The adaptive pattern of families with a leukemic child

Abstract

Studied 10 families with leukemic children (aged 4 yrs 7 mo to 13 yrs 4 mo) by means of semistructured interviews to evaluate their family structure and, thus, propose clear psychotherapeutic goals. All families had a similar pattern of organization, including tendency to enmeshment and the inclusion of the ill child within the parental subsystem and consequently his/her elimination from the sibling subsystem. There was also an alteration in the familial capacity to express in a clear and direct form the feelings and fears of each member, which represented an important limitation in the mechanisms used for the solution of their conflicts. It is possible that this pattern might be present in any other type of family in which there exists disease that represents a serious threat to a child's life. The rigidity in this adaptive pattern seems to depend on the type of familial structure present before the illness. Psychotherapeutic goals should be directed toward the avoidance of the rigidity in the adaptive pattern. (5 ref) (PsycINFO Database Record (c) 2012 APA, all rights reserved)

Full text

The Adaptive Pattern of Families
With a Leukemic Child
Maria Luisa Velasco de Parr a, Ph.D.,
Sandra Ddvila de Cortazar, Psyc,
and Gilberto Covarrubias-Espinoza, M.D.
Ten families with leukemic children (six boys and four girls) were studied
by means of semi-structured interviews in order to evaluate their family
structure and, thus, propose clear psychotherapeutic goals. All families had
a similar pattern of organization including: a) tendency to enmeshment;
b) the inclusion of the ill child within the parental subsystem and con-
sequently his elimination from the sibling subsystem; c) a rigid alliance
between the mother and the leukemic child associated to the peripheral
position of the father and siblings; d) tendency to include the maternal
grandmother and/or a parental daughter within the parental subsystem.
Besides, there was an alteration in the familial capacity to express in a clear
and direct form the feelings and fears of each member, which represented
an important limitation in the mechanisms used for the solution of their
conflicts. It is possible that this pattern might be present in any other type
of family in which there exists a disease which represents a serious threat
to a child's life. The rigidity in this adaptive pattern seems to depend on
the type of familial structure present before the illness.
A family with a child with leukemia has to face basically three problems: a) the
fear and sadness secondary to the suffering and the possibility of death of the child;
b) the family's limited possibilities for satisfying all of the patient's needs; and c) the
guilty feelings caused in each member of the family in connection with the disease (1).
Since the affected child demands a great deal of attention, his or her mother places
her duties in relation to the rest of the family members on a rather secondary level.
As a consequence, a rigid mother-child alliance is established which interferes with
her spouse role and the father, in turn, adopts a rigid attitude, becomes careless, and
remains isolated from his wife. Inasmuch as their life as a couple is completely blocked,
they find it difficult to communicate their real feelings to one another (4). On the other
Maria Luisa Velasco de Parra, Ph.D., is at the Department of Psychiatry, Hospital Infantil de Mexico.
Sandra Davila de Cortazar, Psyc, is a member of
the
faculty of the Universidad de las Americas. Gilberto
Covarrubias-Espinoza, M.D., is at the Department of Oncology, Hospital Infantil de Mexico.
The authors are indebted to Dr. Adalberto Parra and Mrs. Susan Dick for their correction of the
manuscript and to Ms. Esperanza Cardenas for her secretarial assistance.
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