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Nathan Ackerman began as a therapist, and his training is evident in his formulations of the nature of family dysfunction and the path towards change. Psychoanalytic training itself does not lead to a focus on family process, however; Ackerman describes himself as a “maverick” who was influenced by Harry Stack Sullivan and by social science, which broadened his intra-psychic orientation to include interpersonal and social considerations.
For Ackerman, a healthy family exhibits a “homeodynamic principle”, a term that combines the opposite notions of homeostasis and change. Homeostatic balance refers to a complimentarity in the roles and relationships of the family members that allows for structure and stability rather than uncertainty and family chaos. This homeostasis is dynamic in the sense that it is adaptive in nature, changing as the family ages (causing a role reversal) and as new situations arise for the family to adapt to. The dysfunctional family is not adaptive; its rigidity leads to isolation or emotionally distant members, factions, demoralization, and the inability to fulfill various family functions. While this failure to fulfill family functions may be seen in the presenting problems, such as learning disabilities, acting out, parental abuse, etc, Ackerman defines a symptom either as “a unit of relational adaptation that is irrational, inappropriate, automatized, and repetitive” or as pathologically loose, rapidly changing role relationships that lead by stages to the disintegration of the family”. The sources of these pathological states are the defenses used by individual family members, which create the transactional symptoms described above.
Given this formulation, it is not surprising that the therapist intervenes on the level of conceptulization and interpretation. Ackerman is highly active during sessions, noting, exposing and interpreting defenses, so as to neutralize imbalances and scapegoating, and to point out the effects of such symptoms on the emotional health of the family members. As with “making the unconscious conscious,” the purpose of exposing defenses is to create change by upsetting a heretofore automatic set of reactions, to imbalance dysfunctional homeostasis and allow it to be examined rationally and thereby change to a new, more functional level of homeostasis. Change itself comes about by the promotion of improved reality testing, heightened levels of awareness, leading to freer and more open communication and improved problem-solving techniques among the family members.
Psychoanalytic training was also the starting point for Walter Kempler; he later became interested in existential issues and family therapy. He worked for a time with Fritz Perls, and there is much overlap in their orientations.
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