Salvador Manuchin

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school, what to say when they turn in homework, and so forth indicates over-involvement with the sibling subsystem; a man who calls or visits his mother every time he argues with his wife shows a weak boundary between the immediate and extended families. In therapy it's quite common to see a little boy suddenly make everyone laugh at precisely the moment the therapist is asking the uncomfortable parents how their marriage is going. Without knowing it, the boy, usually prompted by some subtle signal from his parents, protects the family by taking the heat off them and their fragile relationship. The therapist, seeing the family operating as a whole (self-preservation through distraction) rather than as isolated individuals (Mom, Dad, the son),
might then comment. In alcoholic families the member who drinks controls the whole family with his/her behavior. His/Her unavailability, bad health, violence, unpredictability, and self-contempt distort every interaction between family members. ...

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him or failing to confront, and thus defuse alliances forming elsewhere in the family. When a couple in session argues about how it started, the therapist can let them know that there is more interest in where it's going: "How will you resolve this here?" With specific reference to alcoholics, many have inherited biological and family stresses and have low self-esteem and other dynamics which can all play a part. What counts for the alcoholic isn't looking for causes so much as cutting the �feedback circles� that maintain drinking.
A good clinician will refer the client to AA, consider hospitalization, assess for suicidal intent, advise a physical, ask about weapons in the home, and ...

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