See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/271852368

The Portrayal of Black Swan Through a Multicontexual Framework

Article in The Family Journal · January 2015

DOI: 10.1177/1066480714555670

CITATION READS
1 3,560

4 authors, including:

Candace Austrich Renee Brown Hangartner

University of South Florida U.S. Department of Veterans Affairs
1 PUBLICATION 1 CITATION 26 PUBLICATIONS 293 CITATIONS

SEE PROFILE SEE PROFILE

Lindsey Steding
University of South Florida
13 PUBLICATIONS 34 CITATIONS

SEE PROFILE

All content following this page was uploaded by Renee Brown Hangartner on 14 May 2019.

The user has requested enhancement of the downloaded file.

Student Section
The Family Journal: Counseling and
Therapy for Couples and Families
The Portrayal of Black Swan Through 2015, Vol. 23(1) 97-101
ª The Author(s) 2014
Reprints and permission:
a Multicontexual Framework sagepub.com/journalsPermissions.nav
DOI: 10.1177/1066480714555670
tfj.sagepub.com

Vi D. Smith1, Candace G. Austrich1, Renee R. Brown2,

and Lindsey H. Steding2

Abstract
Family systems theory emphasizes the importance of examining multigenerational contexts of the individual, family, and
sociocultural influences when trying to understand dysfunctional behavior patterns. Problems arise when individuals and
families encounter transition points without the ability to adapt to the changing condition, symptoms emerge as indicators that
the family system is unable to move on to the next stage. The following analysis of Black Swan will examine how the prota-
gonist’s learned patterns of interaction develop into problematic behaviors in the midst of instrumental events depicted in the
film. As vertical stressors of societal expectations and family patterns of enmeshment intersect with the horizontal stressors of
accomplishing the critical life tasks of young adulthood, Nina experiences extreme distress. Her attempts to cope with the
demands of these stressors are maladaptive and eventually lead to her death.

Keywords
family systems theory, Black Swan, social expectations, enmeshment, movie, family counseling

To understand how people evolve, the multigenerational con-
texts of individual, family, and sociocultural influences must
be examined as people move through time (McGoldrick &
Shibusawa, 2012). Problems arise when individuals and fami-
lies encounter transition points without the ability to adapt to
the changing condition, symptoms emerge as indicators that
the family system is unable to move on to the next stage
(Goldenberg & Goldenberg, 2008). A multicontextual frame-
work allows the analyst to conceptualize the flow of multiple
stressors impacting the life of naive yet troubled ballerina, Nina
Sayers, the protagonist in the film Black Swan. The story fol-
lows Nina’s experience rehearsing for the prestigious lead role
in Swan Lake. Nina lives in a cramped apartment with her
mother in the city, and every aspect of her daily life revolves
around her dance career. Nearly every therapeutic analysis
would classify Nina’s behaviors and manner of interacting with
others as dysfunctional, but a family systems understanding of
this character’s presentation differs from other orientations by
incorporating the interdependent and ever-evolving contexts of
Nina’s existence. According to this model, Nina is entangled at
the intersection of two dimensions of stressors. The following
analysis of Black Swan will examine how the protagonist’s
learned patterns of interaction develop into problematic beha-
viors in the midst of instrumental events depicted in the film.
dimensions: (a) vertical, representing patterns of relating
and functioning transmitted down generations of a family and
(b) horizontal, characterizing the flow of anxiety produced as
the family moves through time (Carter & McGoldrick, 1989).
Vertical stressors can be depicted as moving downward in
time as anxieties and behavioral patterns are relayed genera-
tionally, while horizontal stressors can be perceived moving
forward in time as current events unfold over the life span
(McGoldrick & Shibusawa, 2012).
Vertical Stressors
Sociocultural system level. At the sociocultural level, vertical
stressors represent history that has been passed down in the
form of group legacies, beliefs, stereotypes, and values
(McGoldrick & Shibusawa, 2012). One highly ingrained
value of American society is the beauty ideal of thinness. The
message to be thin penetrates many aspects of society via
advertisements, news coverage, and entertainment media. As a
professional ballerina, pressures for the character Nina to be thin
1
Rehabilitation and Mental Health Counseling, University of South Florida,
Tampa, FL, USA
2
Department of Psychology, University of South Florida, Tampa, FL, USA

Stressors Corresponding Author:

Renee R. Brown, Department of Psychology, University of South Florida,
The multicontextual family therapist investigates these elec- Tampa, FL 33620, USA.
trical currents by searching for influential stressors along two Email: rrbrown5@usf.edu
98 The Family Journal: Counseling and Therapy for Couples and Families 23(1)
are amplified, and thus, reinforces society’s emphasis on the
thin ideal. Furthermore, because ballet requires rigorous prac-
tice and tremendous fitness to execute the strenuous leaps,
turns, and lifts, a petite shape is idolized in ballet companies.
Perhaps the most pervasive, yet detrimental, stressor
exerted in Nina’s life at the sociocultural level is the perpetual
need for perfection. The ballet environment accentuates the
power and beauty of the stage, where dancers are immorta-
lized in their performances. After years of intense training,
many dancers come to believe that their ‘‘sense of self-
worth depends on their ability to do things right’’ (Van
Staden, Myburgh, & Poggenpoel, 2009). Nina spends tireless
hours on perfecting technique during rehearsal and then goes
home to continue practicing in her living room ballet studio.
Her movements are succinct and precise as she obsesses over
getting every move right. Although Nina’s body is over-
strained, she pushes herself to perform, driven by the deep-
rooted belief that anything less than perfection is intolerable.
Family system level. Nested in the sociocultural system, the fam-
ily system is smaller but is particularly forceful in that its
effects are more directly and emotionally felt. The family stres-
sors on the vertical axis characterize transgenerational patterns
of relating and functioning passed along in various ways. These
historical factors include family legacies, emotional patterns,
myths, attitudes, expectations, communication styles, bound-
aries, and triangles (McGoldrick & Shibusawa, 2012).
Nina’s mother, Erica, attributes the end of her own dance
career to becoming pregnant with Nina, and still holds some
resentment about this sacrifice. Erica’s lack of resolution with
her past provides a historical backdrop into her daughter’s
inherited emotional patterns. While Erica craves Nina’s suc-
cess because it satisfies her own infatuation with the ballet,
Erica is also envious at the same time. Erica’s bedroom is
inundated with homemade paintings of young Nina in her
tutu, suggesting Erica lives vicariously through her daughter’s
dancing achievements. Conflicted by unfulfilled desires and
passive–aggressive ambivalence toward Nina’s success, Erica
puts extreme pressure on Nina to fulfill her fickle and often
unrealistic needs.
A maladaptive cross-generational structure is illustrated
by the diffuse boundaries between Nina and her mother.
Boundaries refer to the unspoken rules among family mem-
bers regarding the flow of information and emotional interac-
tions (Wachtel & Wachtel, 1986). An enmeshed transactional
pattern is illustrated in Erica and Nina’s relationship, meaning
they are overly involved in each other’s personal affairs and
identity. In their home, there appears to be no privacy. Erica
will barge in on Nina in the bathroom. Even though Nina is
in her 20s, Erica puts her to bed, brushes her hair, and is
excessively concerned with Nina’s interactions at the ballet
company. This structure is maladaptive because it makes dif-
ferentiation of identity difficult for both parties and prohibits
Nina from achieving the critical tasks of her life cycle stage.
During adolescence, parents’ roles with their children are
supposed to be redefined as they become more independent
and more autonomous. However, Nina cannot engage in peer
relationships, chores, or other self-discovery activities that
would facilitate her individuation.
Although it is clear that Erica has the majority of the
power in this dyadic relationship, the enmeshment is rein-
forced by Nina’s sense of loyalty to her mother. Nina appears
to accept her mother’s behavior as normal and appropriate,
likely because of her childlike need for parental approval.
Aware of the stress her mother feels as a single parent, Nina
may reduce her demands for her mother and feel a sense of
responsibility for her mother’s feelings (Nixon, Greene, &
Hogan, 2012). Further reinforcing this enmeshed structure is
the boundary established between Nina and her mother as a
family unit and the outside world. They appear to lack signif-
icant interaction with others outside of their family unit. Just
as we see no windows in their small apartment, the two are
closed off from the rest of the world. This lack of involvement
with outsiders strengthens the enmeshment between Nina and
her mother (Strauss & Karpel, 1977).
A consequence of enmeshment is that what affects one per-
son also affects others in the system. In the case of Nina and
her mother, this overresponsiveness relationship has taken to
an extreme level, especially since the system is exclusively
the two of them. One common way for dyads to deal with
stressful situations is to bring in a third party (Wachtel &
Wachtel, 1986). When it becomes difficult for Nina to balance
her needs for closeness and individuation in her relationship
with her mother, she seeks relief in a relationship with the
character Lily. Lily is another dancer in the company who rep-
resents the more confident, mature, and promiscuous identity
that Nina desires to adopt in becoming the Black Swan. Nina
hopes that by associating with Lily she can adjust her relation-
ship with her mother and gain more independence.
The instability and emotional reactivity of Nina and Erica’s
relationship would be affected by involvement of any third
person. No mention is made during the film regarding the
identity of Nina’s father or Erica’s relationship with this per-
son. It is possible to imagine how he may have either rein-
forced or served a protective force against the enmeshment
of Nina and her mother. The therapist must be cognizant of
this missing piece in the presenting family picture as a way
of understanding the goals for intervention (Taibbi, 1996).
Individual system level. At the individual level, the vertical axis
includes biological heritage and temperament (McGoldrick &
Shibusawa, 2012). Nina is obsessive in her vigilance to
achieve perfection, and her soft-spoken, passive temperament
compounds her difficulties as she appears unable to speak up
for herself or express emotions. Nina is chronologically at the
young adult life stage, but emotionally she is still the young
child. Her room is covered with stuffed animals and pink
frills. She observes the world with timidity and recoils during
confrontations. She yields to anyone who possesses a role of
authority and is repeatedly chastised by the ballet director,
Thomas Leroy, for being too submissive and dispassionate.
Nina’s fragile personality, weak ego strength, and emotional
Smith et al.
immaturity leave her with a fragmented identity, rendering
her more prone to internalizing behaviors.
Horizontal Stressors
Developmental. Along the horizontal axis, developmental stres-
sors signify changes and transitions of the family life cycle
(Goldenberg & Goldenberg, 2008). The primary life task for
young adults is to come to terms with their family of origin and
enter the adult world of work and relationships (McGoldrick &
Shibusawa, 2012). Therefore, Nina’s life cycle task is to differ-
entiate from her mother and develop intimate peer relationships.
Nina never successfully negotiated out of the young child
life stage. She must resolve life cycle tasks at one level before
she can advance developmentally to the next level, but Erica
cannot bear to let go of her little girl. When threatened, Erica
encircles a tighter border around the parental–child subsystem.
The escalating ‘‘push and pull’’ between Nina’s physical devel-
opment and her mother’s emotional suppression obstruct Nina
from navigating into young adulthood.
Another developmental stressor in Nina’s life is her matur-
ing sexuality. Nina’s growing encumbrance of this stress is
seen when she attempts to explore masturbation, only to be
violated by the shocking realization her mother is asleep a few
feet away from her. To become the Black Swan, Nina will
have to find and embrace her sexual self. However, the family
taboo against sexuality and her mother’s need to keep her
swaddled in the role of young child further denies the emer-
gence of the sexual woman Nina has physically become.
Unpredictable. Unpredictable horizontal stressors are unexpected
and often traumatic (Goldenberg & Goldenberg, 2008). They
creep up and leave the unsuspecting individuals unprepared.
An initial unpredictable event occurs when artistic director
Thomas announces he will cast one lead to play both the White
Swan and the Black Swan. This riveting departure from the
classical tale of Swan Lake provokes excitement that revitalizes
the ballet company. Yet, the stakes are doubled as two opening
female leads are transformed into one.
A fundamental, unanticipated event transpires when Nina
acquires the starring role. Incapable of grasping the persona
of the Black Swan, she predictably disappoints Thomas in her
audition. At first, he has selected another dancer, but at the last
second Thomas decides to cast Nina as the Swan Queen after
all. Immediately, she is whisked away into a world of promi-
nence. At the Patron of the Arts fund-raiser gala, Nina becomes
acquainted with high society. As Thomas bids farewell to Beth
Macintyre, the ballet company’s old star, all eyes are on Nina
as he showcases to the world a fresh, new face. Unfortunately,
another unpredictable incident ensues when Beth drunkenly
and desperately steps into the path of an oncoming car.
Perhaps the most unnerving, unexpected event for Nina is
the addition of Lily to the ballet company. Paradoxically,
Nina’s rival offers her the most opportunity for growth, as Lily
resembles everything Nina is not. Lily simultaneously intrigues
and threatens Nina. Robed in black with her free-flowing hair,
99
Lily is a rebel and siren. In comparison, Nina, covered in pink
and white with a tightly coiled bun, is a conformist and wall-
flower. Lily’s dancing is explosive and exudes sex, while
Nina’s dancing is soft and inhibited. The competition soon
goes beyond dance. Lily’s sexual appeal seduces Thomas,
male lead David, and the flirtatious waiter, fueling Nina’s
growing inferiority and inadequacy.
Intersection of Stressors
The point where the vertical and horizontal stressors converge
raises a red flag for multicontextual family therapists, as it
indicates a period of particular vulnerability and stress over-
load. It is essential for therapists to seek not only the sources
of vertical and horizontal stressors but also the junctures at
which they intersect.
Nina’s eating disorders (EDs) can be portrayed as mani-
festing from a combination of multiple stressors interacting
at a critical point. Historically, Nina is influenced by strong
sociocultural factors to be thin, though this is only a part of
the picture. Thompson and Stice (2001) contend most women
are exposed to the same societal pressures to be thin, but
not everyone internalizes those standards. A difference that
might serve as a risk factor with respect to internalization is
the degree to which individuals have a clear sense of their
own identity (Vartanian, 2009). As discussed earlier, Nina’s
personality unquestionably lacks a solid self-concept, placing
her in a vulnerable position. EDs among females manifest due
to passive, pathological strategies to gain control in an envi-
ronment where they only feel power through the one thing
they can manipulate and utilize to acquire influence—their
bodies (Fredrickson & Roberts, 1997). Furthermore, Nina
repeatedly receives messages to be perfect from the ballet
culture, and this is cemented by her tendency to internalize
those messages. Studies have shown perfectionism to be a
distinguishing characteristic of anorexia nervosa and a perti-
nent personality trait in bulimia nervosa (Brandsma, 2007;
Midlarsky & Nitzburg, 2008).
With so many vertical stressors, only a small amount of
horizontal stress may be necessary for the emergence of
symptomatology. The competition with Lily is a particularly
concerning horizontal stressor with regard to EDs and body
image. Ferguson, Munoz, Contreras, and Velasquez (2011)
argue that the most compelling effects for body dissatisfaction
may not stem from ‘‘distal influences such as the media but
through more proximal influences such as actual female com-
petitors for desirable mates’’ (p. 461). At the intersection of
these stressors, the seeds for Nina’s EDs have been sown.
Another important intersection is when the vertical stress
of the ballet culture’s preoccupation to become the prima
ballerina interacts with the horizontal stress of Beth’s car
accident. Although Nina basks in the attention of being the
new star of the ballet, she begins to piece together its dark side
as she bears witness to Beth Macintyre’s demise. She sees
Beth fling herself into oncoming traffic just as she was flung
aside by Thomas once she was no longer useful to him.
100 The Family Journal: Counseling and Therapy for Couples and Families 23(1)
When Nina is faced with the inevitable degradation of
success and the ultimate imperfection of her perfect idol Beth,
she nevertheless plunges onward in her quest for success and
perfection, hoping her fate will be different. People have a
propensity to maintain an established equilibrium when it’s
disrupted in any way (Wachtel & Wachtel, 1986). Nina’s
homeostatic mechanism operates to maintain the status quo
of her life and overrides her capacity to change its direction.
When the vertical family stress of Erica’s enmeshment
clashes with the horizontal developmental stress of navigating
through the family life cycle, there is a surge of anxiety in the
system during Nina’s attempts toward differentiation. Up until
this point, Nina and her mother’s tenuous relationship had been
maintained in a negative feedback loop. As Nina continues to
act like a child and constantly seek her mother’s approval, mom
exerts her power by following up every compliment with a
backhanded criticism. The more Nina seeks validation that she
is performing to her mother’s approval, the more her mother
raises the bar and communicates that Nina could be doing bet-
ter. This feedback loop prevents Nina from normal individua-
tion from her mother by keeping their interactions with each
other stagnant. A cross-generational inequality exists as if Nina
were still a 12-year-old girl and not a 21-year-old professional
ballerina. Each point in the system is causing its perpetuation.
A positive feedback loop becomes apparent when Nina begins
to individuate from her mother. Mother increases her exertion
of control with each attempt Nina makes to separate herself.
Erica’s reaction to Lily’s dropping by to visit Nina is to inter-
vene and discourage the interaction. Not only does Nina assert
herself by speaking with Lily alone, she takes it a step further
and goes out drinking with Lily. Nina’s attempt to individuate
by partying before opening night causes her mother to close in
more by taking it upon herself to call in sick for Nina. Mother’s
intrusion and ultimate attempt to control Nina causes Nina to
storm out of the apartment, threatening to move out. This is the
proverbial ‘‘kaboom’’ as the pressure from the positive feed-
back loop becomes too high. A positive feedback loop will
‘‘feel’’ the pressure of change and tends to initiate when a neg-
ative feedback loop is ineffective at maintaining the status quo
(Nichols, 2008). The negative feedback loop that Nina and her
mother were in cannot coexist with Nina’s need to grow up.
The vertical stressor of Erica’s destructive strategies in han-
dling unfinished business overlaps a horizontal stressor where
Nina has to manage the pressure of playing the principal lead.
Without a proper role model to show her how to navigate suc-
cessfully with the pressures of the ballet, Nina acquiesces to a
variety of unhealthy coping mechanisms. When she becomes
self-conscious, she copes physically by scratching her back and
picking at her cuticles. As anxiety takes over, she vomits in an
effort to release the pressure. Delusions start to occur, as she
invents another personality for herself. It is unacceptable for
Nina to be the Black Swan. So, she hallucinates an alternate
self to allow the repressed, dark, and seductive part of her to
emerge. As the gravity of opening night materializes, Nina
plunges into an abyss of distorted reality. As the pressure
mounts, her reality blurs into a deep and chaotic psychosis.
A gnawing battle of Nina’s internal deterioration spirals
uncontrollably when the inherited stress of perfectionism inter-
sects with the horizontal stress of Thomas’s new interpretation
of the Swan Queen. While Nina’s impeccable poise and timid
vulnerability make her the quintessential White Swan, her very
strengths are her weaknesses as the Black Swan. The most
famous part of Swan Lake is The Black Swan’s Coda, which con-
sists of 32 consecutive fouettes. On one hand, the most difficult
and demanding part of the play requires a mastery of technical
prowess, which Nina has been prepared to handle. On the other
hand, the role also commands Nina to let go, beckoning her to
dance with abandon and self-indulgence. For Nina to be perfect,
she must also learn to be imperfect. Her worldview of perfection
is shattered as Thomas redefines perfection as both being able to
maintain technical control, while also being able to let go. She
has spent her whole life preparing for the one and denying the
other. On opening night, Nina stumbles upon a realization con-
firming her fears. Her performance as the White Swan impresses
the audience but nothing more. Her impersonation of being per-
fect merely satisfies the crowd; it does not move them. Through
her complete metamorphosis into the Black Swan, the audience
is enthralled by an electric performance. They are seduced by
and have fallen in love with the Black Swan, causing Nina to
become engulfed by the betrayal of the pursuit of perfection.
Conclusions and Implications
In the film Black Swan, the intersection of the vertical stressors
of societal expectations and family patterns of enmeshment
with the horizontal stressors of accomplishing the critical life
task of young adulthood engender anxiety for Nina and are key
components to her crisis of self. Nina’s plummet into psychosis
was the labor in which she birthed her repressed Black Swan
self. Once the Black Swan emerged, she embodied all that Nina
had unconsciously longed to become. It wasn’t perfection Nina
had desired after all. It was freedom, and her newly acquired
black wings pulsed with passion to escape her cage and fly free.
Nina kills her perfect White Swan self, symbolically conquer-
ing the young child she had once been.
Clinicians working with families will benefit from a multicon-
textual framework in guiding their assessments and interventions.
Any evaluation of individual family members’ life stressors must
take place within the changing contexts of the family and the
larger culture for family therapy to be effective. Understanding
the family’s perception of vertical stressors (e.g., religion, media,
family legacies, and family expectations) and horizontal stressors
(e.g., difficulties in school, interpersonal conflicts, and transi-
tions) that they are experiencing will help to give depth to the
family’s complex situation. This type of assessment may help the
therapist discover learned patterns of interaction and examine
how those patterns of interactions have developed into proble-
matic behaviors over the family’s life transitions. Clinicians use
this information in their interventions to ensure that the family
unit is the client and to emphasize the multiple pressures that are
negatively impacting the family system, which relieves the temp-
tation to find a scapegoat, or someone/something to blame.
Smith et al.
Movies can be used as a technique in family therapy to help
portray the different perspectives each family member may hold.
The clinician assigns a movie that is related to the family’s
presenting concerns (Dermer & Hutchings, 2000). Movies often
allow for conversation about particular characters, that charac-
ter’s perception of others, and how others perceive them; this can
often lead into discussion about family perspectives. Other
topics discussed in therapy may be portrayed in assigned movies
(e.g., bereavement, stepfamily, or religion). Clinicians should
be prepared to help the family process what they’ve watched
and how their presenting problem is similar to that of the movie.
Discussing the problems of the characters can be a safe way to
begin discussing their concerns in an externalized way, before
they begin talking about the issues in relation to the family’s
own problems (Dermer & Hutchings, 2000). This technique
lends itself to the multicontextual approach in a concrete way,
as vertical and horizontal stressors can be observed and dis-
cussed between the family and clinician during therapy sessions.
Declaration of Conflicting Interests
The author(s) declared no potential conflicts of interest with respect to
the research, authorship, and/or publication of this article.
Funding
The author(s) received no financial support for the research, authorship,
and/or publication of this article.
References
Brandsma, L. (2007). Eating disorders across the life span. Journal of
Women and Aging, 19, 155–172.
Carter, B., & McGoldrick, M. (Eds.). (1989). The changing family life
cycle: A framework for family therapy (2nd ed.). Boston, MA:
Allyn & Bacon.
Dermer, S. B., & Hutchings, J. B. (2000). Utilizing movies in family
therapy: Applications for individuals, couples, and families. The
American Journal of Family Therapy, 28, 163–180.
Ferguson, C., Munoz, M., Contreras, S., & Velasquez, K. (2011).
Mirror, mirror on the wall: Peer competition, television
View publication stats
101
influences, and body image dissatisfaction. Journal of Social and
Clinical Psychology, 30, 458–483.
Fredrickson, B. L., & Roberts, T. (1997). Objectification theory:
Toward understanding women’s lived experiences and mental
health risks. Psychology of Women, 21, 173–206.
Goldenberg, H., & Goldenberg, I. (2008). Family development:
Continuity and change. In M. Flemming (Ed.), Family therapy:
An overview (7th ed., pp. 25–53). Belmont, CA: Brooks/Cole.
McGoldrick, M., & Shibusawa, T. (2012). The family life cycle.
In F. Walsh (Ed.), Normal family processes: Growing diversity
and complexity (4th ed., pp. 375–398). New York, NY:
Guilford.
Midlarsky, E., & Nitzburg, G. (2008). Eating disorders in middle-aged
women. The Journal of General Psychology, 135, 393–407.
Nichols, M. P. (2008). Chapter 4: The fundamental concepts of family
therapy. In: P. Quinlin & N. Warner (Eds.), Family therapy: Con-
cepts and methods (8th ed. pp. 97–114). Boston, MA: Pearson
Education.
Nixon, S., Greene, S., & Hogan, D. M. (2012). Negotiating relation-
ships in single-mother households: Perspectives of children and
mothers. Family Relations, 61, 142–156.
Strauss, E. S., & Karpel, M. A. (1977). The theory and practice of
family evaluation. Keene, NH: Institute for Continuing Profes-
sional Studies, Antioch-New England Graduate School.
Taibbi, R. (1996). Doing family therapy. New York, NY: Guilford.
Thompson, J., & Stice, E. (2001). Thin-ideal internalization: Mount-
ing evidence for a new risk factor for body-image disturbance and
eating pathology. Current Directions in Psychological Science, 10,
181–183.
Van Staden, A., Myburgh, C., & Poggenpoel, M. (2009). A psycho-
educational model to enhance the self-development and mental
health of classical dancers. Journal of Dance Medicine & Science,
13, 20–28.
Vartanian, L. (2009). When the body defines the self: Self-concept
clarity, Internalization, and body image. Journal of Social and
Clinical Psychology, 28, 94–126.
Wachtel, E. F., & Wachtel, P. L. (1986). Family dynamics in individ-
ual psychotherapy. New York, NY: Guilford.