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Family Therapy for the

"Truncated" Nuclear Family

Gerald H. Zuk

ABSTRACT: The "truncated" nuclear family is the commonest or garden-

variety family psychopathology observed by therapists, and consists of a
two-generation group in which heated, prolonged conflict has produced a
polarization of values which has generated pathogenic relating, raising the
potential for a family member to become scapegoated and react in a dis-
organized or disoriented manner. Although many so-called intact families
are of the "truncated" variety, the single-parent family is at special risk.
Go-between process is a useful family therapy for the "truncated" nuclear
family because it enables the therapist to depolarize sharply conflicted
values and is a mechanism for reducing pathogenic relating.

The field of family therapy is nearing 30 years of age; but rather

than likening it to a strapping young man, it would be better to pic-
ture a troubled youth struggling to define himself vis-a-vis peers,
family, and community.
There is not one family therapy but rather there are several. The
generalization that the field divides itself into psychoanalytically-
oriented versus systems-oriented advocates still has validity, but to-
day there are important subcategories within these major divisions.
The discussion here will be about the go-between process, the sys-
tems-oriented family therapy which I have been in process of
developing since about1961 and which, according to Stanton (1980,
in press), is one of the three major systems-oriented approaches in
the field.

Gerald H. Zuk, Ph.D. is the editor of this journal and is affiliated with the Eastern Penn-
sylvania Psychiatric Institute, Henry Avenue and Abbottsford Road, Philadelphia, PA 19129.
Reprint requests should be addressed to the author. This article was originally an invited
presentation for the Third Annual Research Symposium of the Eastern Pennsylvania
Psychiatric Institute, held in Philadelphia on February 22, 1980.

International Journal of Family Therapy, 2(3), Fall 1980 193

0148-8384/80/1500-0?93500.95 9 1980 Human Sciences Press



Go-between process has had, in my judgment, the benefit of the

most intensive and thorough empirical research in the field to date.
In a 6-year research program sponsored jointly by the Com-
monwealth of Pennsylvania and the Federal Government, Garrigan
and Bambrick (1975, 1977a, 1977b, 1979) demonstrated in studies
repeating a basic research design, using a total sample of 70 families
that had children attending a school for emotionally disturbed, that
the children exhibited an improved readiness to learn and that their
conduct improved after undergoing a course of family therapy
utilizing the basic principles of the go-between process. At follow-up
1-2 years later, a significantly greater percentage of the treated
children had returned to regular public school classrooms, and more
of the untreated children had had encounters with law enforcement
It is pertinent that the Garrigan-Bambrick positive results were
achieved not by experienced family therapists, but rather by
graduate-level counseling students at Lehigh University in Penn-
sylvania who received a 150-hour training program especially devis-
ed by Bambrick. Although family therapy is indeed an art as well as
clinical science, and few are supreme masters of this art, it seems
clear that its rudiments can be taught fairly rapidly and applied ef-
fectively in selected circumstances by unskilled but motivated


Go-between process is, I believe, the most clearly defined system

of family therapy in the field today. Its numerous concepts and
terms have been defined elsewhere, but here I want to set down
seven of the terms which seem to me fundamental to the system;
that is, a set of seven terms which form the core of the system.

1. Go-between process itself refers to the transactions between

therapist and family in which the therapist enacts the roles of go-be-
tween, side-taker, and celebrant as sources of leverage producing
change in the family deemed desirable by the therapist and family.
2. The go-between role is a special source of leverage for change
in which the therapist sets the rules of communication among family
members during interviews.


3. The side-taker role is a special source of leverage for change in

which the therapist takes sides with or against family members on
issues that arise in interviews.
4. The celebrant role is another special source of leverage for
change in which the therapist celebrates and certifies important
family events or crises, thus confirming and/or restoring stability and
continuity to a family under strain.
5. Pathogenic relating is a major component of family psycho-
pathology observed by the therapist in such malicious conduct in
family interviews as physical threat or verbal intimidation, double
binding, and silencing. It sets the stage for scapegoating and an out-
break of symptoms stemming from the intense pressure set up by
pathogenic relating.
6. Continuity values are those which stress the goodness of emo-
tional expressiveness, humanitarianism, egalitarianism, and the
wholeness of human experience. In family conflict, they are more
likely to be expressed by wives against husbands than vice-versa, by
children against parents, and by the family against the community.
7. Discontinuity values are those which stress the goodness of
order and rationality, efficiency, and analysis of human experience
into component parts. In family conflict, they are more likely to be
expressed by husbands than wives, by parents than children, and by
the community than family.


The family therapist functions as go-between, side-taker, and

celebrant during interviews, and expresses in each of these functions
both continuity and discontinuity values. His selection of functions
and values is determined by his perception of pathogenic relating in
the family. The therapist must be sympathetic and respectful of
both value systems, for both are equall3# important in human affairs,
although in any one human transaction it may be proper for one to
dominate over the other.
Of the theories in family therapy, go-between process is the one
that takes the greatest account of the influence of ethnic, racial, and
religious factors, and also of the effects of current crises or ac-
cidents of living. It takes the greatest account of educational or
socioeconomic status of families as they may affect the process of
therapy. It specifies how therapists shou Id structure the approach to
take account of these factors. Although other theories address these


factors, I think it is entirely fair to state that none incorporates them

in theory and practice as does go-between process (Zuk, 1971,1975,
Because of the high drop-out rate characteristic of family therapy
when it is not limited to affluent, well-educated families, go-
between process has focused on the problem of engaging am-
bivalent families. Most family therapy is short-term (of less than 6
months' duration) because most families do not tolerate well the
strain of a longer contact, whereas they can benefit from the short-
term contact. In order to obtain the benefit of a short-term contact,
it is necessary to maximize the likelihood of family engagement
because without engagement there can be no therapy. By develop-
ing a specific procedure to promote engagement, the go-between
process hopes to maximize the possiblity of a good result.
Go-between process does not aim at personality change, which is
an unrealistic goal of psychotherapy, but rather at a change in ideas,
attitudes, and conduct in family members. It does not deal much
with family history, but rather concentrates on current events affec-
ting the family and how it may be possible to alter responses to these
events that are proving disruptive, disorganizing, and disorienting to
family members.
Go-between process includes a formulation of the garden-variety-
type family psychopathology present in large numbers of American
families today. Necessary ingredients of the formulation are a
technologically advanced society in which there is high mobility in
the population, relative economic affluence, a large pool of skilled
personnel and managers, and immense educational resources and
hu man services. This is the kind of society that has made possible the
emergence and domination of the nuclear family over the tradi-
tional extended family system. The nuclear family provides a special
intimacy and privacy; it has been referred to by the social historian
Christopher Lasch as the "haven in a heartless world."
But it is known that the nuclear family is somewhat unstable
relative to the traditional extended family form, and has certain
weaknesses. It is under great pressure in our American post-in-
dustrial society in which families are being asked almost daily to
adapt to new technology and the management associated with new
technology. Vast social changes are taking place: Blacks, women,
and Hispanics are asserting themselves as never before in the
marketplace and elsewhere; there are now more than I million
divorces every year in the country resulting in several million
children being added yearly to the rolls of those raised in single-
parent families; in nearly 90 % of those children are raised by their


The garden-variety family psychopathology that I observe in

family therapy consists of a wife-mother whose values have become
central to her children, of a husband-father who is either estranged
or absent from wife and children and whose values are thus suspect
by them, and children passing into adulthood with a poor attitude
toward society because society's values tend to overlap closely the
values of the husband-father. Perhaps this will be less true as more
women enter the work force and become more conversant with the
values of the workaday world, or less true as the presence of women
in large numbers in the workaday world produces changes in its
values more consonant with those more typically advocated by
women. What we know is that in 1974 almost one-third of all those
arrested for felony were under 17 years of age-- an alarm ing statistic
that is also a reflection on the plight of the American family.
I find in adolescents seen today in therapy with their families an
alarming lack of sympathy or tolerance for the values of the com-
munity--a lack which has not sprung up out of thin air but which has
had a long period of incubation. The husband-father, the major in-
strument in the family for the transmission of those values which are
dominant in the workaday world, has often not been sufficiently pre-
sent to teach them adequately. Children ally with the values taught
them by their mothers, which are predominantly "continuity"
values, and are hostile to the values taught by the father, which I
have referred to as "discontinuity" values. The children are, accord-
ingly, poorly prepared for the workaday world with its enormous em-
phasis on "discontinuity" values.
I call the family referred to above the "truncated" nuclear family,
and it is the commonest or garden-variety type of family psycho-
pathology observed by therapists. The "truncated" nuclear family
shows the following characteristics which are believed to occur in
causal sequence: (1) heated, prolonged, unresolved conflict bet-
ween spouses, between parents and children, or between family and
community, leading to (2) the polarization of "continuity" and
"discontinuity" values, leading to(3) pathogenic relating, leading to
(4) the increased risk of members reacting in a disorganized,
disoriented or chaotic manner.
The single-parent family is not necessarily a "truncated" nuclear
family, but it is at higher risk than the so-called intact family because
of the disproportionate emphasis, due to the absence of one parent
(most often the husband-father), on a set of values which does not by
itself satisfactorily prepare offspring for the workaday world. Both
"continuity" and "discontinuity" values need to be effectively
taught in the family, and it is my view that two parents do this better
than one. There are differing explanations for why this should be so,


but I shall provide one that makes the best sense to me.
Underlying my view of the "truncated" nuclear family is the belief
that, although undoubtedly there is a wide area of overlap, the wife-
mother espouses and teaches her children selected different values
from the husband-father. She is better suited than her husband to
teach her children the values of emotional responsiviW, continuity
of traditions, and humanitarianism. Her husband is better suited to
teach the values of order and reason and efficiency in managing
one's affairs. This view would undoubtedly be attacked by members
of Women's Lib, but nevertheless I think it has been true in the past
and is still true today.
Perhaps I will be forgiven a personal example of how profoundly
differently parents are valued by their children, even when very
young. As the somewhat overaged father of twin 4wear-old
daughters, I have come to accept with some regret that in most in-
stances of joy or hurt they will turn first to their mother for a
response. But one very interesting event occurred a few months
back: Suddenly a storm broke out while the family was at home, and
there was much thunder and lightning. Both children ran right past
their mother and leaped into my arms! This alarming event had hap-
pened outside the home, and apparently my daughters concluded
almost reflexively that daddy was the natural protector in these
strange outside events.


At a time when certain extravagant claims are being made on

behalf of family therapy, there seems need of a cautionary word.
Family therapy is not, as some have claimed, a "historic" movement
in mental health although it is an important event. Happily, it coin-
cided with the idea to utilize existing technology and expertise to
make more humane the treatment of the mentally ill. Of course the
idea I am referring to was embodied in the historic legislation in 1963
that created the community mental health movement. What had
been possible up until that moment, suddenly became reality. For all
of its disappointments, let us not forget for a moment that the com-
munity mental health movement was an embodiment of the wish of
this society to be more humane toward its citizens who suffer a men-
tal illness. It is too early to make a sound judgment, but I believe that
there will be a substantial consensus in the next few years that the
country made a good practical decision when it undertook the great
experiment known as the community mental health movement.


Family therapy will not solve our national and international

disputes, and it is certainly not the treatment of choice for all
psychiatric disorders. But it has, I believe, proved itself an excellent
resource to manage some of the intolerable tensions experienced by
families, and the consequences of such tensions. It has important
applications in child and spouse abuse, in juvenile delinquency, in
scholastic underachievement, and in helping persons attain creative
goals in living. In the realm of psychiatry, it would be a foolish claim
that family therapy is a cure for alcoholism or drug abuse, or
psychosis or schizophrenia, but it has an important role to play in the
management of these disorders. Family therapy has a legitimate
claim as a primary treatment of neurotic and psychosomatic
disorders, and a particularly good claim as a primary treatment of
depressive disorders, since it is widely acknowledged that marital
and family strife play a major role in the depressions.
It is essential now that tougher evaluations of the major family
therapies be undertaken for currently there are too many claims for
effectiveness being made in the absence of definitive research.
Although I am not entirely in agreement with the recent call of
Gerald Klerman, ADAMHA administrator who oversees federal
mental health research and development programs, that psycho-
therapies be held to the same standards of evaluation as drugs, there
should be more evidence of such research in the field of family
therapy which currently has more than its share of muddled theory
and practice. There is little excuse at this time for any major clai-
mant in the field not to subject his or her claims to stringent and
rigorous evaluation.

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