The identified patient (IP) is the family member who displays the most obvious signs of dysfunction in a family. They may develop mental health issues as a way to shift attention from the family’s core problems. Treatment depends on the individual case and may require intensive psychotherapy.
In the psychology of the dysfunctional family, the identified patient is the family member in which the dysfunction has manifested itself most clearly. As the primary symptom carrier in the family unit, an identified patient enacts the family’s problems on an unconscious level. This type of psychological projection is an unconscious attempt by the identified patient to shift attention from family nexus problems to a tangible and visible external component.
Most of the identified patients are the first people in a family to show signs of inner turmoil or conflict. The rest of the family does not automatically associate the identified patient’s problems as indicative of larger family problems. Instead, the identified patient, or PI, is seen as a problematic individual or, in extreme cases, as someone the family would be better off without. The PI is traditionally the first person in the dysfunctional unit to seek outside help in psychoanalysis, which, in cooperative families, may lead to family therapy.
A IP can develop as a result of any number of psychological issues within a family. It is usually an involuntary, subconscious response to harmful family situations. Examples of issues that can lead to the creation of an IP are narcissistic parents; physical, emotional or sexual abuse; unresolved trauma; or scapegoating, the act of blaming or treating an individual negatively on unwarranted grounds for problems not attributable to the individual.
The type and extent of behavior exhibited by a PH varies from patient to patient. IP can simply be seen as buggy or difficult. In many cases, the PI has developed a depressive disorder or some other form of psychosis as a way to shift the family’s attention from their core issues to an external problem that can be more easily dealt with. In more extreme circumstances, the PI may develop a drug or alcohol addiction or become involved in criminal activity.
Treatment of IP will depend on the particular ways in which the family’s problems have manifested themselves in him or her. Unfortunately, just because a PI has troubling issues doesn’t mean the nature of the family’s problems will be immediately apparent. It usually takes intensive psychotherapy to get to the root of the behavior of the PI, who, despite his actions and position in the family, may try to protect the family unit at any cost. Mental health professionals often point out to PIs that certain current behaviors and circumstances are not the causes of family dysfunction, but symptoms of larger underlying problems within the family nexus.
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