Chemical Dependency: A Family Affair

Rating:
Summary: Review of Curtis: Chemical Dependency, A Family Affair
Review: Some authors pass down source material like a suit on its third pass through the Salvation Army Thrift Shop, without checking the label. Ignoring the paper trail can be especially dangerous in addictions and family systems writing, where authors must navigate the reefs and shoals of folk, pop psychology and pseudoscientific models. A recent example is Chemical Dependency: A Family Affair by Olivia Curtis (Curtis 1999) This short text has the imprimatur of Brooks-Cole, premier publisher of counseling texts. It is well-written, lively, user-friendly and helpful in its review of skills. This subject of this review, however, is the erroneous attribution of ideas, widespread in family addictions training, posing a problem for faculty dedicated to building a solid intellectual base for their students.

On pages 4-6, Curtis describes the work of Gregory Bateson and his colleagues in the "Palo Alto" group (Bateson et al 1956, 1963) who pioneered in family systems research. They hypothesized that the disturbed behavior of the "identified patient" might serve to unite conflicting family members, or reflect disturbed communications systems in the family. While family therapy owes a great debt to these researchers, their conclusions about the etiology of schizophrenia : the famous "double-bind" theory, has been relegated to the dustbin of history. As is now known, schizophrenia has complex roots in neurochemistry and brain development, not scapegoating, double-messaging, or poor mothering (Andreasen 1999) . Curtis uncritically presents the fatally anachronistic double-bind theory of schizophrenia as her prime example of systems theory. Moreover, a case vignette - parental empty threats and inconsistency when a child jumps on a couch, is not what Bateson and company had in mind as the madness-inducing, toxic family system.

Chapter Two, entitled Theoretical Approaches to Family Treatment, begins by citing Celia Dulfano's description of family systems approaches in alcoholism treatment, which appeared in her contribution to the compendium Practical Approaches to Alcoholism Psychotherapy (Dulfano1985). Unfortunately, Dr. Dulfano is consistently referred to as "he". Next is a consideration of alcoholic family types (pp. 14-15) , which cites a summary by Edward Kaufman in his text Substance Abuse and Family Therapy (1985) including the "neurotic, enmeshed family", the "disintegrated" family . (Kaufman 1985 pp 30-1) , as well as the "absent" and "normal" families. .However, Kaufman failed to cite Salvador Minuchin (1967, 1974), who developed the concepts of family enmeshment and disengagement . By relying solely on Kaufman, Curtis misses Minuchin as well as his conceptualization of enmeshment and disengagement as two poles of an axis in family typology, and his consideration of ethnicity. (1967) By the time we get to Curtis, we've arrived at a third generation in the lost tribes of psychotherapy! The reviewer would like to emphasize that it is not just intellectual sloppiness or dishonesty that's at issue in our chastisement of secondary and tertiary authors (although it is troubling when peoples work is not given its due) but that the student or counselor is denied an opportunity to find out about the rich, eloquent, and subtle work of such as Minuchin. For example, Minuchin noted that "Members of enmeshed subsystems or families may be handicapped in that the heightened sense of belonging requires a major yeilding of autonomy" (1974, p. 54) Chapter Eight is largely concerned with "family survival roles" as described by Sharon Wegscheider-Cruse (1981). Curtis prefaces her summary by stating that Wegscheider-Cruse discovered the "survival roles" of family hero, scapegoat, mascot, and lost child roles in the alcoholic family. Indeed, a reading of Wegscheider-Cruse, whose template is widely accepted within the children of alcoholics recovery milieu, gives no hint that intellectual forebears exist. Yet descriptions of these roles were standard in family systems research for much of the 20th Century independent of alcoholism concerns: Alfred Adler , Salvador Minuchin, etc All of these concepts have been highjacked, oversimplified, their serial numbers filed off, and repackaged by Wegscheider-Cruse as a template specifically of alcoholic/addictive family roles.

Each small practice manual need not flood the reader with bibliographic citations going back to 1956. Yet they should not perpetuate popular myths on the origin of theory , and they should provide at least some major, accurate bibliographic links for the advanced or curious reader. Curtis would have done well to review primary sources in family therapy, which would have revealed a more substantive theoretical underpinning for addictions family therapy. The addictions field increasingly seeks quality assurance in training through certification and accreditation - authors and publishers need to take care not to enshrine scientoid sources within textbooks.

Rating:
Summary: Review of Curtis: Chemical Dependency, A Family Affair
Review: Some authors pass down source material like a suit on its third pass through the Salvation Army Thrift Shop, without checking the label. Ignoring the paper trail can be especially dangerous in addictions and family systems writing, where authors must navigate the reefs and shoals of folk, pop psychology and pseudoscientific models. A recent example is Chemical Dependency: A Family Affair by Olivia Curtis (Curtis 1999) This short text has the imprimatur of Brooks-Cole, premier publisher of counseling texts. It is well-written, lively, user-friendly and helpful in its review of skills. This subject of this review, however, is the erroneous attribution of ideas, widespread in family addictions training, posing a problem for faculty dedicated to building a solid intellectual base for their students.

On pages 4-6, Curtis describes the work of Gregory Bateson and his colleagues in the "Palo Alto" group (Bateson et al 1956, 1963) who pioneered in family systems research. They hypothesized that the disturbed behavior of the "identified patient" might serve to unite conflicting family members, or reflect disturbed communications systems in the family. While family therapy owes a great debt to these researchers, their conclusions about the etiology of schizophrenia : the famous "double-bind" theory, has been relegated to the dustbin of history. As is now known, schizophrenia has complex roots in neurochemistry and brain development, not scapegoating, double-messaging, or poor mothering (Andreasen 1999) . Curtis uncritically presents the fatally anachronistic double-bind theory of schizophrenia as her prime example of systems theory. Moreover, a case vignette - parental empty threats and inconsistency when a child jumps on a couch, is not what Bateson and company had in mind as the madness-inducing, toxic family system.

Chapter Two, entitled Theoretical Approaches to Family Treatment, begins by citing Celia Dulfano's description of family systems approaches in alcoholism treatment, which appeared in her contribution to the compendium Practical Approaches to Alcoholism Psychotherapy (Dulfano1985). Unfortunately, Dr. Dulfano is consistently referred to as "he". Next is a consideration of alcoholic family types (pp. 14-15) , which cites a summary by Edward Kaufman in his text Substance Abuse and Family Therapy (1985) including the "neurotic, enmeshed family", the "disintegrated" family . (Kaufman 1985 pp 30-1) , as well as the "absent" and "normal" families. .However, Kaufman failed to cite Salvador Minuchin (1967, 1974), who developed the concepts of family enmeshment and disengagement . By relying solely on Kaufman, Curtis misses Minuchin as well as his conceptualization of enmeshment and disengagement as two poles of an axis in family typology, and his consideration of ethnicity. (1967) By the time we get to Curtis, we've arrived at a third generation in the lost tribes of psychotherapy! The reviewer would like to emphasize that it is not just intellectual sloppiness or dishonesty that's at issue in our chastisement of secondary and tertiary authors (although it is troubling when peoples work is not given its due) but that the student or counselor is denied an opportunity to find out about the rich, eloquent, and subtle work of such as Minuchin. For example, Minuchin noted that "Members of enmeshed subsystems or families may be handicapped in that the heightened sense of belonging requires a major yeilding of autonomy" (1974, p. 54) Chapter Eight is largely concerned with "family survival roles" as described by Sharon Wegscheider-Cruse (1981). Curtis prefaces her summary by stating that Wegscheider-Cruse discovered the "survival roles" of family hero, scapegoat, mascot, and lost child roles in the alcoholic family. Indeed, a reading of Wegscheider-Cruse, whose template is widely accepted within the children of alcoholics recovery milieu, gives no hint that intellectual forebears exist. Yet descriptions of these roles were standard in family systems research for much of the 20th Century independent of alcoholism concerns: Alfred Adler , Salvador Minuchin, etc All of these concepts have been highjacked, oversimplified, their serial numbers filed off, and repackaged by Wegscheider-Cruse as a template specifically of alcoholic/addictive family roles.

Each small practice manual need not flood the reader with bibliographic citations going back to 1956. Yet they should not perpetuate popular myths on the origin of theory , and they should provide at least some major, accurate bibliographic links for the advanced or curious reader. Curtis would have done well to review primary sources in family therapy, which would have revealed a more substantive theoretical underpinning for addictions family therapy. The addictions field increasingly seeks quality assurance in training through certification and accreditation - authors and publishers need to take care not to enshrine scientoid sources within textbooks.