Impaired Agency in Schizophrenia: Family Therapy with a Young Adult Patient

ABSTRACT

This article illustrates the value of utilizing brief psychodynamically oriented interventions to examine how problematic family dynamics exacerbate underlying internal deficits in a young adult with schizophrenia. The propensity for enactments to occur in psychodynamic family therapy is also emphasized. A clinical example illustrates the family therapist's capacity to detect and understand the potential for an enactment, to remain differentiated from the family, and to make conscious the family's unconscious defensive behaviors, which allows family members to begin to recognize the ways in which they are caught in loyalty binds that may inhibit the development of a personal sense of agency by the young adult.

KEYWORDS:

• Impaired agency
• family therapy
• schizophrenia
• enactment
• loyalty bind