdened by severe external stressors brought about by poverty, five dysfunctional family structures were differentiated: (a) enmeshed families; (b) disengaged families; (c) families with a peripheral male; (d) families with noninvolved parents; and (e) families with juvenile parents. A sense of feeling overwhelmed and helpless was common to these families, often led by single mothers, who struggled to control or guide their delinquent children.

Just as the social context as stressor was apparent in the Wiltwyck population, so the inadequate internal responses to stress—the other component of the dysfunctional equation—played a key role for the Philadelphia working-class and middleclass families suffering from psychosomatic disorders (Colapinto, 1991). Here the problem stemmed from inflexibility, particularly the family’s inability to confront and seek to modify those transactional patterns that had ceased to satisfy the needs of family members. The result was an inadequate and stereotypical family response to stress, as the family persisted in employing obsolete patterns as new situations arose. For example, a couple having negotiated a complementary relationship before the arrival of children, but one not allowing for much open conflict, failed to adapt readily to becoming parents, where a change from their implicit contract was in order due to differing circumstances. To cite another example, parents accustomed to dealing with young children were unable to adapt to growing teenagers who now demanded more autonomy. Fear of oneself or one’s partner departing from established patterns often led to rigid repetition of failed patterns.

Disengagement or enmeshment—avoiding contact with one another or continuous bickering—were both directed at circumventing change, thus failing to achieve conflict resolution. Overprotection of the sick child by the entire family helped cover up underlying family conflicts and tended to discourage the development of a sense of competence, maturity, or self-reliance on the part of the symptomatic child.

Minuchin (1974) reserves the label of pathological for those families who, when faced with a stressful situation, increase the rigidity of their transactional patterns and