The patterns operate in intact, single-parent, step parent, and other nuclear family configurations. .
Clinical problems or symptoms usually develop during periods of heightened and prolonged family tension. The level of tension depends on the stress a family encounters, how a family adapts to the stress, and on a family's connection with extended family and social networks. Tension increases the activity of one or more of the four relationship patterns. Where symptoms develop depends on which patterns are most active. The higher the tension, the more chance that symptoms will be severe and that several people will be symptomatic. .
The four basic relationship patterns are:.
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Marital Conflict - As family tension increases and the spouses get more anxious, each spouse externalizes his or her anxiety into the marital relationship. Each focuses on what is wrong with the other, each tries to control the other, and each resists the other's efforts at control.
Dysfunction in One Spouse - One spouse pressures the other to think and act in certain ways and the other yields to the pressure. Both spouses accommodate to preserve harmony, but one does more of it. The interaction is comfortable for both people up to a point, but if family tension rises further, the subordinate spouse may yield so much self-control that his or her anxiety increases significantly. The anxiety fuels, if other necessary factors are present, the development of a psychiatric, medical, or social dysfunction.
Impairment of One or More Children - The spouses focus their anxieties on one or more of their children. They worry excessively and usually have an idealized or negative view of the child. The more the parents focus on the child the more the child focuses on them. He is more reactive than his siblings to the attitudes, needs, and expectations of the parents.