Where is MFT now Essay
James Framo and Peter Fraenkel embraced the marriage and family therapy profession at very different points in its evolution; one as a self-proclaimed founder and the other as an enthusiastic convert almost 27 years later (Fraenkel, 2005; Framo, 1996). While they experienced similar enthusiasms and frustrations in the move away from the psychoanalytic approach; their points of view are colored differently by the climate of the time in which they each were introduced to it and the place where they find themselves in their career at the writing of these articles. For each man, the radical shift to family-centric care is a keystone of their professional careers (Fraenkel, 2005; Framo, 1996).
The inefficacy of traditional psychotherapy in mental health treatment and the undervaluation of family influences were serious concerns of both. In these articles they each discuss their involvement as the MFT profession matured and offer advice as to where it should go. Although they are decades apart in presence; they are in surprising accord about the significant contribution of systems theory to mental health treatment and the challenges the profession faces. Framo recounts that the genesis of family therapy arose from attempts by him and other independent psychotherapy practitioners to acknowledge the connection of interpersonal relationships and clinical symptoms (Framo, 1996).
This was 1957; the family structure was primarily nuclear. At this point, as a practicing psychoanalytic therapist for 6 years, he questioned the disproportionate emphasis on diagnosis versus therapeutic management of symptoms. He was helping to research schizophrenic patients, but was recurrently interrupted in the sessions by their families’ interjections. He and his colleagues made a decision to include the families rather than be constantly interrupted.
The benefits of this inclusion evidenced the importance of relationship context in understanding their patients’ behavior. Fraenkel becomes excited by systems therapy in 1984 when he also realized the importance of behavior in the context of the family system (Fraenkel, 2005). His baptism came from discovery of the dynamic family systems literature that accumulated in the years since predecessors like Framo opened the door. Fraenkel was a graduate student at the time and recounts his doubts about the tenets of psychoanalysis. He admired the simplicity of asking his patient why he was doing the things he was doing? These men faced similar challenges in practicing family systems therapy. Framo and Fraenkel point out that comprehensive research and training for marital and family therapy was lacking even 30 years after its inception (Fraenkel, 2005; Framo, 1996). Both authors further explain that competition for reimbursement, logistics of time and space, and internal conflicts in the profession about definition and direction plagued its growth. Framo believes there has become a “pop” quality to having the newest idea or technique and it has become more important than the treatment of patients (Framo, 1996). In the 1984 article, Fraenkel states the changing face of the family itself undermines the profession’s popularity while demonstrating its flexibility and resilience (Fraenkel, 2005).
The viewpoints of these articles seem to broadly agree. The major contrast between these articles and these men lies in their perception of their place in the history of MFT. Framo very much claims his place as a creator of the theory (Framo, 1996). He announces the importance of respecting history to the present cohesion and collective understanding. He bemoans the current practitioners who are forgetting their founders and marginalizing the early work in the field in favor of the next big idea. Ironically, the journal he criticizes as not prototypical of the field, The Family Therapy Networker, is the journal in which Fraenkel publishes his reflections (Framo, 1996). Fraenkel belongs to the new generation of MFTs that Framo disparages. While Framo is a founder; Fraenkel admits to being a band wagoner (Fraenkel, 2005) .
Framo applauds thorough questioning the beliefs of psychoanalysis while Fraenkel points out that in the practice of the profession always questioning, questioning; it questions itself causing instability from self-criticism (Fraenkel, 2005). Reflection on their histories demonstrate cautious optimism for the future of MFT Each gives guidance on how the field should stay focused and on where it could mature. I enter my journey in the marriage and family therapy profession with the benefit of the wisdom of these pioneers who have honed what MFT and family systems means. I am encouraged that the field is actively seeking to grow and adapt to the political, ideological and practical trials predicted for the future. I am cognizant of the need for respect of history and willingness to extend beyond current theories with deliberation and cohesion of the profession.
As I embark on my education as a student of marriage and family therapy, I acknowledge a kindred excitement with the authors as they have shared in their treatises.
Fraenkel, P. (2005, May/Jun 2005). Whatever happened to family therapy. Psychotherapy Networker, 29, N/A. Framo, J. L. (1996). A personal retrospective of the family therapy field: Then and now. Journal of Marital and Family Therapy, 22(3), 289.