Mifne Treats Infants & Their Families
Raising children is still one of life’s fundamental journeys. The dilemmas of how mothers and fathers should act with their children, so that their wishes for them become a reality, bedevil even the hardiest parents. The profusion of advice, research and books about such questions as how much gratification and how much discipline to give a child, and how much difference it makes anyway, signifies our culture’s preoccupation with doing the best by our youngsters (Massie & Szanberg, 2005, p.39).
Parenting is a Life Event
Transition to parenting is a life event, generating normative pressure. This process is accompanied by various expectations and hopes for the ideal child, alongside anxiety in facing the unknown, and the need to recreate equilibrium in the family (Bollas, 1987). The parents are considered the performers, carrying out the family ideology. Bollas’ term ‘family ideology’ incorporates the entire range of expectations, basic assumptions and beliefs, the culture and family traditions, the roles of the family members and the means to carry them out effectively. The family ideology is significant in consolidating the family structures and characteristics – on the one hand from within, and on the other in delimiting them externally. During the consolidation of a family unit, the members must surmount various obstacles (the need for independence, the sense of loss of freedom, acceptance of responsibility etc.). A significant part of this experience is the bringing up of children.
Birth of a Child with a Disability
When a child is born with a disability, the unintended and unexpected aspect of the event is likely to increase significantly the pressure and a sense of crisis in the family (Minnes, 1988). This event upsets the equilibrium of the family system, obliges the family to make many changes in the family members’ way of life, compels all its friends to adapt to the situation, and entails ongoing effort to cope with pressure situations (Summers, et al., 2005). A family, whose equilibrium has been upset, sometimes reacts with rigidity when it comes to relationships. The choice between rigidity and flexibility reflects the tolerance level of the system, when a temporary state of unstable equilibrium and disorder is present, until the system finds a way to rebalance itself. A different baby upsets the state of equilibrium and causes imbalance in the family, both at its birth and later on, when developmental disorders are diagnosed.
Given the Diagnosis
When the family gets the diagnosis of the disorder, a state of disequilibrium and shock may be created among the family members. Reactions similar to bereavement are evident, such as shock, denial, guilt, ‘nobody understands’, isolation, panic, anger, acceptance and hope, and stress (Kuebler-Ross, 1974). Parents can sometimes enter a period of denial in which they refuse to recognise their child’s real situation. Parents may oppose the diagnosis and try to convince themselves that it is not correct. Kuebler-Ross claims that parents, and mainly mothers, sometimes have ‘guilty feelings’. This process and its effects were often magnified for mothers of children with autism because for many years they were held responsible for their children’s disability, due to initial explanations of autism as a result of lack of maternal affection. They feel that they may have done something wrong during their pregnancy or previously, that caused the child’s state and become more stressed. Kuebler-Ross stated that a family in an agitated state, losing its equilibrium, would struggle to survive. Such a family has great difficulty in finding its way. The conjugal relationship is badly damaged. Parents feel guilty and also tend to blame themselves. Lack of stability, with an increase in emotional reactions, is very typical of a family fighting to survive. Before it finds its direction, the new situation is characterised by a great deal of confusion, and all the family members suffer on a daily basis. The children may become confused by the parents’ inconsistent reactions.
The Different Child
A child who is different confronts the parents with an obstacle. Lack of feedback from the baby might cause the parents to feel a sense of failure in the main task they have taken upon themselves, both individually and as a couple. The couple enlists the jointly accepted methods anchored in their family ideology, in order to cope with the difficulty. When these means are perceived as ineffective, the parents might undergo a gradual process of regression. This regression is expressed by searching for individual means to cope with the situation. This leads to the widening of the behavioral differences between the parents and causes the natural family consolidation process to come to a halt. Regression increases the adherence to individual mechanisms rooted in the personal biography (defense and coping mechanisms) and may reduce the functional competence of the family (Bollas, 1987).
Parents of a child with autism very often undergo conjugal crises that sometimes threaten the child.
The parental ‘togetherness’, that integrated philosophy of life, transmitted to the children until now, has been harmed, breached and undermined. A gap between the attitudes and the perspectives of the parents has opened up. Sometimes one of them will place the responsibility for the situation on the other. This is a stress situation, characterized among other phenomena, by a return to the past patterns of each parent. In this way, the distance between them grows and the partnership is significantly damaged.
Autism, very often creates a chronic stress situation that may have a negative effect on the parents throughout their lives. Stress is defined as a dynamic state of imbalance between demands and perceived resources, in a specific situation (Lazarus & Folkman, 1984). According to Pipp-Siegel, et al. (2002), stress can be defined as a physiological cognitive or emotional strain or tension. One type of stress is the stress people feel in their roles as parents. In parent-child interactions, parents who are more stressed display more negative interactive patterns with their children. Parenting may be stressful itself, but having a child with disabilities accentuates the level of stress. The level of stress these parents experience depends on various factors, such as the child’s characteristics and their own; their personalities and the ensuing implications; their socio-economic situation; their marital relationship; the existence of a supportive framework; the family atmosphere and its cohesiveness (Brown, et al, 2003). It also depends on the quality of their married life.
The appearance of the child with autism in the family may also affect its functioning. In this situation the amount of care to be invested increases, as well as the physical and economic burden it entails, the functions within the family may have to be redistributed, and the family’s psychological adjustment depends on their anxiety regarding the future (Carr, 1995). Bringing up a child with autism is accompanied by pressure situations from various sources, for instance physical and emotional pressure, caused by the child’s lasting dependence on the parents (Olsson &Hawang, 2001). Furthermore, in a family that has failed to stabilize and to regain equilibrium owing to the many factors generating pressure, a confusion in the distribution of functions ensues, needs are not met and progress towards the family aims is arrested. Such a situation may lead to a family crisis (Minnes, 1988).
Struggling to Survive
A family in a state of turmoil is dealing with a struggle to survive. In many cases, families adopt a style of ambiguity, affecting the family communication system and causing confusion. Parents often find themselves in a state of stress and seek help (Alonim, 2007).
The Mifne Puzzle
The Mifne approach sees the nuclear family as a whole puzzle in which each of its pieces has a great impact on the others, and therefore, each piece of this puzzle has to be taken into consideration while getting into a therapeutic process. This is one of the main focuses at the Mifne Center, since 1987. The treatment program at Mifne includes the entire nuclear family whose participation in the treatment process nurtures their special family member. The program includes counseling for parents, training in RPT with observational and hands on experience with their baby, feedback from their sessions together, and individual, couple and family therapy sessions, according to the specific needs of the family.