One truth of the human experience is that people do not operate in isolation. This extends to mental health, too — wellness is deeply rooted in the ecosystems we grow up in and continue to live within. Family systems, trauma, and intergenerational dynamics play a significant role in the trajectory of mental health and recovery.
Recently, The Dorm hosted a collaborative Roundtable Dinner with Sabino Recovery, where experts came together to discuss the topic of family systems and healing from trauma. Led by Amanda Fialk, PhD, LCSW, LICSW, Partner & Chief Clinical Officer at The Dorm, and Shara Turner, LPC, MSC, NCC, Eagala, Clinical Director at Sabino Recovery, the conversation covered topics from cultural influences in family therapy to clinician countertransference. Below, we recap and reflect on key family trauma insights that emerged during that discussion. For more about countertransference, visit Sabino Recovery’s blog here.
Key Article Takeaways:
The Role of Family Systems in Mental Health Recovery
Human beings are wired for connection. We build systems within ourselves, our families, and our communities as a way to make sense of our life experiences. When one part of that system is disrupted, roles shift, often unconsciously, in an effort to restore balance.
As Sabino Recovery’s Shara Turner emphasized, “when one person is dealing with mental health or substance abuse struggles, the focus goes onto that person, and everybody else [in the family system] develops a role around them.” Turner goes on to explain that when that person leaves the home to receive treatment and come back recovered as an individual, they return to a family system that has not done any work. This causes the family to shift right back into previous dysfunctional roles. This is why it’s essential in treatment settings that the entire system is considered to promote the best outcomes.
Dr. Amanda Fialk compared this cycle to a mobile hanging over a baby’s crib: “When our kids yank one of the toys on the mobile, the entire mobile becomes unbalanced. And if they’re really strong and they can pull the little elephant or giraffe completely off, the only way that it can get back to being balanced is if you put that elephant back on. But with treatment, when we take one off, we don’t want to just put them back into the old place, because the old place was not bringing them meaning, purpose, joy and health and happiness in their life. So everybody else also needs to adjust.”
Even when a family consciously wants their loved one to get better, the unconscious resistance to change can be powerful. Thus the need for family involvement in treatment becomes more apparent: healing one part of a system means everyone else must adapt.
Intergenerational and Unseen Family Traumas
When families begin doing this deeper work, many encounter trauma that stretches beyond the individual. Trauma doesn’t have to be overt to be impactful. A lack of emotional safety, chronic tension, or the subtle presence of fear in a household can affect a child’s development in profound ways. By exploring the broader family context, we can provide an understanding of why these mental health struggles came to be.
As humans, we are drawn to what we know. If what we know is dysfunctional, we will continue to seek that out until work is done to heal from it. As Turner explained, “we will play out our trauma and our past in every relationship we get into. Until we reconcile it, we will keep looking for that same person to mend that wound.”
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Dr. Fialk also emphasized the importance of not underestimating how uncomfortable change can be. She gave an example one of her professors had shared while she was in school, asking the students to take off their watches, or any other piece of jewelry they had on, and put it on the other wrist.
To Dr. Fialk and the other students, wearing the watch on their opposite wrist felt uncomfortable, awkward, and wrong, and they wanted to change it back to what they were used to. This, in a treatment setting, extends far beyond a watch. “What we are asking of the people that we work with is so much more than that,” Dr. Fialk said. “So change, even though it’s for the good, and even if you’re not feeling well, is hard.”
Cultural Influences in Family Systems Trauma Work
When working with families, it is crucial to understand the cultural framework the system is built upon. Family structures, roles, and expectations vary widely, and applying a one-size-fits-all model often misses core beliefs and ideologies.
Turner shared an anecdote working with an individual from the Orthodox Jewish community, noting that she couldn’t use the same interventions she often used with others because their worldview, philosophies, and expectations were completely different. For Turner, she found that the most effective work could be accomplished when she met people where they were, and not where she thought they should be.
Healing must be specific to each individual, even if cultural norms may differ from our own values.
Resilience: What Helps Families Heal
Resilience within a family system is one of the most important parts needed to heal. Even in the face of trauma or adversity, the willingness to remain in treatment and work through challenges as a unit allows for progress and recovery. Turner shared some traits of resilience that have helped families work through traumas:
- Awareness and Willingness: Being able to first make yourself aware of the specific roles in your family system, and the willingness to do things differently and change your roles, makes a large difference in a family’s healing.
- Open Communication: Having healthy communication means being willing to be vulnerable, letting go of black-and-white thinking, and shared decision making within the family system.
- Supportive Environment: Progress cannot be made without support, and healing rarely happens alone. Recognizing the family as a system, and having support in all parts of that system, is crucial to recovery.
- Healthy Regulation: Using tools such as mindfulness, exercise, and therapy can help widen an individual’s “window of tolerance,” which means improving their capacity to respond appropriately instead of react on instinct in adverse situations.
And, remember, even seeking any kind of help at all is already a step forward. As Dr. Fialk stated, “I do truly believe in my heart that just by nature of the fact that families are showing up shows some very real strength and inner resilience. For every one family that walks in the door, how many hundreds of thousands are out there thinking that they just can’t say they might need help and can’t say they’re willing to try? But just because they’re showing up and staying, that’s a huge testament to their resilience.”
At The Dorm, we involve family throughout the entire treatment journey because of our strong belief in the fact that family is a system. With offerings such as parent coaching, family therapy, trauma treatment that is whole-system centric and family-specific groups such as the Parent Collective and the Parent Process Group, we aim to provide families with robust support.
We thank Shara Turner, LPC, MSC, NCC, Eagala, and Amanda Fialk, PhD, LCSW, LICSW for sharing their insights into family trauma and how to heal.
Want more from Turner and Dr. Fialk? For more about of their thoughts on countertransference, visit Sabino Recovery’s blog here.
For more about The Dorm’s family programming, visit our family therapy page, or read a real life example of how we’ve supported a family’s healing in our clinical case study.
