Family Experience of Borderline Personality Disorder

Individuals with borderline personality disorder (BPD) struggle with unbearable emotions that arise out of interpersonal difficulties. Self‐harm and suicidal behaviours serve to regulate these emotions and to gain a sense of well‐being and control in a treatment context where hospital admissions are avoided by mental health services. Clinician engagement with families may be constrained by their knowing the accepted etiology of the disorder, which includes a causal link with the family environment. Other constraining factors include the negativity of those with BPD toward their family, and their clinicians' diagnostic uncertainty or confusion. This qualitative study explored the experience of families whose close relative with BPD has a long history of self‐harm and/or suicide attempts. Family members were found to have chronic and traumatic stress. Family roles and relationships were strained, as were relationships between the family and the mental health system. The findings of this study indicate that treatment for BPD needs to adopt a systemic approach that considers individuals and their significant family relationships, as well as relationships between the family and treatment providers.     

Generalized average rules as stable Nash mechanisms to implement generalized median rules

We consider a problem in which a policy is chosen from a one-dimensional set over which voters have single-peaked preferences. While Moulin (Public Choice 35:437–455, 1980) and others subsequent works have focused on strategy-proof rules, Renault and Trannoy (Mimeo 2011) and Renault and Trannoy (J Pub Econ Theory 7:169–199, 2005) have shown that the average rule implements a generalized median rule in Nash equilibria and provide an interpretation of the parameters in Moulin’s rule. In this article, we first extend their result by showing that a wide range of voting rules which includes the average rule can implement Moulin’s rule in Nash equilibria. Moreover, we show additionally that within this class, generalized average rules are Cournot stable. That is, from any strategy profile, any best response path must converge to a Nash equilibrium.     

Australian Family Therapy: Have We Lived Up To Our Mission Statement?

In 1983 the Fourth Australian Family Therapy Conference had the theme ‘Merging the Streams — Integrating Trends in Family Therapy’. In his keynote address Brian Stagoll outlined concerns regarding the nature of family therapy as it was then developing in Australia. This article revisits some of these themes to see where we have come from, where we are heading and which topics continue to be ignored. Evidence is drawn from articles that stood out for me in the Australian Journal of Family Therapy (later the Australian and New Zealand Journal of Family Therapy) and selected relevant papers from the 1983 conference itself. Finally, I speculate upon possible reasons for the absence of discussion on certain issues, most strikingly: systemic influences upon indigenous Australians, farm families, working with children in families, certain aspects of gender, the systemic implications of addiction; and environmental impacts on families now and for the future. The danger for family therapy is becoming stuck in a closed system that ignores the wider system.     

Non-Equilibrium, Chance and Change in Family Therapy

The model of the systemic approach that we commonly use in family therapy is mainly an homeostatic model insisting essentially on negative feedback and allowing little room for amplification phenomena and for abrupt changes that may occur. Our approach, called “systemic,” is related principally to models applying in cases of processes occurring at thermodynamic equilibrium or at stationary states close to equilibrium. In those instances, stability is maintained no matter what external or internal perturbations are exerted on the system. But our practice shows that a modification limited to one part of the family system extends quickly to the whole system. How are those changes brought about? How is an open system, such as the family in which feedback loops exist, pulled away from a stationary state? It was partly to answer such questions that we started to give attention to organizational forms likely to appear away from thermodynamic equilibrium and particularly to the work done in this field by the team ofllya Prigogine. Starting with a few examples of “dissipative structures” some concepts will be introduced which seem likely to be fruitful in our field.     

Becoming the Family Archivist

The author describes some of the ways in which conventional amateur family histories fail to portray the emotional realities of family life. Recent trends in biography and autobiography are explored briefly, and the possibility of a family history informed by systemic as well as psychoanalytic insights is considered. The author's own work, A Family in Time, attempts such a history. The author outlines his sources of information, both documentary and oral, and the special challenges posed by their interpretation. The decisions governing the ordering and selection of data for publication are explored, the author's aim being to present the facts in such a way that a systemic conception of family process over time will be implicit in the material. Implications for the author, for the family itself, and for therapists working with intergenerational process are briefly considered.     

Games implementing the stable rule of marriage problems in strong Nash equilibria

In a marriage problem, we introduce a condition called “exclusive matchability (EM)”: the condition mainly says that each pair of a man and a woman can choose to be a matching pair regardless of others' actions. This condition is essential to strong Nash implementation of the stable rule. We show that any mechanism which satisfies exclusive matchability implements the stable rule in strong Nash equilibria. Received: 17 May 1999/Accepted: 30 August 2001 I would like to thank anonymous referees for their helpful comments. Financial support from the Social Sciences and Humanities Research Council of Canada is gratefully acknowledged.     

The Family Rule Concept in the Theory of Family Therapy**

This paper is an exploration of the usefulness of the concept of a family rule in systems thinking. Wittgenstein's analysis of rule conforming behaviour is considered alongside the early contributions of Jackson, Haley and others. Confusion has resulted from using the word “rule” in both its everyday sense and as a theoretical construct. A parallel confusion shows Itself in the activity of reframing where the selection of an alternative context is often theoretically based while the client receives an explanation in the language of everyday intentional actions.     

Identification of domain restrictions over which acyclic, continuous-valued, and positive responsive social choice rules operate

We consider a social choice problem in various economic environments consisting of n individuals, 4≤n<+∞, each of which is supposed to have classical preferences. A social choice rule is a function associating with each profile of individual preferences a social preference that is assumed to be complete, continuous and acyclic over the alternatives set. The class of social choice rules we deal with is supposed to satisfy the two conditions; binary independence and positive responsiveness. A new domain restriction for the social choice rules is proposed and called the classical domain that is weaker than the free triple domain and holds for almost all economic environments such as economies with private and/or public goods. In this paper we explore what type of classical domain that admits at least one social choice rule satisfying the mentioned conditions to well operate over the domain. The results we obtained are very negative: For any classical domain admitting at least one social choice rule to well operate, the domain consists only of just one profile.     

On asymptotic strategy-proofness of the plurality and the run-off rules

In this paper we prove that the plurality rule and the run-off procedure are asymptotically strategy-proof for any number of alternatives and that the proportion of profiles, at which a successful attempt to manipulate might take place, is in both cases bounded from above by , where n is the number of participating agents and K does not depend on n. We also prove that for the plurality rule the proportion of manipulable profiles is asymptotically bounded from below by , where k also does not depend on n. Received: 10 February 2000/Accepted: 19 October 2000     

The Dodgson ranking and its relation to Kemeny’s method and Slater’s rule

In this paper we provide a binary extension of Dodgsons non-binary preference aggregation rule. This new aggregation rule is then compared to two other rules which, as Dodgsons rule, are also explicitly based on distance functions, namely Kemenys and Slaters rule. It is shown that the alternative which is top ranked by any of those rules can occur at any position in the Dodgson ranking.I am very grateful to Nick Baigent, Daniel Eckert and the participants of the CEPET 2002 Workshop in Udine and the Graz University Research Seminar for their comments on earlier drafts of this paper. It goes without saying that any remaining errors are exclusively the authors responsibility.     

How to choose a non-controversial list with k names

Barberà and Coelho (WP 264, CREA-Barcelona Economics, 2007) documented six screening rules associated with the rule of k names that are used by diferent institutions around the world. Here, we study whether these screening rules satisfy stability. A set is said to be a weak Condorcet set à la Gehrlein (Math Soc Sci 10:199–209) if no candidate in this set can be defeated by any candidate from outside the set on the basis of simple majority rule. We say that a screening rule is stable if it always selects a weak Condorcet set whenever such set exists. We show that all of the six procedures which are used in reality do violate stability if the voters do not act strategically. We then show that there are screening rules which satisfy stability. Finally, we provide two results that can explain the widespread use of unstable screening rules.     

Assessment in Marriage and Family Therapy: A Review of Clinical Updates for Family Therapists

This article presents information from an integrative literature review that examined assessment processes presented to marriage and family therapists in Clinical Updates for Family Therapists, Volumes 1 (2005), 2 (2006), and 3 (2007). The study was based on the concern that marriage and family therapy is losing its systemic relational focus as practitioners must comply with diagnosis models using the Diagnostic and Statistical Manual of Mental Disorders. Using integrative literature review methods, similar to qualitative research, 54 articles were deconstructed to identify assessment tools and diagnostic processes being presented as best practice. Of the 54 articles, 96% identified the importance of having a family or couple relational perspective for working with individuals with mental disorders; however, only 54% provided any explanation to how this could be accomplished. These findings suggest a need to increase the identification of unique, relational assessment practices in articles that offer best practice techniques in marriage and family therapy.     

Object Relations Family Therapy: Articulating the Inchoate

In recent years there has been a renewed interest in psychodynamic ideas within the family therapy literature. While some authors have explored the usefulness of psychodynamic concepts in the systemic context (Byng-Hall, 1995; Flaskas, 1993, 1996; Luepnitz, 1988, 1997), others have argued that psychodynamic models of family therapy should be given more credence in systemic work with families (Guttman, 1991). This paper describes Object Relations Family Therapy (ORFT), a psychoanalytic model of family therapy, in plain English in order to minimise the obscurity of some of the existing terminology and to emphasise the utility of more contemporary formulations. ORFT addresses the interface between psychoanalytic and systemic theories. It offers a way of conceptualising complex family dynamics at both the interpersonal and intrapsychic levels. It also integrates an understanding of nonverbal, unstated and often implicit processes in its formulation of problem development. The unique contribution of ORFT is elaborated using a clinical example.     

Enhancing Family Therapy's Relationships With Research

The contention of this article is that systemic family therapy has much to gain from a realistic appraisal of its research base, which is as positive as possible. And that through such an appraisal we can find ways of developing the scope of family therapy to the benefit of the profession and thereby, of our clients. Family therapy will benefit if practitioners can present an informed view of research. As a preliminary approach to this objective, I review reasons why perceptions of family therapy underestimate its research base, and why therapists might resist involvement with research. The article then explores the reasons for regarding randomised controlled trials as a ‘gold standard’, and why they are not well fitted for the purpose of evaluating or developing a relational therapy. Next is a consideration of alternative approaches to research, including a consideration of what clients actually want from their therapy, then a brief review of the positive findings of outcome research. Greater emphasis on researching processes in therapy is proposed, and consideration of the ‘common factors’ debate is shown to support priorities that are specific to systemic therapies. The article concludes with suggestions for increasing the involvement of family therapists with research, both as consumers and as research practitioners.     

How and Why Do Family and Systemic Therapies Work?

My reviews of the evidence base for family therapy conducted over the past 15 years have been guided by four key questions. Does systemic therapy work? What sorts of systemic therapy work for specific problems? What processes occur in effective systemic therapy? Is systemic therapy cost‐effective? In this paper answers to these questions are given. Systemic interventions are effective for about two out of three cases. Specific models of effective systemic therapy have been developed for most common mental health problems. There are many processes shared by evidence‐based models of practice that can be incorporated into the routine practice of research‐informed family therapy. Systemic therapy is cost‐effective and in many cases leads to medical cost‐offsets. Available evidence indicates that family therapy can make a very significant contribution to alleviating suffering and making the world a better place to be.     

Minimal monotonic extensions of scoring rules

Noting the existence of social choice problems over which no scoring rule is Maskin monotonic, we characterize minimal monotonic extensions of scoring rules. We show that the minimal monotonic extension of any scoring rule has a lower and upper bound, which can be expressed in terms of alternatives with scores exceeding a certain critical score. In fact, the minimal monotonic extension of a scoring rule coincides with its lower bound if and only if the scoring rule satisfies a certain weak monotonicity condition (such as the Borda and antiplurality rule). On the other hand, the minimal monotonic extension of a scoring rule approaches its upper bound as its degree of violating weak monotonicity increases, an extreme case of which is the plurality rule with a minimal monotonic extension reaching its upper bound.

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Exploring the Organisational Collage of Memetic Paradigms for (a) Change — A Research Note

Exploring organisations is the prerequisite for any intentional attempt to strategic change. Yet, what is it that we observe when we observe organisations? The argument chooses a narrative approach to exploring organisations. With Niklas Luhmann we look at the operations of organising which makes the organisation an organisation. The paper suggests the organisational collage (I.) of stories as a starting point of the exploration. The specific focus is on meaning-creation and sense-making as the genuine act of organisational self-observation. The disciplinary matrix (II.) reflects on how stories and narratives crystallise and rule the organisation in a paradigmatic way. Along Thomas Kuhn's understanding of paradigms (III.) management is referenced as an activity of a community of practice based on a disciplinary matrix of models, methods and instruments. Giorgio Agamben's conceptualisation of paradigms as reference giving examples allows the opening up of the implicit side of organisational culture. Memetics (V.) approaching reference giving examples as memes and culture as a meme-complex enable the observation of dynamics and cultural evolution over time. Concluding we come to understand the organisational implications (V.) of the conservative nature of organisational development and the systemic sensitivity that allows for management, learning and change. And as always, advances in research come at the price of new questions.     

Family Therapy and Substance Abuse

The approaches of family therapies to substance abuse are reviewed and evaluated. Questions from a systemic perspective are raised about the therapeutic efficacy of the structural/strategic family therapies which predominate in the literature. Consideration is given to certain clinical issues and to the place of a systemic perspective in a drug and alcohol service.