'n Multigeneratiewe perspektief op gesinne waarin paniekversteuring voorkom

Abstract

English: The introduction (Chapter 1) shows that panic disorder is prevalent in a substantial section of the South African population and that it is more prevalent in certain families. The focus of this study was to research the factors, especially the emotional processes of the multigenerational family, which have an influence on the development of panic disorder. The purpose of the study was to do explorative and descriptive research from a multigenerational perspective about families in which panic disorder is prevalent. This was done to make scientifically grounded social work assistance available to those concerned. The conceptual framework of the study is the Bowen Theory. An explanation of Bowen’s conceptualisation of the family as multigenerational emotional system was provided in the literature study (Chapter 2). The way in which the family functions as a multigenerational emotional unit was discussed with reference to Bowen’s eight linked concepts. The Bowen Theory also provides a framework for a holistic analysis of the multigenerational emotional processes of the family, which could possibly lead to the development of panic disorder. Panic disorder as a phenomenon was discussed in Chapter 3. The classification, diagnostic characteristics and symptoms of panic disorder were discussed with reference to the DSM IV TR (2000:429). This discussion is therefore done according to the medical model which emphasises the biological factors involved in the development of panic disorder. The medical model, which was originally a more linear approach to causality, acknowledges the various factors which play a reciprocal role in the development of panic disorder. This corresponds with the systemic approach of the Bowen Theory in which the role of the various factors in symptom development is acknowledged. The geneagram (Chapter 4) developed primarily from the Bowen Theory and is used as a tool to assess a family’s systemic functioning. The format is of such a nature that multigenerational family information (e.g. themes and patterns) can be presented systemically. The case study was utilized as a qualitative research method (Chapter 5). The case study, as research design, was used as a holistic method to investigate the various factors in the development of panic disorder. As research method, the case study thus leaves room for an in-depth study of panic disorder within the context (the multigenerational family) in which it occurs. The empirical study is qualitative (Chapter 6) and semi-structured interviews were conducted with three participants. The participants were diagnosed with panic disorder by two psychiatrists of Bloemfontein and were approached to participate in the study. The interpretation of data, received from the participants, was narrative and descriptive in nature with reference to the eight concepts of the Bowen Theory. The conclusions, based on the literature study and data from the empirical study, were presented in Chapter 7 to determine whether the goal of the study was achieved. The Bowen Theory was utilised successfully in the study of the interaction of various factors in the emotional system of the multigenerational family, which contributes to the development of panic disorder. The conclusion is that factors such as triangulation and emotional isolation contributed to the development of panic disorder in the participants. It is recommended that social workers should be better trained and should obtain theoretical knowledge on panic disorder to be able to assist the panic sufferer and his family. Recommendations for social welfare assistance in practice include among others that certain therapeutic models are used, for example the task-orientated model which will ensure assistance is provided to the panic sufferer and his family. Further research needs to be undertaken to expand theoretical knowledge on this phenomenon and also to enable the social worker to help the panic sufferer and his family. This could also serve as a motivation to include the social worker as a member of a multi-disciplinary team at a psychiatric institution or any other medical institution.

Afrikaans: In die inleidende oriёntasie (Hoofstuk 1) word aangedui dat paniekversteuring by ’n beduidende aantal mense in die Suid-Afrikaanse bevolking voorkom en dat dit meer algemeen in sommige families aangetref word. Die fokus van die studie was om ondersoek te doen na die faktore, in veral die emosionele prosesse van die ultigeneratiewe gesin, wat ’n invloed op die ontwikkeling van paniekversteuring uitoefen. Die doel van die studie was dus om vanuit ’n multigeneratiewe perspektief ’n verkennende en beskrywende ondersoek te doen na gesinne waarin paniekversteuring voorkom, ten einde wetenskaplikgefundeerde maatskaplikewerkhulpverlening op die betrokkenes af te stem. Die konseptuele raamwerk van die studie is die Bowenteorie en in die literatuurstudie (Hoofstuk 2) word ’n uiteensetting van Bowen se konseptualisering van die gesin as multigeneratiewe emosionele sisteem gegee. Die wyse waarop die gesin as multigeneratiewe emosionele eenheid funksioneer word aan die hand van agt aaneenskakelende konsepte verduidelik. Die Bowenteorie bied in die ondersoek die raamwerk vir ’n holistiese analise van die multigeneratiewe emosionele prosesse van die gesin wat moontlik kan bydra tot die ontwikkeling van paniekversteuring. Paniekversteuring is in Hoofstuk 3 bespreek. Die klassifikasie, diagnostiese kenmerke en simptome van paniekversteuring is gedoen aan die hand van die riglyne in die DSM IV TR (2000:429). Dit is dus gedoen volgens die mediese model waarin klem gelê word op biologiese faktore betrokke by die ontwikkeling van paniekversteuring. Die mediese model, wat aanvanklik ’n meer liniêre benadering tot oorsaaklikheid gevolg het, erken dat verskeie faktore ’n wederkerige rol in die ontwikkeling van paniekversteuring speel. Dit sluit aan by die sistemiese benadering van die Bowenteorie waarin die rol van verskeie faktore in simptoomontwikkeling erken word. Die geneagram (Hoofstuk 4) het primêr uit die teorie van Bowen ontwikkel en word as hulpmiddel in die assessering van die gesinsistemiese funksionering benut, aangesien die formaat van so ’n aard is dat multigeneratiewe gesinsinligting (byvoorbeeld temas en patrone) sistemies voorgestel word. Die gevallestudie (Hoofstuk 5) is as navorsingsmetode in die kwalitatiewe ondersoek aangewend. As navorsingsontwerp leen die gevallestudie hom by uitstek daartoe om ’n holistiese ondersoek na verskeie faktore in die ontwikkeling van paniekversteuring uit te voer. Die gevallestudie, as navorsingsprosedure, laat dus ruimte vir ’n in-diepte ondersoek van paniekversteuring binne die konteks (multigeneratiewe gesin) waarin dit voorkom. Die empiriese ondersoek is kwalitatief (Hoofstuk 6) van aard en semigestruktureerde onderhoude is met drie deelnemers gevoer. Die deelnemers is deur twee psigiaters van Bloemfontein met paniekversteuring gediagnoseer en genader vir deelname aan die ondersoek. Die interpretering van data wat van die deelnemers verkry is, is verhalend en beskrywend aan die hand van die agt konsepte van die Bowenteorie weergegee. In Hoofstuk 7 word die gevolgtrekkings gemaak uit die literatuurstudie en die empiriese ondersoek om vas te stel of die doel van die studie verwesenlik is. Die Bowenteorie, as teoretiese raamwerk, is suksesvol benut in die ondersoek na die wisselwerking van verskeie faktore in die emosionele sisteem van die multigeneratiewe gesin wat bydra tot die ontwikkeling van paniekversteuring. Die gevolgtrekking is dat faktore soos driekhoekvorming en emosionele afsnyding in wisselwerking met mekaar bygedra het tot die ontwikkeling van paniekversteuring by die deelnemers. Daar word aanbeveel dat maatskaplike werkers beter toegerus moet word om hulpverlening aan die panieklyer en sy gesin te bied. Dit kan gedoen word deur opleiding en uitbreiding van teoretiese kennis met betrekking tot paniekversteuring as verskynsel. Aanbevelings vir maatskaplike hulpverlening in die praktyk behels onder meer dat bepaalde terapeutiese modelle, byvoorbeeld die taakgesentreerde model benut word in hulpverlening aan die panieklyer en sy gesin. Verdere navorsing behoort onderneem te word om die teoretiese kennis oor die verskynsel te verbreed en om die hulpverleningsaksies van die maatskaplike werker aan die panieklyer en sy gesin te verfyn. Dit kan verder ook as motivering dien om die maatskaplike werker as volwaardige lid van ‘n multidissiplinêre span by psigiatriese inrigtings of ander mediese inrigtings in te sluit.