ESPECIALIZAÇÃO AVANÇADA EM

TERAPIA FAMILIAR E DE CASAL

Módulo: As bases da terapia familiar e de casal

Formador: Luana Cunha Ferreira

As bases da terapia familiar e de casal

(ou a resiliência como ponto nodal)

Organizaçã0 da Especialização

1.As Bases daTerapia Estado da Arte doContexto Conceptualização

Familiar e de Casal Familiar e deCasal de casos clínicos
2. Correntes de Intervenção Emotionally Focused CoupleTherapy
Familiar Sistémicas Clássica (EFT)
Avaliação da Mudança
Intimidade e Intervenção na Infidelidade
• Estratégicas e da Eficácia

A prática do processo
O processo na prática
A base do processo

• Estruturais Satisfação no Casal e Coping Diádico Terapêutica

• Experienciais e Transgeracionais Intervenção Conjugal na Sexualidade
Intervenção com Crianças eAdolescentes Gestão de Casos
1.Correntes de Intervenção em Terapia Familiar
Familiar Sistémicas Mediação Familiar na Separação e
Divórcio OrientaçãoTutelar
Contemporâneas
Intervenção Familiar na
• Narrativas Homoparentalidade
• TBOS
Intervenção Familiar e Conjugal
Intercultural
2.A Pessoa do Psicoterapeuta Intervenção Familiar com Jovens
Intervenção Familiar em Contextos de
Risco
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas Organização,
b) Cibernética numeração,
autonomia e
c) Ecologia do desenvolvimento humano
alterações
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desinstitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Bibliografia
 As Bases da Terapia Familiar e de Casal

1. O Modelo Core
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desinstitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Bibliografia
Able to maintain a relational approach

http://www.ucl.ac.uk/clinical-psychology/competency-
maps/systemic-therapy-map.html
Lista completa de recursos: https://www.ucl.ac.uk/pals/research/clinical-educational-and-health-
psychology/research-groups/core
Paradigma sistémico

Intra-
individual

Ambiental -
Contextual Interpessoal

Tempo Stanton, 2009

Hábitos (ou vícios?) do pensamento sistémico
• Desafiar os modelos mentais pré existentes
• Ver o sistema
• Compreender a complexidade
• Reconhecer a reciprocidade
• Considerar as conexões
• Aceitar a ambiguidade
• Conceptualizar a mudança
• Observar os padrões e as tendências
• Considerar as consequências não intencionais
• Capacidade de mudar de perspetiva
• Considerar o factor tempo
https://www.youtube.com/watch?v=DOZkJ5zR_o0
Síntese de competências essenciais para TFC
Identificar e usar os
Avaliar o Sistema Reconhecer o papel da
recursos e forças
familiar equipa emTF
familiares

Promover relações Saber trabalhar de forma

Explicar o raciocínio da intercultural (i.e. ter a
construtivas intra e inter
abordagem sistémica
Sistema familiar noção de privilégio)

Desenvolver a Intervir diretamente nos Promover a mudança

conceptualização de padrões intra e inter entre sessões através de
casos sistemas familiar tarefas para casa

Recrutar os membros Trabalhar através de Saber monitorizar,

significativos do sistema diferentes linguagens no avaliar, rever e finalizar o
(e.g.: crianças e adolescentes) sistema terapêutico progresso terapêutico
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desinstitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Bibliografia
There is nothing as practical as a good theory
Kurt Lewin
 Lynn Hoffman (1924-2017)
” Unlike the “System,” which derives from engineering
and technology, Rhizomes are tied to the natural
world. This link with nature privileges a kind of
communication that Bateson called “the grammar of
the Creatura,” a language which is based on gestures,
images, embodiment, and similitude. Moving on to
social architecture, Deleuze and Guattari compare the
Tree, with its top-down hierarchy of root, trunk, branch
and crown, with the Rhizome, which has no up or down
but lives in an eternal middle.
These thinkers admire the rhizome’s ability to put out
an underground root or aerial shoot and re-grow itself
in another space. Some rhizomes are seen as pests, like
crabgrass, others are valued like iris or daffodils, but Inspirada pelas ideias de Deleuze e Guattari, e em íntima
they are hard to kill. Stamped out in one yard, they just
ligação com o terapeuta comunitário Chris Kinman, Lynn
sprout up next door. The Tree, on the other hand,
symbolizes a bureaucratic structure that is a propõe a metáfora do RIZOMA :
characteristic of modern life.”
In http://christopherkinman.blogspot.com/2008/01/lynn-hoffman-and-
rhizome-century.html
once you see it you cannot unsee it
Teoria geral dos Sistemas - Ludwig von Bertalanffy
Permissas base TGS

• Foco está na Interacção/Conexão & no Contexto

• Reacção contra o reducionismo/ causalidade linear
• Visa a unificação da ciência (cognitivas e sociais): Usamos os mesmos
instrumentos ou mecanismos para a avaliar um pró e contras ou uma rede
de padrões complexos.

https://www.youtube.com/watch?v=zE7PKRjrid4
Conceitos base

• Sistema: Conjunto de elementos em constante interação que formam um todo

• Homeostase: Equilíbrio do sistema (tendência fundamental). O sistema possui
resistência à mudança
• Feedback e retro-feedback: Os sistema são dinâmicos, sofrem influências do
exterior e reagem a essa influência de forma a baixar a entropia e a regressar à
homeostase.
• Entropia: Caos e desorganização do sistema.
• Abertura dos sistemas: toda a organização é um sistema aberto, influencia e é
influenciada pelo seu exterior (ctx)
Propriedades do sistema

• Globalidade: Mudanças no todo provocam mudanças nas partes e vice versa

• Totalidade: O todo é maior do que a soma das suas partes(1+1=3)
• Circularidade vs linearidade
• Equifinalidade: diferentes meios, mesmo fim
• Multifinalidade: mesmos meios, diferentes fins
• Retrofeedback (feedback negativo que mantem a homeostasia) e Feedback (absorve os inputs do
sistema e transforma-o: morfogénese)

Vasconcellos, 2010
• Feedback negativo: a resposta é oposta ao estímulo, diminuindo-o
(homeostase)
• Feddback positivo: a resposta é a favor do estímulo, aumentando-o
(morfogénese)
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desintitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
Norbert Wiener &Cibernética

• Estudo e desenvolvimento de uma linguagem e técnicas que permitam abordar

o problema do controlo, dos fluxos de informação e da comunicação em geral
• A mensagem é o elemento central na comunicação (Wiener)
• A 1ª Cibernética: conceitos de input e output, enfatiza a presença do observador
fora do sistema e como expert (objetividade), e a compreensão dos fenômenos
ainda está arraigada à causalidade linear (estabilidade).

“a maior dentada na fruta da árvore do conhecimento que humanidade já deu nos

últimos 2000 anos”.
Bateson
• A Cibernética de 2ª ordem (Heinz Von Foster)
• noção de sistemas observantes e visão construtivista: o observador é parte do
sistema observado
• 3 Presupostos:
• complexidade ve simplicidade: está ligada a sistemas, ecossistemas, causalidade circular,
recursividade, contradições e pensamento complexo.
• instabilidade vs estabilidade: está relacionada à desordem, evolução, imprevisibilidade, saltos
qualitativos, auto-organização e incontrolabilidade.
• intersubjetividade vs objectividade: envolve a inclusão do observador, autorreferência,
significação da experiência na conversação e co-construção

(Vasconcellos, 2010).
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desintitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
 Teoria Ecológica do Desenvolvimento Humano
Urie Brofenbrenner

“Researchers say that before Bronfenbrenner, child psychologists studied the

child, sociologists examined the family, anthropologists the society, economists
the economic framework of the times and political scientists the structure. As the
result of Bronfenbrenner’s groundbreaking concept of the ecology of human
development, these environments — from the family to economic and political
structures — were viewed as part of the life course, embracing both childhood
and adulthood”

(In memoriam,APS
https://www.psychologicalscience.org/observer/in-appreciation-urie-Bronfenbrenner)
Teoria Ecológica do Desenvolvimento Humano
Urie Brofenbrenner

• Estudo científico da interação mútua e progressiva entre por um lado um

indivíduo activo em contante crescimento e por outro as propriedades
sempre em transformação dos meios imediatos em que o individuo vive,
sendo estes processos influenciados pelas relações entre os contextos mais
imediatos e os contextos mais vastos em que aqueles se integra.
(Portugal, 1992, p.37)
• Psicologia = Ciência do
Comportamento • X tábua rasa
• Comportamento = Sujeito + • Reciprocidade Sujeito
Contexto contexto
• % Sujeito = % Contexto • Ambiente ≠ contexto
imediato
#sóquenão
 Mesosistema

Cronossistema (Tempo)
https://www.youtube.com/watch?v=nYtNLWYSiFM
 Casal sem E as famílias
filhos reconstituídas

Casal “Fase Casal com

do ninho filhos
vazio” Ciclo de pequenos

vida do
casal
E os casais sem
filhos?
Casal com
Casal com
filhos em
filhos
idades
adolescentes
escolar Alarção, 2002,2006
Relvas, 1996, 2000
 Casal sem filhos
Aceitação da separação pais -filhos; reorganização das redes familiares e
sociais

Casal com filhos pequenos/idade escolar

Gestão doméstica; criar espaço para os filhos; relação com avós

Casal com filhos adolescentes

Aceitar a autonomia dos filhos; Início da função de suporte à geração mais
velha

Casal “Fase do ninho vazio”

Gerir entradas e saídas; Renovação ou separação do sistema conjugal
Resiliência
 Resiliência….é o quê?

Capacidade de um material absorver energia quando é

comprimido e libertar essa energia quando é descomprimido.
 Resiliência….é o quê?
Adaptação positiva à adversidade apesar das
sérias ameaças à adaptação ou
desenvolvimento.

Masten
 Resiliência….é o quê?
Propriedade emergente de um conjunto de sistemas protetores
hierarquicamente organizados que amortecem de forma cumulativa os
efeitos da adversidade e que quase nunca devem ser pensados como
propriedades intrínsecas dos indivíduos.

(Roisman et al., 2002)

 Resiliência….é o quê?

Resiliência é não só ultrapassar a adversidade como também

potencialmente transformar subtil ou drasticamente aspetos
dessa adversidade

(boing boing collective)

 Malala Yousafzai
Prémio Nobel da Paz 2014
(com Kailash Satyarthi )
 Acesso aos Reconhecimento
melhores internacional
Recursos
internos, cuidados Luta global e
familiares, e Forte Impacto
contextuais exposição real?
positiva nos
média
 Resiliência é não só
ultrapassar a adversidade
como também
potencialmente transformar
Acesso aos Reconhecimento
internacional
subtil ou drasticamente
Recursos melhores
internos, cuidados Luta global e
aspetos dessa
familiares, e adversidade
Forte Impacto
(boing boing collective)
contextuais exposição real?
positiva nos
média
Os aspectos do contexto incluem as propriedades
objectivas destes mas também o modo como isso é
percebido pela pessoa

Objectividade Realidade? Subjectividade

 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desintitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
Teoria da Comunicação Humana
(Bateson/Watzlawick et al)

• Sintaxe, semântica e pragmática

• Pragmática: aspectos comportamentais da comunicação
• Conceito da metacomunicação (comunicação sobre a comunicação)
(Watzlawick, Beavin, & Jackson, 1973).
• Aa comunicação afeta o comportamento e consequentemente as relações
interpessoais.
• Bateson propõe que a mente é um fenómeno sistémico característico dos
seres vivos, uma característica relacional.
Watzlawick et al (1973)
Axiomas da comunicação humana

1) É impossível não comunicar;

2) Toda comunicação tem um aspecto de conteúdo e outro de relação
3) A natureza de uma relação está na pontuação das sequências
comunicacionais entre os comunicantes (cada comportamento é causa e
efeito do outro)
4) Os seres humanos comunicam de maneira digital (comunicação verbal) e
analógica (comunicação não-verbal)
5) Todas as trocas comunicacionais são simétricas ou complementares e
estão baseadas na igualdade ou na diferença

(Watzlawick et al. 1973).

Paul Watzlawick (1921-2007)

• Pragmatics of Human Communication, 1967

• Change (with Weakland and Fisch), 1974
• The Situation is Hopeless, but notSerious,
1983
• The Invented Reality: How Do We Know
What We Believe We Know? (Contributions
to constructivism), 1984

48
Gregory Bateson (1904–1980)

“A informação é a diferença
que faz a diferença”

https://www.youtube.com/watch?v=1IbkVtSDq9E
 I

Não podemos não comunicar

Every behaviour is a kind of communication. Because behaviour does not have a
counterpart (there is no anti-behaviour), it is not possible not to communicate.

• What the couples did not say (“we are happy”, “we are not comfortable”, we are
not satisfied) is still communicated.

• If you come to the interview, the fact that you do not disclose something, is a
communication, or a statement.

• The fact that you feel good does not need to be communicated, it shows!

50
 Level of disclosure Mariana & Francisco (40)

This passage refers to the turning points where intimacy has increased or decreased and
it’s relation to conflict (and the transcendence of conflict).

M (her): (...) I don’t think there were big ups and downs. I think that even in situations
where there was a rupture in communication there wasn’t a rupture in the relationship.
(…) I think there is something permanent, I don’t know if it’s a bubble or what it is, that
it might be more or less filled, more or less shining, but I think it is maintained, there
might be sometimes when it is a bit more wilt {wilted?} a bit more crumpled (…)
F (him): (…) I see it as…there is a bigger thing here, there can be complicated torments, but
I know that it’s only a question of surpassing those obstacles, I know that right over
there, in front of us, there is the ray of light. It’s just a question of being with each other,
because I know it’s still there. (…) When there are conflicts, there must be a fluctuation
in intimacy. But there is always the vision that the stronger think is on the other side. I
think that, until now, there was only one time that I didn’t see it…like in the middle of
the conflict… “Gosh, it has been raining for too long…is there anything on the other
51
side?”
 Level of disclosure Mariana & Francisco (40)

M: I think it’s that image of “I don’t see anything over there…I hope you do, because I
don’t see anything” (…)
F: With so many conflicts along the way (…) there is some certainty that the thing is going
to go on. I have had many conflicts with you, I was already really mad at you, but it all
goes away, why wouldn’t it happen again?
M: In moments of “des-union” (…) we ask “do you have an answer for this? I don’t have an
answer for this. How are we going to do this?” Maybe it’s also having the confidence
that the other still has something to give. Sometimes, we feel that we have nothing
else to give, isn’t it?
F: “Do what you want; I can’t give anything else for this. I know the light is on the other
side but I…”
M: There ends up happening a sign, a rope that is thrown, when sometimes we feel adrift,
when we see no hope, we see no light. But suddenly the other throws us a rope, a buoy,
turns on that light [L: That is a beautiful image] and we think “this is what I wanted,
this is what I needed”. [F: This is what I needed, you weren’t saying it] You weren’t
saying, what took you so long? Sometimes, we don’t even really know what that is." 52
 Level of disclosure Mariana & Francisco (40)

Francisco, regarding paternity and its challenges, refers again the ambivalence between the constant
needs of their children and his need to be alone, to have his own space, and the way that lack of
personal time affects his relationships.

"F: in this side, well, beyond the post-labour limitations, there is something else that I think is very significant,
which is like, in that movie he says to his children "It's a flying plane, you have to manage it and you can't
do what you want". If we want our kids to be alright and to do things properly, it makes us give a lot of our
time, our availability. And, sometimes, we just feel like saying "go do your homework" but it makes us be
there, for hours and hours, with our children. "Do what you feel like, do whatever you want, but let me be,
in peace, for a moment" - that's what you feel like saying. And so, if I'm not at peace, I'm there kind of
forced, I'm not doing the thighs I want to and I don't feel well with myself. If I'm not well with myself, I'm
not well with anyone. So things obviously affectintimacy."
53
 Level of disclosure Maria & Paulo (15)

L – So… what else disturbs your intimacy?You have already mentioned tiredness right?What else?
(…)

P – Conflict.

M – Conflict in our case only revolves around lack of money and our relationships...

P – When we are under a great deal of financialpressure.

M – Sometimes we are counting cents, not Euros.

P – And the relationship with our families of origin [M – Ah, yes. Also]. Especially Maria with my
family, which is not very easy. (…) it’s something that makes us argue (…) and it’s disturbing of
our intimacy.

54
 II
Cada comunicação tem um aspect de conteúdo e um
aspect de relação, sendo que o o ultimo classifica o
primeiro e é portanto uma meta comunicação

All communication includes, apart from the plain meaning of words, information on how the talker
wants to be understood and how he himself sees his relation to the receiver of information.

That way they talk to me (and vice versa), classifies our

relationship. Besides the communication of content, it is a
communications about our relationship, and in this case, how
satisfactory it is for all involved. 55
 On the co-constructed relationship Mariana e Francisco 40
L: Francisco do you agree with Alvim when he says that men don’t talk about intimacy? [Smiling]
F: [laughs] He was saying that and I was thinking “ah…! You are right!”[Claps hands}
L: You think he is right? Maria, do you also thinkso?

F: yes, yes
M: Yes, I must say I do. Well, again, my closest friends are women. It doesn’t mean that the opposite doesn’t exist, with the example I have at home (…) I would
say yes.
L: But at home, do you talk about intimacy?
(…) M: yes, ours, whenever we need to [both laugh].
L: [smiling] whenever you need to

M: Whenever there is need and time”

L: And how about the best friends of your desire?
(silence)
It was clear to me, during
M:Time. the interview, that the
F: Presence. laughs and some sort of
L: So, being there, availability?(…) respectful tenderness
(cosiness, warmness ),
F: It don’t think availability so much…just being there is enough [laughs]
attunement and
M: No, but there must be availability spontaneity ) were mutual
F: No, availability….yeah [laughs]
M: Availability is created with time, with being there.” 56
 On the co-constructed relationship, Maria & Paulo 15

After I read the stories and ask for their comments on each of the couples,
Maria is the first one to reply, but in the space of only 20 seconds, she repeat
4 times the sentence “It’s like we said in the beginning”, so she was finding it
a bit repetitive, I believe.

L: So do you see these stories?

M –Yes, It was what we said right at the beginning

L – in some parts, right. Here, you can see this (the stories sheet)

M – No, Rui and Rita don’t have any individuality, or personality. It’s a fusion. And the
other couples was what we said. Each one is a fulfilled person with a personality and
then there is the relationship. . That’s what we said in the beginning.

L – So you identify more with John andJoanna.

57

M –Yes. It’s what we said in the beginning

 III
A natureza da relação é dependente da
pontuação inferida pela comunicação
entre os parceiros

Both the talker and the receiver of information structure the communication flow differently and
therefore interpret their own behaviour during communicating as merely a reaction on the
other's behaviour (i.e. every partner thinks the other one is the cause of a specific behaviour).
Human communication cannot be dissolved into plain causation and reaction strings,
communication rather appears to be cyclic.

58
 How do they communicate during the interview?
On changing opinion [accepting influence] and on being surprised (Mariana & Francisco,
40)

M: Yes, I think the three are balanced, or should be (…) yes, the higher the sexual desire, the higher and the
sense of intimacy. The higher the sense of intimacy, the higher the sexual desire or at least its
concretization. I also think that perhaps intimacy is more valued if there is more differentiation. If there
is less differentiation, intimacy gets poorer. (…)[Explains sample couple story on differentiation and
desire] (…) I don’t know if differentiation can potentiate sexual desire. [L: In that case, it potentiated
John’s, didn’t it?]. John’s, exactly...
F: Tough I said I saw it as disassociated, what you just said makes a lot of sense (…) completely. Me, seeing
you in a place, having fun, in a good mood and whatnot…I see that she’s really cute, man, she’s cute!
[L: You have the perception of her being separate] Exactly. There is a withdrawal and a distanced
observation. (..) [L: Do you have that experience? Is it very positive? (…)] Yes
M: I think that is a very positive experience too, [F: yes] not only to see the other with our own eyes, but
also the other trough the eyes of the other persons [F: Exactly] [L: Like if we’ve never met him] Not
that we don’t think he has these qualities (…) but when you confront it with…
F: It’s a break in monotony [M: with the vision that others have] a different vision from the day to day
M: Yes, it can be a work or a social situation
L: It’s like it is given back to us that person, I have the privilege of access but it really is a person
59
independent from me? [M: yes] (…)
F: hum…that’s funny…it is…
 How do they communicate during the interview? (Maria & Paulo, 15)
Not quite gentle, he challenges her, as if he is inviting her to the reflection, but he just sounds a bit without
patience. Her diminished availability for the interview starts to be more noticed around this time, in 3 almost consecutive
moments. I think I might compare her to other 2 exhausted PhD moms in my sample.
L – Ok. Beyond desire, what else is important for couple satisfaction? You mentioned frequency, what else?
P – Now you talk, I’m talking a lot
M – No…
P –You can’t remember…?
M – Knowing what gives the other pleasure. Knowledge [P – Hum hum.]
L – (…) OK, how about gender differences in desire? Do you notice any? (…)
M – No
L – How about in other couples, do you think there are any gender differences in terms of sexual desire??
M – I don’t know…
P –You don’t? [looking at her]
M –What?
P – Of people, if men and women think about this stuff in a very different way…
M – Oh, if it’s different…...maybe
L – Can you tell me how do you think it’s different? In what ways?
60
M – I don’t know, women maybe…not quite more…well, gather…like, maybe more…I don’t know how to explain…(…) not
more conditions yet, I don’t know sometimes it’s more physical, sometimes more a physical need. And in women it’s
not just physical… (…) in men it’s more immediate
 VI
A comunicação humana envolve
modalidades digitais e analógicas

Communication does not involve the merely spoken words (digital

communication), but non-verbal and analogue-verbal communication as
well.

61
 laughs

On the validity and their agreement of asking about graphs. This one referring to sexual desire.

M: Before life in common, actuality, I think it was going up. Then I think there was a decrease, at least
for me. Then I think the idea of being parents made it go up .In the follow up of the births there was
a decrease. And after that I think there is a stability that has spikes, it’s not regular. I think that in
this moment it has a higher level that for example, in a post-wedding [phase]

L: Ok. (...) It’s a well defined graph

F: As a matter of fact, [she] was talking and I was remembering her. And it really [happened] like that.
(Laughs)
62
 sighs
At minute 61, Maria gave me clear indication she was getting tired:

L: How about differentiation how do you see that trajectory in a couple?What are the turning points?
M –It’s similar. It’s very similar because it’s all related to intimacy.
P –Yes.
L – In what way is it related to intimacy?
M – I don’t know,…this is getting a bit… (sighs);..You talk about this part [turning to Paulo]

At this moment, I considered ending the interview. However, since they had been informed that
they could quit the interview at anytime and considering that Paulo quickly continued her
answer, and seconds later she gives another answer, I decided to continue, unless they asked
me to quit. Currently, I'm at peace with my decision, but I’m not if I would do it again.

One may pose questions regarding the quality of the data gathered beyond this point, particularly regarding
her affirmations.
63
 V
A comunicação inter humana é simétrica ou complementar

Depending on whether the relationship of the partners is based on differences or parity.

Agreement

Disagreement

Complementary

Dismissal - Contempt
64
 Mariana & Francisco 40

I could tell they were really paying attention since sometimes I would paraphrase one of
them and they would correct my paraphrase in very specific details, so they were really
making an effort to make their speech match their feelings and thoughts. They seem
very at ease, and they are not reticent in contradicting me or saying no.

"L: in what you just said Maria, was the issue of privacy also included?

M: No, it wasn´t. [L: Would you include it as part of the couple intimacy?] Yes, I think so;
because without it we wouldn’t be beings…well, let’s say I think privacy even comes before
the relationship. The relationship comes after and which doesn’t necessarily puts an end to
privacy. But I wasn’t thinking about privacy when I answered “the relationship”.
65
 Mariana & Francisco

They seem to respect the other’s discourse, they when they interrupt, they do it very
gently, to complement what the other is saying, to make suggestions or to give
examples.

They normally start the sentences with “Yes”.

I wonder how do Maria & Paulo start?

66
 On contempt Maria & Paulo 15

In this part, when I’m asking about the ideal, and Maria quickly dismisses the question, Paulo interrupts her, challenging her to think more
about it and show a slight bit of contempt (one of the family therapist’s major alarm calls):

L – Ok. How about the idea of couple intimacy, what’s that like? The “dream” couple intimacy?
M – I don’t think about that.
L – You don’t think about that.
P – oh, yes you do!
M – No. The ideal?
P – yes. When we talk... [M – of intimacy? The ideal of intimacy, Paulo.] The ideal of intimacy for me it’s that image. Is, let’s say,
getting older... (She laughs), travelling and,
M –That…that’s different...
P – No, it’s an ideal of intimacy (the) the progressing relationship (…) increasing intimacy and being partners (…) a higher deepening
and a bigger knowledge of the person we are with (…) life partners (…) our kids growing up (…) that the image I associate with
[the ideal].
L – So Paulo proposed us an ideal of intimacy in the future, right? [M – Right, in the future]. It can be in the future or in the present.
M – Yes but I agree in terms of the future. Now, but in terms of the present, the ideal…I’m not always thinking about what is ideal.
Hum... (Pause). It’s like we are now... [L – It’s like what happens now].Also because if I wasn’t satisfied, I wouldn’t be married.67
(All laugh)
 So what is really happening with Maria & Paulo?
introducing a big current theme for this couple: her tiredness and their lack of sex:

L – (…) is there something that you would like to change in your current intimacy? Big changes, small changes?
P –I would like to change sexuality a little bit (both: laughter).
M – I already knew that. (Both: laughter).
L –Which is interesting.You didn’t discuss [sexuality] in the beginning as part of intimacy
M – It’s a phase. We are in a critical phase. (Both: laughter). I know that it is a bit because of me. Because it’s like this: I’m doing my PhD, which
I started when my child was 6 months (…) I work in [far from home], I take care of my child, our child,…and sometimes I feel that I’m at the
limit...more physical than psychological (…) I’m not available because sometimes I can’t even open my eyes. I get up at 6.40am for a 2 hour
drive. In the evening, Paulo [gets home] at 11pm (…) I’m at the computer trying to do something for my classes or my PhD (…)
P – And you are tired right?There isn’t that thing anymore, about watching a movie…
M – (…) sometimes I fall asleep on the couch (…) it’s like I’m dead, I don’t know where I am when I wake up (..) I haven’t slept in 3 years, since
my child was born I haven’t slept past 6am (…) and it accumulates (no Saturdays or Sundays anymore (…) and until she was 6 months old
she would nurse every 3 hours…That’s why…all that accumulates, right? And sometimes, like, [at] 2 or 3 in the morning, sometimes Paulo
wakes me up and I say (Laughs) “No way”.
P – so, but when it happens it’s really good
M – yes, I think the problem is more about frequency (laughs). But when there isn’t availability, I don’t force myself
P – I recognize that I get a little frustrated (…) a bit rejected and putaside

M – Like that, in the middle of the night….all right I really can’t …can’t even talk sometimes. (…) it’s complicated. 68
 So what is really happening with Maria & Paulo?

Here information comes up, what I considered to be a pretty important one.

L – So, you see some individual differences over there

M – I never left my child. She is 3 years old and she never stayed with anyone. Except at school. But it’s my
option.
And it fulfils me and in the beginning one is really into it (…)

I think this one of the big issues for this couple, in 3 years; they made no use of their social support or other
strategies to have some couple time. He appears to resent her for that, tough nor blatantly,

And she appears to feel that as well and to resent him for making her feel guilty about something that has given
her so much pleasure and fulfilment. 69
 On structure
They question themselves, create their own interview exercises, make rhetorical questions to each other, they
seem to be actively co-creating this interview with me.
This is much more “a conversation with a purpose” than to other interview. There is still structure tough, in the
sense of a succession of pre-established themes…but the conversation does flow into unexpected realms
very smoothly. I don’t have to be constantly worried about how my next question is going to make them
comfortable and open in the interview.

M: If we do the exercise of thinking where would we be now, ten years after, if we didn’t have children, right? I don’t
know, we never did that. But. I don’t know. [F: I can’t even imagine] [L: Can you imagine Maria?] I can, but I

don’t see much. [L: There would be something missing] Yes, but if we didn’t had any children, it would have

been by option or by some constraint. How would we live with it? If could have been our option and in that case

we still would have time to change our minds, if we wanted to... But these tem years, I don’t know, how do you

think it would be? It would be very weird… [F: I don’t know)

70

Mariana & Francisco 40

 On structure and emotional charge
The last minutes of the interview are spent answering a ritualized question, created precisely after Maria and Paulo’s
interview when we felt maybe they weren’t in a good place before the interview and the interview didn’t help them
feel slightly better, so we figured out a way to get couples to always leave on a positive note, regardless of how they
entered the interview: The biggest pridequestion.

L: Ok. Anything else F.? What is your biggest pride in being the couple that you are today?
(silence)

F: (with tearful eyes) Maybe that in a time of such confusion, where it is so easy to break up, that
we manage to have a “five person couple” [L: A five person couple?] yes
M: five? [F: five] yes, I thought about children as well, on one side. Although it's not an unfinished
business (…)But in anyway it is something that in the day to day makes us often look at each
other, Exchange a look or a Word and say “They are [F: awesome] yes!”. Which is a bit like
saying that we are too. And in the day to day that is a motive of pride. Na then also the fact of
this challenge [interview] “I heard this on the radio” and “do you want to go” “what did you
thought of it” “Is it interesting?” “Is it a good idea for us to participate?” (…)And now, actually,
having this conversation is also going to enrich us, on one side [F: awake us] and It is also
allowing us to say something that maybe we didn’t said in a long time, we did felt it but did not
verbalize it…and I think that is a sort of pride too.
L: Well that is motive of pride for me too [M: yes]. [Laughter] I’m glad. Yes, I thought that you were
71
feeling good along the interview. [M: yes]. And it was a pleasure to me. Thank you. [M:
(laughing), you welcome!]
 Metaphors
• M: (..) I don’t think there were big ups and downs. Even in situations where there was a rupture in communication there wasn’t a rupture in the relationship.The space
of our intimacy, was maintained, although there were (…) several disagreements. I think there is something permanent, I
don’t know if it’s a bubble or
what it is, that it might be more or less filled, more or less shining, but I think it is maintained, there might be
sometimes when it is a bit more wilt
{wilted??} a bit more crumpled (…)
• F: (…) I see it as…there is a bigger thing here, there can be complicated torments, but I know that it’s only a
question of surpassing those obstacles, I know that right over there, in front of us, there is the ray of light. It’s
just a question of being with each other, because I know it’s still there. (…) When there are conflicts, there must be fluctuations in intimacy. But there is always the vision
that the stronger think is on the other side. I think that, until now, there was only one time that I didn’t see it…like in the
middle of the
conflict… “Gosh, it has been raining for too long…is there anything on the other side?”
• M: it’s that image of “I don’t see anything over there… hope you do, because I don’t see anything” (…)
• F: With so many conflicts along the way (…) there is some certainty that the thing is going to go on. I have has many conflicts with you, I’ve been already really mad at you, but it all goes
away, why wouldn’t it happenagain?

• M: In moments of “des-union” (…) we ask “do you have an answer for this? I don’t have an answer for this. How are we going to do this?”. Maybe it’s also having the confidence that the
other still has something to give. Sometimes, we feel that we have nothing else to give, isn’t it?

• F: “Do what you want, I can’t give anything else for this. I know the light is on the other side
but I…”
• M: There ends up happening a sign, a rope that is thrown, when sometimes we feel adrift, when we see no
72
hope, we see no light. But suddenly the other throws us a rope, a buoy, turns on that light [L: That is a beautiful
image] And we think “this is what I wanted, this is what I needed”. [F: This is what I
 me @ 15

• My posture was quite assertive a bit cold right at the beginning of the interview. I was
definitely a bit tense.
• I was also nervous since this was our third interview, so I was still very stuck to the protocol,
not as free or as relaxed as in later interviews. I talk fast and in a quite serious way:

• "Luana –Well, we are now going to talk about several themes, like intimacy and sexuality,
trough this interview. These are complex themes, like intimacy or sexuality [and] it would be
important not to interrupt the interview, unless by major motives, so we ask you to turn your
cell phones in the silence mode, ok?”

73
 me @ 15

• Long monologue tirades by him, not quite the question, answer and rebate, conversational
interview. The beginning of the interview went more like: my question, big answer from
him, I redirect to her, she answers monosyllabically, and he completes it

• I noticed right at the beginning of the interview that he was more prone to take time in his
answers, to question the issue deeply and to reflect on it, while she seemed she just want to
answers monosyllabically so that the interview wouldn’t take up much time.

74
 me @40

Right from the beginning there was laughter in a room, a calm, cosy, warm laughter in
between questions. I could just feel them getting in to the interview, and I mean really
getting into the themes and questioning themselves in it, deeply engaging with it.The
image that comes up, when I hear their voices I remember those moments, is of us three in
a warm bubble, sliding smoothly along the curves of the themes and ideas, without an inch
of friction or awkwardness.

75
 me @ both

• I talk a lot more than in later interviews

• I interrupt more

• I use more technical language

76
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desintitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
"The awareness of complexity makes us
realize that we can never escape from
uncertainty and that we can never have total
knowledge - totality is not truth"

Edgar Morin

Pensar o mundo como um todo indissociável, propondo uma abordagem multidisciplinar e

multirreferenciada para a construção do conhecimento.
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desintitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
 • O conhecimento não só é construído (construtivismo), como o é
apenas socialmente, através das nossas relações e
Construcionismo social linguagem/narrativas
• Burr,Gergen

• um sistema vivo está constantemente a autoproduzir-se,a

autorregular-se, e a manter interações com o meio, e este apenas
Autopoiésis desencadeia no ser vivo mudanças determinadas na sua própria
estrutura, e não por um agente externo (Varela e Maturana)

• Anos 60, avanços na medicação (anti-psicóticos) permitiram a

Movimento de estabilização de doentes com psicopatologia grave
desinstitucionalização • Necessidade de respostas na comunidade e novas intervenções
psicoterapêuticas (psicologia comunitária e terapia familiar)
 As Bases da Terapia Familiar e de Casal

1. O ModeloCore
2. Princípios básicos da intervenção sistémica com casais e famílias:
a) Teoria geral dos sistemas
b) Cibernética
c) Ecologia do desenvolvimento humano
d) Teoria da Comunicação Humana
f) Complexidade sistémica
g) Construccionismo social -– Autopoiésis - Desinstitucionalização
3. Instrumentos de recolha de informação em terapia familiar
4. Biblio
 Ferramentas #1

• Genograma
• Linha da vida
• Mapa rede social
Não há nada tão prático como uma boa teoria:
Um caso de TFC
Família multi Tipologia neto Ideação Cliente
desafiada adolescente + avó suicida involuntário
 Como trabalhar para a resiliência?

• Premissa: As dificuldades humanas são o produto da interação entre o

sujeito e a realidade
• Cuidadores como co-terapeutas que promovem a mudança,
providenciando a família com estratégias e recursos para gerirem a sua
realidade.

• 3 princípios da intervenção do MRI:

• Não consertar o que não está partido;
• Parar de fazer o que não funciona e fazer algo diferente;
• Se funciona, fazer mais disso.
 Chaves para a resiliência familiar
Sistema deCrenças
Significados atribuído à Transcendência e
Esperança e Optimismo
crise familiar e desafios espiritualidade

Recursos organizacionais
Flexibilidade e Recursos familiares,
Rede, ligação, liderança
estabilidade sociais e económicos

Processos de comunicação
Mensagens claras e Partilha emocional e Postura colaborativa e
consistentes humor proactiva
Wals
h
 1) Dificuldade em
•EncaminhamentoCPCJ
Encontro •Avó como co-terapeuta
gerir o
comportamento
do Rui
1) Definição do 2) Falta de
Avaliação de
problema: foco expressão
necessidades baseada
no presente e emocional por
nas rotinas de forma a
foco na queixa parte de Rui;
perceber como se
principal
processam as actividades 3) Dificuldades de
familiares diárias comunicação
2) Soluções entre os dois
tentadas
Gritar e Bater Forte desqualificação de
Raquel, afirmando,
3) Definição de
magoada, que Rui estava
objectivos 1) Desempenho escolar muito parecido com ela
positivo; e que Raquel não se
2) Maior abertura na preocupava com
comunicação e partilha ninguém, especialmente
entre ambos com o filho.
 Evolução Ideação suicida
“Rui, quando eu me for o que vai ser de ti?”
“nessa altura mato-me…não ando cá a
Paradoxo 1: Rosa não fazer nada…o que é que eu sou?”
consegue responder às
solicitações de criar um
jovem, mas receia o
afastamento de Rui, •Desempenho escolar vs. comportamento
‘natural’ ou por
reaproximação à mãe •Papel de cuidadora vs. autonomia
dele. •‘Tristeza transgeracional’

Paradoxo 2: Quer
ajudar a filha
(trabalhando no seu
O discurso em sessão afastou-se do
café) , mas sente-se tom negativo para um discurso de
injustiçada por não forças e competências, focado no facto
receber nada (afecto, de Rosa ter conseguido, sozinha, criar
dinheiro) em troca do os seus netos de forma saudável.
seu sacrifício.
Quebras 1 Mês de faltas (queixas vagas)

Forte ambivalência Resistência e desdobramento da intervenção de

Rosa/Raquel: forma guardar a aliança terapêutica
Sessão familiar
Re-focar: “O que faz para conseguir ter um neto que
-temas da promoção da não faz nada em casa?” ou ilusão de
autonomia alternativas
Pausa para reflectir:
“ruindade vs “violência gera violência”.
1) discurso : “ele é agressivo”
-- questões de disciplina 2) sentimento “eu tenho medo dele”
3) expectativa dos outros “a minha filha
COMO CONCEPTUALIZAR ESTECASO? avisou-me que ele pode ser violento”
4) provocação, já que Rosa lha bateu;
COMO
-- projectar o Rui para uma INTERVIR?
5) reacção a adoptar “se ele vier para mim
vida para além da morte da eu agarro tudo o que tiver à mão
avó
Sr.Cat: Systemic ReflexiveCase AnalysisTool

Foco nos
sistemas
Papéis Circularidade

Fronteiras e limites Padrões

Narrativa e
Contexto cultural linguagem

Ciclo de vida Poder e controlo

Co-construção da relação Recursos
Hipótese sistémica
Sr.Cat: Systemic ReflexiveCase AnalysisTool
pouco apoio social e questões de
vinculação
Foco nos dificuldade em se pôr na
cuidadora e vítima perspectiva de Raquel
sistemas
Papéis Circularidade
intimidade física
entre avó e neto Padrões
Fronteiras e limites desqualificação , violência
doméstica, entrega dos filhos
Operária e
forte crença no trabalho Narrativa /linguagem
Contexto cultural foco no negativo
deixar de ter dependentes e passar
a depender; autonomia de Rui Poder e controlo
Ciclo de vida poder de cuidadora e o poder
de vítima
Co-construção da relação Recursos
verbaliza o gostar das sessões vs. criou três crianças sozinha, Rui
Hipótese mantêm boas relações com
ameaça à aliança
sistémica professores, canais de
comunicação abertos
Sr.Cat: Systemic Reflexive Case AnalysisTool

pouco apoio social e

Foco nos
sistemas
Circularidadquestões dee
Papéis
vinculação
Aproximação de Raquel a Rui é ameaça para Rosa. Depender de
cuidadora e vítima dificuldade em se pôr
Fronteiras e alguém naPadpersrõepectivas
limites em vez de ter dependentes.
de
Raquel
Ambas estasfísica
intimidade questões provocam uma situação desqualificação
de cristalização
entree

de homeostase que paralizam Rosa e empurram Rui para uma

terra de ninguém.
Quebras 1 Mês de faltas (queixas vagas)

Forte ambivalência Resistência e desdobramento da intervenção de

Rosa/Raquel: forma guardar a aliança terapêutica
Sessão familiar
Re-focar: “O que faz para conseguir ter um neto que
não faz nada em casa?” ou ilusão de
-Promoção da alternativas
autonomia “ruindade vs “violência gera violência”.
1) discurso : “ele é agressivo”
-Disciplina 2) sentimento “eu tenho medo dele”
3) expectativa dos outros “a minha filha
avisou-me que ele pode ser violento”
- Projectar o Rui para
4) provocação, já que Rosa lha bateu;
uma vida para além da 5) reacção a adoptar “se ele vier para mim
morte da avó eu agarro tudo o que tiver à mão”
 Mudanças

• Elogios aos comportamento e assiduidade, menos duas negativas

• Corte de cabelo “Não me chateei com ele, nunca mais lhe falei nisso e
funcionou”
• Rui “está diferente, mais meigo, até já voltamos aqueles cumprimento que
tínhamos” (sic) – referindo-se a “Olá avó… Olá neto”…”está mais homem”
• Não mudança em relação à percepção de Raquel: “quando a minha filha fala a
verdade cai-lhe um braço e ela ainda têm os dois”.
Finalização
• Arquivamento do processo CPCJ; Melhoria de 4 negativas – transitou de ano

• Follow-up e Prevenção de recaídas

• Amplificação das mudanças

• Aumento do sentimento de competências
• Desenvolvimento de novas narrativas (sucessos, soluções e forças)
• A família possui recursos para ultrapassar eventuais dificuldades futuras

• Diferenciação entre Rui e Raquel “o caminho que ela levou ele não leva”

Rosa - “Rui, quando eu morrer o que vai ser de ti?” (sic)

Rui -“Eu fico aqui em casa e depois arranjo trabalho e
mulher…tenho que organizar a vinha vida”
“…a resiliência constitui um processo natural, em que aquilo que
somos num determinado momento deve obrigatoriamente
tricotar-se com os meios ecológicos, afectivos e verbais. Basta
que um só destes meios falhe para que tudo desabe.
Basta que encontremos um único ponto de apoio e a construção
poderá começar”

Cyrulnik (1999, p.14)

"All I want is an
education,
and I am afraid
of no one."
 Para casa: imersão sistémica

• Bateson - http://www.naturearteducation.org/AnEcologyOfMind.htm
• Morin - https://www.youtube.com/watch?v=ZMGucd5vjfY
• Lynn Hoffman: https://www.youtube.com/watch?v=WjR3nP_VHR8 e
https://www.youtube.com/watch?v=7qpo18V6MjU
 Bibliografia essencial para o módulo
• Alarcão, M. (2000). (Des) equilíbrios familiares: uma visão sistemática.
• Portugal, G. (1992). Ecologia e desenvolvimento humano em Bronfenbrenner. Aveiro: Centro de Investigação. Difusão e Intervenção
Educacional.
• Modelo CORE (mapas de competências) online
• Stratton, P., Reibstein, J., Lask, J., Singh, R., & Asen, E. (2011). Competences and occupational standards for systemic family and
couples therapy. Journal of Family Therapy, 33(2), 123-143.
• Bertanlanfy, L. Teoria Geral dos sistemas https://issuu.com/julioefrainlopezcancino/docs/von_bertalanffy_ludwig_general_syst
• Stratton, P. (2005). Report on the evidence base of systemic family therapy. Association for FamilyTherapy.
• NICEClinical Guidelines recommending Family and CoupleTherapy
• Leeds Manual of Family Therapy: https://medhealth.leeds.ac.uk/download/665/leeds_systemic_family_therapy_manual
• Cyrulnik , B. (1999). Uma infelicidade maravilhosa. Lisboa: Editora Ambar.
• Walsh, F. (2003). Family resilience: A framework for clinical practice. Family Process, 42 (1),1-18
• Hoffman, L. (2003). Terapia Familiar. Climepsi Editores.
• Nelson, G. and Prilleltensky, I. (2005) Community psychology : in pursuit of liberation and well-being. Palgrave Macmillan, New York