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Families and mental health: Dynamics, relationships, therapies

What Is Family?

There is no singular definition of “family.” Throughout time, across nations, and in different cultures, family has meant different things to different people. For some, it may refer to generations of common ancestors living on the same land; for others, it may consist of a small group of roommates without any biological relation.

Whatever your definition of family, psychologists agree that family—defined as a small social group, typically living together, often (though not always) consisting of parents and children—has a great impact on your mental health.

No matter your family structure, every single person alive today was once a child. The family structure that provided for (or neglected) you as a child also laid the foundation for your understanding of the world. These lessons, explicitly or implicitly taught, affect how you:

  • Relate to your body physically

  • Process life mentally

  • Express yourself emotionally

  • Conduct yourself socially

  • Identify yourself spiritually

Types of Family

The definition of “family” is broad, but in general, most families fit into at least one of five types: biological, nuclear, blended, extended, and found.

1. Biological Family

Your biological family is related to you genetically. Beyond your parents and siblings, extended families and ancestral families are also part of your biological family.

Although some people’s family members are all genetically related, many families are not. Foster families, adopted families, and blended families may not be biologically related, but they are still family. Similarly, biological family members who have been separated, disowned, or estranged may not consider themselves family, even though they are technically related.

2. Nuclear Family

Although the term “nuclear family” arose as recently as the 1920s, it is a useful term for small, core groups of family, usually consisting of parents and their children living together. Nuclear families can look like single-parent households, parents and their children, or childless couples. They can include foster children or adopted children. Pets may also be considered part of a nuclear family.

3. Blended Family

Blended families consist of two or more nuclear families coming together to create a new family unit, usually through marriage or a domestic partnership. Blended families can include stepchildren, stepparents, half-siblings, and more. They may also include the biological family of a foster child or adopted child.

4. Extended Family

Extended family tends to consist of biological relations beyond parents and children, such as grandparents, cousins, aunts, uncles, and other relatives. Some cultures consider their extended family as part of their nuclear family, especially if they live together. Similarly, extended family members who take on primary guardianship of a child may be considered parents.

5. Found Family

Found family consists of small social groups built on sharing daily life together. They may also be based on shared values. Found families may last a lifetime, or they may exist only for a short season.

Common examples of found families include roommates living together, work colleagues, friend groups formed at school or university, and small community groups based on something in common, such as spirituality, religion, gender identity, sexual identity, or hobbies.

Different Family Relationship Dynamics

Because there are so many different types of families, family relationship dynamics also vary. You may identify with multiple family roles, such as parent, child, sibling, partner, and grandchild. How these roles intersect and overlap can affect your identity as well as your mental health. Common family relationship dynamics include:

  • Parent/child relationship: The first family dynamic most people experience is as a child in a parent/child relationship. Even children who do not know their parents or are neglected by their parents are affected by that absence of a parent/child relationship. Later in life, some people assume the role of parent in a parent/child relationship, experiencing that dynamic from the opposite role.

  • Siblings/only child: How many siblings you have, their differences in age, and how closely you relate to them affects your identity as well as your mental health. Being an only child is also a formative family dynamic.

  • Partners/spouses: Committing to a long-term romantic relationship creates new family roles to navigate as a partner, in-law, roommate, and potential parent.

  • Co-parents: If you are not partners with your child’s other parent, you may have to learn how to balance parenting skills with them while being partners with someone else or living on your own.

  • Pets: Pets are a joyful part of any family, but they also create new family dynamics. Many people learn to care for and provide for others by caring for a pet. Similarly, many people first experience loss after the loss of a pet.

5 Characteristics of Functional Families

Families can create a solid foundation of identity, security, and mental health. However, they can also leave scars and wounds when they are unhealthy or dysfunctional.

Being part of a family can make it difficult to get an unbiased idea of whether your family dynamics are healthy, dysfunctional, or actively harmful. Psychologists are trained to identify how your childhood and family may be affecting your mental health. Functional families tend to share five traits in common:

  1. Unity: Family members identify each other as a single family unit. They claim each other as family and desire to see each other flourish.

  2. Safety: Family members protect and provide for each other in ways that are appropriate for their roles. For example, parents protect and provide for their children instead of children protecting and providing for their parents (not including adult children of elderly parents).

  3. Empathy: Family members relate to and attempt to understand one another emotionally. When members express their feelings or share different perspectives, they are not automatically shut down or punished. Family members do not enjoy or celebrate the struggles of another family member, but instead desire to help them.

  4. Boundaries: Family members care for one another while understanding their own limits and prioritizing self-care. They also respect the boundaries and limits of other family members. Family members are interdependent, not codependent.

  5. Communication: Family members communicate clearly and directly. They are able to express their love and care for one another verbally. When angry, they are assertive while still being receptive, not passive-aggressive, aggressive, abusive, or violent. Family members are willing to listen to and learn from one another.

Complicating Factors of Family Relationships

Even the most loving families will have to contend with societal factors outside of their control that may influence family dynamics. Common complicating factors include:

  • Age/generation: Differences in age, generation, cultural norms, and upbringing can strain relationships between parents and children as well as siblings with a large age gap.

  • Race/ethnicity: Cultural expectations based on race and ethnicity, as well as discrimination faced both inside and outside of the home, can complicate family relationships.

  • Gender: Cultural expectations regarding gender roles and gender expressions can create untenable living situations for family members who differ from those norms.

  • Sexuality: Lack of acceptance of different sexualities beyond heterosexuality can cause suffering for family members who identify as LGBTQIA+.

  • Disability: People with disabilities may face discrimination both inside and outside of the home. They may also struggle financially to adapt their home to accommodate their disability.

  • Socioeconomic class: When individuals struggle to put food on the table, keep their home, and pay for school, healthcare, and other necessities, it can add significant stress to their life and to the family as a whole.

  • Religion/values: Differences in religious beliefs or values can cause strain between family members.

  • Mental illness: Having a family member with mental illness, or struggling with mental illness yourself, can strain family relationships.

Mental Health and Relationships

How Does Family History Affect Your Mental Health?

  • Genetics: Studies show that people whose families have a history of mental illness are more likely to develop mental illness.

  • Epigenetics: Research has shown that trauma can change the way certain genes are expressed by causing them to turn “on” or “off.” These altered gene expressions (known as epigenetic changes) are then passed down through generations to children and grandchildren who never experienced the trauma but still carry its genetic legacy. This is known as intergenerational trauma.

  • Learned behaviors: Not all mental health conditions are purely the result of genetics. Some unhelpful or harmful behaviors are learned, either explicitly by a family’s teachings or implicitly through an unpredictable or unstable environment.

Effects of Family Problems

A troubled home life can cause or exacerbate a number of mental health disorders and adverse conditions, such as:

  • Trauma and posttraumatic stress disorder (PTSD)

  • Abuse and neglect

  • Anxiety

  • Depression

  • Grief

  • Obsessive-compulsive disorders (OCD)

  • Eating disorders

  • Other mental illnesses

How Mental Illness Affects Family Relationships

Just as family can affect mental health, so can mental health affect family. How mental illness affects you and your family often depends on the roles you inhabit within your family and how functional or dysfunctional your family may be.

For example, if you are married to a person with mental illness, you and your spouse may choose to attend couples counseling. Seeking therapy as a couple can help you learn how best to support each other and understand what your partner’s diagnosis means for your relationship.

However, if you’re a child of a parent with mental illness, you may have little say in whether or not your parent seeks treatment. Their untreated mental health condition may manifest in ways that negatively affect your own mental health. In that case, you would benefit from receiving individual therapy.

Similarly, if you are the one struggling with mental illness, then your family may love and support you or exacerbate your struggles. Your diagnosis can help destigmatize mental health conversations in your family, leading others to seek necessary treatment, or it may create a barrier between you and your family. Your therapist can help you navigate new family dynamics as you seek treatment for your illness.

How to Help a Family Member with Mental Illness

  • Take care of yourself first: You may have heard the idea that, when an airplane is having problems, you are supposed to put on your own oxygen mask before you help someone else with theirs. This applies to mental health as well. Before you can help someone else, you need to make sure you are taking care of yourself.

  • Destigmatize mental health: Talking about mental health is still stigmatized in U.S. culture, which means the topic is still taboo in many families. When discussing mental health problems, never equate them with weakness or moral failing. Instead, express love and support for your family member, and let curiosity and compassion, not fear, drive you to learn more about your family member’s condition.

  • Ask questions: Normalize asking questions about mental health in your family, such as “How are you feeling?” or “What’s on your mind today?” If a family member appears to be struggling, ask them how they’re doing and if there’s anything you can do to help. Compassionate questions can create an environment in which people feel safe sharing their mental health struggles.

  • Express concern: If your family member is struggling or is hesitant to seek treatment, it’s okay to express your concern. They may not know or believe that you care until you explicitly say so.

  • Learn together: Some people will try to “handle” a family member’s mental illness by diving into research and trying to eliminate uncertainty. However, it’s important not to treat your family member as a problem to be solved. Let your family member know that you want to learn more about their condition, and seek out ways to learn together.

  • Encourage help: Encourage your family member to explore all options for treatment. Let them know there is no shame in seeking help through therapy, medication, or some combination of the two.

  • Join a support group: It can be difficult to love and care for a person who is struggling with their mental health. Consider joining a support group with individuals who love and care for family members with the same condition or similar.

Seeking Treatment

Family Therapy

There are multiple kinds of family therapy, including:

  • Supportive family therapy: Creates a safe environment to express concerns, feelings, and problems in the family

  • Systemic family therapy: Seeks to address and understand implicit messages between family members and to strengthen communication skills

  • Structural family therapy: Strengthens relationships and boundaries to develop healthier patterns of interacting

  • Strategic family therapy: Works on communication and decision-making as a family through homework assigned by the therapist

Want to make progress toward becoming a healthier, more functional family? Click here to find a family therapist near you.

Other Therapies

Partners may seek help through couples counseling. Individuals who are struggling with mental health and family dynamics may benefit from individual therapy, including but not limited to:

  • Cognitive behavioral therapy

  • Acceptance and commitment therapy

  • Dialectical behavioral therapy

  • Internal family systems

  • Emotionally focused individual therapy

  • Eye movement desensitization & reprocessing (EMDR)

Seeking treatment for your mental health or the mental health of a family member? Click here to find a therapist near you.

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