The following description is totally fictional.  I just wonder if a psychiatrist or family therapist would say that the description is internally consistent and psychologically cognizable.  Is this a realistic description of a plausible dysfunctional family?

Patient grew up in a two-parent family with a six-years older sister. The family was dysfunctional in that in important but subtle ways the locus of power was not on the parents but in the mother’s older sister. The mother’s older sister was tyrannical; the parents were weak and dependent individuals with a poor level of autonomy. Both parents had never separated psychologically from their families of origin. This was especially true of the mother who was profoundly dependent on her older sister for emotional support. In important ways the mother’s sister infantilized the mother. Both parents acquiesced in mother’s sister’s arrogation of a parental role. The mother’s sister was childless and married to a man who showed a reaction formation against aggression; he ceded marital power to his tyrannical wife.

There was a lot of marital discord between the patient’s parents.   In the patient’s early years (up to age 12) there was serious and continual discord centering on the father’s inability to serve as an adequate provider and the fact that mother was a Catholic and father had an Orthodox Jewish background. All of the family members showed extreme individual narcissism, especially the mother’s older sister who was flagrantly grandiose.  The mother’s sister once said to the patient: “I gave you everything you have.  If it had been up to your father you would have had shit!”

The father had a violent temper. He used to beat the patient with a belt or cat ‘o nine tails when the patient was a boy. On one occasion the father attempted to murder the mother by strangulation in front of the children.

At least as it related to the patient, the mother was a negligent caretaker.

The mother’s mother (patient’s grandmother) was a paranoid and dysfunctional individual who was intensely and obsessively anti-Semitic.She emigrated from Poland at age 18 but never learned more than rudimentary English.  In the mother’s family of origin there was severe role reversal, with the mother’s older sister having to assume a parental role in early childhood to compensate for the grandmother’s inadequacy.  The mother’s family of origin struggled with extreme poverty in the days before social welfare programs: mother reported that there were many days when there was nothing to eat but rice boiled in milk.

There was a lot of parental favoritism in the patient’s family. The daughter, patient’s older sister, was assigned the role of good child. The patient was assigned the role of bad child, or scapegoat. The mother’s sister idealized patient’s sister but maintained a degrading and aggressive manner with the patient.  Mother’s sister was contemptuous of the father, often referring to the father as a “louse” in front of the patient. Because of the mother’s dependency on her older sister she was psychologically incapable of protecting her son from her sister’s aggression against him.

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