A Follow up from the Identified Patient
So dear friends, in my last post I talked about the "identified patient" or "I.P." and how the identified patient is the one member of a family who usually comes in or is sometimes dragged in to therapy. This is because, rightly or wrongly, the "I.P" is the "one with the problem", who has, or is causing, or even IS the problem (in the opinion/estimation of the family).
This sets up the fiction that the rest of the family HAS no problems..... other than of course the identified patient.
Now the other piece that comes out of this story and follows naturally from it is that if and/or when the I.P. goes into therapy and starts to get better it presents other unique problems for both the IP and the family.
So, here I will now give you a skill-testing question.
Please answer the following:
1. In any highly dysfunctional family, there is usually only ONE person who is the cause of all the family's problems. True or False?
The answer is.... BOTH!
So, when the identified patient begins to go into therapy and here we can also talk about rehab, the patient/client begins to see his or her past patterns of behaviour. Moreover they begin to see the dysfunctionality of how they got to where they are.
So for example, you have an individual who is in recovery from heroin for example. Well, they go into detox and then rehab and then longer term recovery. They stay clean and sober off of their substance of choice.
They also (usually, hopefully) have some sort of psychological support. They go over past hurts and past wounds. And hopefully with a good therapist, they work through or at least start to work through some of their issues that had originally led them to use.
Now... dear friends here is the problem.
It is up to environment and circumstances and to a certain extent fate and to a certain extent the individual's intention whether they become like this:
However, here's the deal:
Should a small, little child begin to start receiving images, messages and actions that tell them they are worthless, then it begins to put them into a so-called Linda Ronstadt moment: "You're no good, you're no good, you're no good. (Little) Baby, you're no good.... I'm gonna say it again." And we are off to ruining a child's self-image and self-esteem.
So the thing is, one has to ask: who came first the child, or the parents?
Obviously the parents came first and so the identified patient is "born" so-to-speak into a dysfunctional family to begin with!
The problem is, that when the IP starts to recognize the dysfunctionality of the family system and perhaps maybe send some of that back, like sending back a bad dish to the kitchen when you order in a restaurant
-- what do you think the response of the various family members will be????
Exactly! The response will be something like: "Well, I didn't get you to do (fill-in-the-blank) substance", in other words. The parents or siblings will say... "Well I didn't force you to drink that drink, or smoke that weed or crack, or stick a needle in your arm."
And so goes the blame game. The identified patient, trying to fix him or herself, perhaps blames the family, while the family takes no responsibility and blames the patient back, further entrenching the patient in their belief that they are indeed, the so-called "problem in the family"
And the family and the IP are indeed justified in saying that...... and not....
Sufficient support tells the "IP" that they are "OK"
You see, friends, when a family system forms and helps to shape the individual, then the family is initially responsible for how the IP turns out.... for a time.
However, when the so-called IP is adult enough or mature enough to realize just how dysfunctional their family of origin in which they were raised are, it then becomes the identified patient's responsibility to "clean up the mess". I know. I know. NOT FAIR. Everyone should clean up their own mess.
Now the other unfortunate part of this is, should the IP return to the family of origin without sufficient support that tells them that they are basically "OK" and not "IP", there is a risk that the IP will slide right back into old ways of behaving and reacting within the family.
But here, dear friends is the real kicker.
Suppose the IP, goes and gets a bunch of therapy. Kinda like shopping at a big box store. Comes back. Showers love and affection on his/her family of origin, recognizing how messed up and dysfunctional they are and then fondly bids the family goodbye as they stride off into their future to conquer the world!
What do you think is going to happen now?
Exactly! The system is going to seek to readjust itself and find a new IP, because until the dysfunctional system is made functional, it will keep repeating its way of functioning.
This is excellently illustrated in the film: "Muriel's Wedding".
After finally finding a sense of self and self-confidence Muriel Heslop, played by Toni Collette leaves her highly dysfunctional family. After finding her new voice she confronts her father, who has his own problems, and admonishes him not to start calling her other siblings down. Muriel's Wedding is an excellent but funny film, if you want to learn more about the identified patient and the blame game and it rings true. And here is the trailer from the same.
I welcome comments, questions for clarification and dialogue respectful to this post and any others.
If you are interested in this or other posts, why not click on the Google + button or submit your email, either way, and follow this blog?
Post a Comment