Creating a family state of mind: using psychoanalytic ideas to treat families where children resist or refuse contact with a parent

Separated families, where children resist or refuse visitation with one parent, present a complex treatment picture for clinicians. Application of psychoanalytic concepts can increase the clinician's understanding of the family members' response to the familial separation and inform the clinician's treatment decisions. The concepts of couple state of mind, projective gridlock, transgenerational transmission of trauma, and Nachträglichkeit, or après coup, are proposed as useful in appreciating the family members' individual and familial psychological responses to the trauma of parental separation. Multiple clinician functions necessary in the treatment of this complex family dynamic are explicated. A case example is included. Family state of mind is proposed as a newly named function for the clinician as well as the family members.