. Family Function and Birth of a Child

Family Function and Birth of a Child


 

William I. Cohen


 

FAMILY FUNCTION


A discussion of family transitions and their effects on children requires consideration of the function and structure of families beginning with the biological family (parents and children). This basic grouping provides the context and crucible for a child’s development. It is important to note, however, that many other family constellations successfully provide for the needs of children in addition to the two biologic-parents model: single-parent families, children raised by extended kinships (including grandparents), same-sex couples, adoptive families, foster families, blended families, and communal families. Despite moral, religious, and legal issues (as is the case of single-parent families and same-sex couples in the early 21st century in the United States), each of these can be as successful in this task as the biological family can be unsuccessful (Table 19-1).


The family serves as a microcosm of society, transmitting core values and beliefs. The children, in turn, learn these values and, in many instances, transmit them to the next generation. These values are not, however, universal: Consider societies where women have inferior status or where children are considered property. In our culture, with its Judeo-Christian tradition reflected in our Western legal tradition, children are protected from physical, emotional, and sexual maltreatment, and the role of the family is to prepare the child for independent functioning.


Picturing the family as a mobile (like those which often hang over an infant’s crib) provides a visual representation of an important aspect of its structure: Each level corresponds to a different generation, reflecting a natural hierarchy (Fig. 19-1). The interconnectivity of family members is also well-represented by this model. As constructed, mobiles are in balance. This balance is dynamic because the elements can move through three dimensions. A force that disturbs the mobile will swing the elements wildly about, but within a short period of time, the mobile returns to its balanced configuration. This homeostatic quality is a fundamental characteristic of families as well. The preservation of the status quo is a strength when it helps the family weather external forces and changes. At the same time, rigidity and inflexibility can be a liability. Add or subtract a member, and the balance will change. Changing the role of any member may also change the balance: An illness or loss of job can have the effect of diminishing the impact of a parent, and the mobile will again shift to a different balance point. The family is in constant motion, seeking stability through dynamic motion. Nevertheless, this homeostatic function is dynamically opposed to the inevitability of change.


The transitions discussed in this and the next three chapters address events that perturb and disturb the equilibrium of a family in a variety of ways, most of them predictable. The ultimate effect on the unit, however, depends on the ability of the family to adapt to the changes: changes in roles and changes in rules. Shonkoff and colleagues1 discuss these issues in more depth.


Students of family systems have observed a natural progression referred to as the family life cycle,2 which begins with the formation of a couple from dating through courtship to a committed relationship or/marriage, followed by the addition of children (via birth or adoption). This last step adds a parental role to the spousal roles already in place. As the children grow and move toward autonomy and ultimately leave home, the couple must renegotiate their relationship and focus predominantly on each other’s needs as the parental role fades. More recently, economic circumstances in the United States have led to the return of adult children into the household, with a variety of dilemmas, mostly associated with hierarchy: These individuals often feel the acute loss of their hard-won autonomy as they are asked to live again under their parents rules. For the parents, economic dislocation caused by loss of employment may affect household functioning not only because of a change in the financial circumstances but also because of the emotional effect on the former breadwinner. The addition of aging, infirm grandparents may be coupled with activation of latent conflict over divided loyalties between one’s parents and children that had been previously suppressed. The family life cycle reminds us that at each juncture in the cycle, the roles and relationships among family members change, and families commonly experience difficulties when these shifts do not occur smoothly.2,3 Some families become stuck and experience great distress requiring professional assistance to move to the next stages.


Table 19-1. Changes to the Family Constellation

































































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Jan 7, 2017 | Posted by in PEDIATRICS | Comments Off on . Family Function and Birth of a Child

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A. Additions to the Family


1. Child


a. Newborn by birth or adoption


i. Healthy


ii. Medical problems


iii. Developmental disabilities


b. Older child


i. Foster care


ii. Adoption


iii. Stepsiblings


2. Adults added to family


a. Adult children returning home


b. Grandparent or other family member


i. For economic reasons


ii. For health reasons


c. Parental partner/spouse (or same-sex partner)


3. Return from separation of parent/partner


4. Return of parent/partner from employment, military service, or incarceration


B. Losses


1. Death of sibling


2. Death of parent


3. Death of grandparent


4. Loss of parent/partner (separation or divorce)


5. Temporary loss of parent/partner


a. Move for employment


b. Military service


c. Incarceration


6. Loss of function (and attendant role) of family member


a. Acute or chronic illness


b. Injury