FAMILY TEAMS: HOW FAMILIES WORK

Just like individuals, families are creatures of habit; they resist change. We grow accustomed to enacting the roles that we have been assigned and that we have assumed in our families, and these ways of relating come to feel natural. For example, Little Brother always remains Little Brother in family gatherings, even if he does happen to be fifty-nine years old, twice as intelligent, and three times as wealthy as the rest of the family. Consequently, adjusting to new circumstances (such as illness) is very difficult for families. The Johnsons are a case in point.
Claudia Johnson was a patient at the Wake Forest University Cardiac Rehabilitation Program who set records for her extremely high cholesterol levels. She was friendly and cooperative in general, but her refusal to follow through with our recommendations about her obvious need to change her diet was confusing to us all. Then we interviewed her husband.
Ed Johnson explained that his wife was the youngest of four daughters from a very close family. Her "family role" had always been that of the good-natured fat sister who loved to eat. Claudia's family was filled with people who believed that the key to good health was to eat food that sticks to your ribs. Accordingly, her family tradition was filled with meals loaded with eggs, red meat, and starches. In addition, the patriarch of Claudia's family—her paternal grandfather—was legendary within the family for having lived to be ninety-one years old although he "ate four eggs and smoked a pack of unfiltered cigarettes every day."
As a natural show of their loving concern, Claudia's family kept her well supplied with country hams, baked desserts, and other traditional family favorites. Ed tried to explain tactfully to his wife's family that what Claudia really needed from them was support and encouragement to change her diet, not encouragement to eat herself to death. The family responded with a clear message that he did not know what was best for Claudia. They reminded him that their family and all its traditions had been a part of Claudia's life far longer than Ed had.
Throughout the first year of Claudia's recovery, Ed seethed in fear and anger at his wife for not being more assertive about refusing her family's food. He accused her of caring more about what her siblings, aunts, and uncles thought of her than about her own health or her own marriage. He finally stopped arguing with her and became resigned to the fact that he could not change her. He explained, "It's just too much to ask her to go against her family tradition and not show appreciation to these people by refusing their food; that's just not who she is. I don't like it, but I can't change it."
Although the potential medical complications of following such family rules are obvious, the way to deal with the emotional discomfort that comes from trying to change age-old family patterns is not so obvious. But by learning about two important factors that influence the workings of your family, you can better control your family reactions. These factors are the circular family dance and family structure.
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