What Is Nagy´s Contextual Therapy?

Contextual therapy was developed by Ivan Boszormenyi-Nagy (frequently referred to as just Nagy), as a combination of family and individual psychotherapy. The model looks at individuals past and current family relationships to help the identified patient and/or family identified patient. This therapy also aims to help families by facilitating their ability to acknowledge and encourage each other’s positive contributions to the family. This integrative approach is based on the assumptions that many personal and interpersonal dilemmas benefit from interventions that enable an individual to restore homestatis.
Nagy proposed the idea that all families have a ethical system, which he conceptualized as a ledger of entitlement and indebtedness. It
is thought that everyone in the family has an expectation of fairness in giving and receiving, whether verbal or non verbal. The therapist help each individual express what they feel is fair or unfair in the family and uses relationship resources to help adjust perspectives of expectations. The goal is to help the clients set realistic expectations and focus more on the positive each member of the family brings to the system. Ultimately, resetting the give and take meter in a good way.
The guiding principle for relating to clients in contextual family therapy is multidirectional partiality. (book) This refers to the therapist positioning themselves to be accountable for everyone who is affected by the interventions, present or not present. The therapist must be partial to everyone, never allowing an individual of the family to be given the blame of the unbalance system. During each session the therapist goal is to point out the progress and contribution in each member of the family. For this reason, realtime session and best with using this model.
The contextual model proposes four areas of relational dimensions: facts, individual psychology, systemic transactions, and relational ethics. Neither of these dimensions being more important than the other. Objectifiable facts looks at the individual and family history. This can be related to intergenerational therapy which involves Murray Bowen’s genogram. A genogram is used as an assessment tool were a family tree is created with information included from previous generations that could possibly help navigate the emotional family tree that may be facilitating the presenting issues. Individual psychology deals with the interpersonal thoughts and beliefs that motivate certain behaviors. Here the therapist explores deep rooted issues to help the client get to the reason why they react in certain positive or negative situations.
Systemic transactions refer to family system rules, structures, and patterns. The therapist is going to want to understand how the family system is structured and how it functions, and what dynamic is creating the real or perceived injustices. The last dimension, relational ethics, explores the idea of trust and fairness. Perceived fairness is what keeps a relationship trustworthy (book). Fairness is measured by entitlements, or ethical guarantees, that individuals perceive as just. Fulfilled entitlements create loyalties and unfilled entitlements create destructive patterns of individuals seeking debtors.
The contextual approach of focusing on fairness between the family makes it different from other models.
Other models focus on the pathology of certain issues but not how the actions are perceive and received from the other family members. It does not focus on the identified patient and actually seeks to celebrate each member equally. Even if the patient has a mental disorder such as schizophrenia the therapist does not adjust his/her method. As in the video “Can I call you mother” Nagy never addressed the fact that the mother was schizophrenic. He encouraged the mother’s desire to find a trade after getting well even when discourage by her son who said that one of the co-therapist said she would never be well. When asked why he encouraged her to pick a trade he said, “One can have the core of the thinking but not rely on it.” Also many models focus on the issue affecting the immediate family, contextual therapy looks the secondary family and multigenerational
patterns.
One of the important legacies in my family is a good work ethic and the importance of education. My great grandmother worked on a farm and later became a maid when she moved to New Orleans, La. A woman who never learn how to read was able to care for her family and purchase a home. Although, I never saw her work during my lifetime I remember the stories she told about life during that time. My grandmother never went pass the third grade, but later attended cosmetology school and became a hairdresser and later opened her own salon. My mom dropped out of college when she was 21, but went back at 35 and became a registered nurse and later opened a home health agency. At the age of 15, I begged my mom to let me work at Old Navy on the weekends. She would only let me start during the summer after school was out. I’ve had a job (or two) since that time. After receiving two degrees and excelling in my career I’m now back in school for my Master’s in Marriage and Family Therapy. I will later open my own practice and join the ranks of entrepreneurs like my mom and grandmother.
Unfortunately, not all family legacies are good. In my family their is a culture of enabling and coddling the men. I believe this started before my great grandmother was born. I can remember her telling a story about how she was expected to work and help the household, although they worked, her brothers would spend some of their money on alcohol and fun. I believe she resented that they were never handle accountable for it. My grandmother was the only girl of four siblings and has always felt that my great grandmother made like easier for her brothers. Even during their older years my great grandmother made the son who had had the most trouble in life the executor of all finances. I can remember my grandmother being so hurt because she felt she was the most responsible sibling. Although, she was the one who did more for my great grandmother my grandmother never felt the love in return. She says the first time she heard my great grandmother say I love you was on her death bed. And in true system form my mom, the only girl of four siblings, feels exactly the same way. Although my grandmother has told my mom she loves her, my mom feels that my grandmother loves and treats her brothers better. Ironically my grandmother has done exactly what her mom did to her concerning being the executor of her estate. Also, my grandmother seems to have higher expectations of my mom’s time and attention. It seems that she desires and expects my mom to give her the love she didn’t feel she received from my great grandmother. This destructive entitlement pattern has actually pushed my mom further away over the years and intern made my mom an overprotective smotherer when it comes to myself and my brother. And still, despite her attempts to not to coddle my brother too much there have been times when I’ve thought “I could never get away with that.”
Although I am close to my grandmother my loyalty lies with my mom. My mom has bent over backward for most people in her life, including my grandmother. The unjust treatment from my grandmother has defiantly caused major trust issues with my mom. They have a very strained relationship which leaves both of them feeling like they are not getting what they need from the other. This disconnect is even with my moms brothers. They seem to have loyalty to my grandmother and there is broken trust with them. My mom used to call and send cards on their birthdays until she realized that was not going to make them ever remember hers. Hurt and hurt my mom has forgiven but that has not healed the missing piece in her heart.
Over the years this has affected me in that I’m not close with my family at all.
Not even with my cousins. If the brothers and sister are not talking neither are the children of these individuals. I grew up wishing I had a close relationship with my extended family. This caused me to create very close bonds with friends. I have three friends that are like my sisters, and I cherish these relationships. In the last year however, social media has facilitated a better relationship with my cousins. We text more often and we are planning a family gathering this summer. In other relationships I find that I’m forgiving to a point. After a person at work, or any other social context, crosses my invisible line I’m quick to cut them off. I believe seeing the pain of unmet expectations causes me to loss faith in expecting anything good from that particular person, which translates to I cannot
them.
I believe contextual therapy would actually help my family. There are so many issues in my family system and among the subset that using other modalities would cause us to spend more time blaming than creating a balanced system of give and take. After studying contextual therapy I believe I will have more resources to interact with my family. Taking away the blame component and replacing it with thoughts of what they contribute in a positive way to the family with help tremendously. I look forward to sharing some of these thoughts with my cousins and hopefully facilitate the beginning of a emotionally balanced family.