The Intimacy Paradox

Author: Donald S. Williamson

A note from the reviewer: I found the book a very slow and tedious read.  It got interesting and easier starting in Part-II, in which the author uses lots of examples from his practice to outline Family Of Origin work.  Part-III provided more context that helped understand Part-II, and Part-IV put me back to sleep, except for chapter 16 by Linda M. Walsh.

I found the book of greatest value as I made my own questions for FOO interviews based on the thoughts that were sparked from the examples the author gave.  The specific questions did not directly apply, but allowed me to see more relevant questions that I can use for my own FOO work.  The myriad of sample questions from a multitude of families made the book worth the effort to read. (The ‘questions’ can be found here)
— A. Guberman

  • Part-I: Personal Authority Theory
    • Chapter 1: Personal Authority in the Family System: An Overview
    • Chapter 2: Background Theoretical Assumptions
    • Chapter 3: Personal Authority: The construct in Theoretical Context
  • Part-II: Personal Authority Method: The Play’s the Thing
    • Chapter 4: Setting the Scene: Playful interventions as a method of Therapy
    • Chapter 5: Auditioning and Casting: Background Preparations for the Conversations with Parents
    • Chapter 6: Black Out Sketches: The Group at Play
    • Chapter 7: The Rehearsal: Preparing the client for Political Renegotiations with Parents
    • Chapter 8: Scheduling the performance and Contract Negotiating with the Players
    • Chapter 9: Writing the Script: The In-Office Agenda for the Primary Triangle – Part 1. The parents Speak.
    • Chapter 10: Writing the Script: The In-Office Agenda for the Primary Triangle — Part 2.  the client Responds and the Consultant Reflects
    • Chapter 11: Performing Outdoors: New Life at the Graveyard — Renegotiation with a Deceased Former Parent
    • Chapter 12: Production Problems: Limitations to the Method
  • Part-III: Personal Authority contextual Issues
    • Chapter 13: Personal Authority: The Personal Story
    • Chapter 14: Personal and Professional Authority in Professional Life
    • Chapter 15: Personal Authority, Professional Authority, and Physical Health
    • Chapter 16: personal Authority and Gender differences: Typecasting
    • Chapter 17: Beyond personal Authority
  • Part-IV: Personal Authority Research
    • Chapter 18: The Personal Authority In the Family Systems Questionnaire: Assessment of Intergenerational Family Relationships

Part-I: Personal Authority Theory

Chapter 1: Personal Authority in the Family System: An Overview

How does one leave home emotionally and yet somehow still remain lovingly connected within the family of origin?

Any love relationship worthy of the name will compromise the freedom and spontaneity of the self of each party involved. … this threat to self is an issue for all emotional significant relationships.  Nonetheless, most people prefer the life shared to the life lived alone. … this is the intimacy paradox.

I do not, of course, by any means choose or control all of the facts or circumstances of my life.  But I am the author of all meanings to me of my experiences. … since I make up the [meaning] in the first place, why not make it up in a way most conductive to personal well-being?

How does one differentiate a self out of the morass of the “undifferentiated family ego mass” (Bowen, 1966) and then subsequently reconnect voluntarily with love and intimacy with the members of one’s own family?

Son or daughter gives up, once and for all, the need to be parented.  Simultaneously, the parents are accepted and embraced as A-OK Perfect As-Is.  The parents are taken “off the hook” as parents.  Their work is finished.  It is complete.  This  is a very powerful message with far reaching implications for both generations.  It is a step not taken lightly or unadvisedly.  It cannot be done unilaterally.  Yet the initiative is always with the son or daughter.  [p. 7]

The most difficult problem for a son or daughter is intergenerational intimidation.

… even after some successful work has been completed, whether in structured therapy or through maturation, the newly differentiated self still has to decide how relationships should continue to evolve with the members of the family of origin.

In a family with small children … a parent-child power coalition is a very destructive pattern.  There must be a clear and firm hierarchical boundary between parents and children; otherwise there will be chaos in the family.

Laing (1979): A man will see every woman as his mother until he sees his mother as a woman.

A highly functional family with adult sons and daughters is one in which there are “former parents” and “former children,” that is, family members who have established a relationship of psychological equality.

Through hearing the personal narrative of the life of each parent firsthand and the private meanings of the various events and sequences of the life process of each, son or daughter demystifies and humanizes the parent.  … It is this humanization that ultimately resolves intergenerational intimidation.

Personal authority work focuses most particularly upon the intergenerational experiences of the individual adult and the parents, previously labeled the “primary triangle.”

… with rare exceptions, the client’s significant power, control and intimacy issues take place within the dynamics between the self and the parents.  Since this is where the story was first written, this is where the script is to be changed.

Personal authority therapy prepares people to talk directly to their parents about everything that is important and to do so as adults and without fear.

.. the foremost therapeutic goal is … the development of strategies and methods for renegotiation and change within contemporary family politics.

[through PAFS] the client will soon have a much greater subjective sense of control over his or her own life and destiny.  Simply learning to be nonreactive [not the goal] will reduce conflict, but it [would] also reduce both intimacy and romance.

… transgenerational family therapy has been reluctant to deal with intergenerational family therapy has been reluctant to deal with intergenerational power politics, head-on and at the source. … It is this specific focus on the equalization of power between the generations that constitutes the novelty of the point of view described in this book.

It is a deliberate intention that the various exercises to be described should take place in frank conversations directly with the parents rather than be, so to speak, “done to them.”

Personal authority method does not place a higher value on reason than emotion.  …  both reason and emotion are wired into the immune system, so both are necessary for personal well-being.  Therefore, the goal should not be to separate but to distinguish the thinking process from the feeling process.

Chapter 2: Background Theoretical Assumptions

Six theoretical assumptions about human behavior for PAFS

  1. Well-being is indivisible; at the heart of human well-being is psychological integrity.
  2. Psychological integrity is the result of the integration of various aspects of the self.
  3. Most of life is managed most of the time by most people at an unconscious level.
  4. The integration of self implies a harmony between the conscious and the unconscious aspects of mind.  It also requires an integration not only within the larger social context in general but within the family of origin in particular
  5. Healthy family organization requires a renegotiation of family politics in the fourth decade of the lives of sons and daughters.  By the time most adults are in their thirties they are ready to deal with and therefore to permit much more material to become conscious.
    • there comes a time when sustaining a healthy family organization and experience requires the freedom to renegotiate family politics.
    • Seeing one’s role in it is, of course, a condition of changing one’s role in it.
  6. The essence of this psychological and political change is that the healthy adult gives up, once and for all, the “parent as parent” and consequently relinquishes the need to be parented.
    • Growing up is, from one perspective, to experience a sequence of de-illusionments whereby one comes to terms with the frailty and hypocrisy of the adult world that one is about to join.
    • the ultimate de-illusionment is giving up or loosing the parent as parent.

Four assumptions about parents underlying personal authority work

  1. Parents are already prepared and waiting.
    Parents are already prepared and waiting to renegotiate the hierarchical boundary with former children.
  2. Parents are initially suspicious.
    • Is the purpose of this inquiry to discover more facts in order to make an evaluation and assess blame, pass judgment, and issue a grade?
    • Once a parent feels reassured that son or daughter is not still approaching in the mode of a critical child but more in the stance of an accepting and compassionate friend, then he or she can relax and breathe deeply enough to be able to talk.
  3. Parents are hungry to talk
    • There is no one with whom they would rather share memories, current fears, and remaining hopes.
    • There is no one for whom they, from their own perspective, would rather set the record straight.
    • There is no one from whom they are more eager to receive acknowledgement and validation.
  4. Discovering “otherness” is the road to intimacy
    • The heart of intimacy is the spontaneous and unlabored sharing with the other of the inner private meanings of the most important experiences in one’s life.
    • … presumes a relationship that is experienced as being safe — accepting and nonjudgmental, and therefore trustworthy.
    • … the two parties have overlapping interests and values in life that are of some considerable meaning and importance to each, and well worth talking about.
    • … an easy mutual identification with one another.  This requires a sense of psychological equality or peerhood between the parties.

Chapter 3: Personal Authority: The construct in Theoretical Context

… we do not discover reality, but create it.  … we do not directly experience reality but, rather, live with a representation of it that has been constructed in language (Rorty, 1979)  It follows that there are no objective (which is to say, uninterpreted) “facts”  … Facts cannot be separated from values, since values strongly influence what are perceived as the facts.

To observe the system is to join the system (Maturana, 1978).  Can one become less reactive?  Yes.  Become objective?  No.

If history is a made-up story, the story can be rewritten.  …  Personal history is rewritten in light of new understandings generated by sustained and intimate conversations with the former parents.

“Reality is a collective hunch.”  (Lily Tomlin)

How does one achieve a meaning and purpose in life that is not determined or overdetermined by family history, family dynamics, or family expectations and values on the one hand, and is not simply a reflex oppositional response to or alienation from or rebellion against family on the other hand?

PAFS is the ability to claim authorship and responsibility for all of one’s thoughts, feelings, and actions and to do so voluntarily.

Many writers and researchers have recognized the act of leaving home physically as an important stage in the family cycle.  … however, that is neither the same thing as nor necessarily a guarantee of the completion of the subsequent critical development step of renegotiating relationships with parents in order to leave home emotionally as well.

Personal authority .. can be seen as the continuation in mature adulthood of the personal identity issue carried over from the teenage years.   … this ‘stage’ takes place during the fourth decade of life and the years following.

Personal Authority: A definition [ page 40 ]

  1. PAFS includes the ability to know and direct one’s own thoughts and opinions as well as the emotional freedom to choose whether or not to express these at any given moment or occasion, regardless of intense social pressures or expectations from family members or others.
  2. PAFS includes the ability to value one’s personal judgment consistently and to be able to make decisions and act on one’s own good judgment.
  3. … the ability to take responsibility for all of one’s experiences, decisions, and actions in life and for the consequences that flow directly from these.
  4. PAFS includes … the ability to connect emotionally with other people in as self-expressive and intimate, or in as reserved, a fashion as seems appropriate, and as one freely chooses at any given time.
  5. PAFS includes the ability to relate to all other human beings as peers — including, indeed beginning with, the parents…

The physical and psychological well-being of adults interacts with a continuing sense of emotional connection to and belonging with one’s own flesh and blood.  Claiming title to one’s life and destiny and yet staying connected to family in intimate ways is the most influential and difficult developmental challenge in adult life.

personal authority then expresses itself in the continuing emotional freedom and energy to initiate, sustain, review and renegotiate, or terminate the experience of emotional intimacy at any given time in any relationship.

Personal authority enables the individual to establish an intimate primary love relationship and still maintain recourse to an independent identity to the self.

Intimidation on both sides of the intergenerational equation is based ultimately on the primitive but well-grounded fear of the death of the self.

Personal Authority Work as Power Politics

  1. The goal of personal authority work is the achievement of fully egalitarian relationships between the adults in the extended family.
  2. Changes in intergenerational politics result in changes in important contemporary relationships, especially love relationships.
  3. PAFS values thoughts and feelings equally.
  4. In personal authority work in general, men are encouraged to deal more courageously with the emotional life and women are encouraged to deal more directly with the political process inherent in relationships.

While the reasoning mind with its binoculars and its radar may be on the bridge of the ship, the emotional life of the engine room represents the heart and soul of the vessel.

Part-II: Personal Authority Method: The Play’s the Thing

Chapter 4: Setting the Scene: Playful interventions as a method of Therapy

… core shared goal is to seek to create connectedness between family members while simultaneously encouraging personal freedom.  … by way of contrast … personal authority work does put an emphasis on the value of judicious reflection and insight.

… trust on the part of the therapist in his or her own creative unconscious, derived from experience, is probably a more useful and certainly a more interesting source of interventions than adherence to formal and learned therapeutic techniques.  (Whitaker)

The child growing up gradually learns that no one lives “happily ever after,” not even the parents.  Life itself is life threatening.  Everyone lives with existential anxiety or fear of non-being (Tillich, 1952)

“stuckness” is just a colloquial way of acknowledging that energy is being dammed up and saved with a view to generating the powerful dynamic thrust needed to bring change in chronic situations.

Everyone, of course, knows that precipitous and headlong change that has not been adequately prepared for and that is out of sync with one or more of the parties involved can destabilize both persons and relationships and have an unfortunate and destructive outcome.

… the personal narrative in life belonging to the client is but a “constructed reality” and, moreover, a story that exists nowhere other than in the client’s mind.  … If the client does, in fact, make up his or her own story (that is to say, personal history), then the story (that is to say, history) can be changed.  … since we make up the story, it follows that we do therefore construct for ourselves most of our own dilemmas and paradoxes in life.

Chapter 5: Auditioning and Casting: Background Preparations for the Conversations with Parents

The chapter goes over various details of preparing spouse and parents for what is being undertaken.  It also discusses the role of a FOO group to do personal preparatory work prior to the actual work with parents.  It also contains an interesting story regarding which set of parents a couple will spend a holiday meal with using some humorous reverse psychology.

Chapter 6: Black Out Sketches: The Group at Play

[This chapter is very strange, and “recommends” several absurd things, wherein context is essential to see the recommendation as anything other than malicious or manipulative.  Bear that in mind regarding excerpts below.]

Since no initiative by son or daughter can force its way inside the parental system or bring change in the former parent’s behavior, it has been suggested that behavioral interactions between two autonomous systems should  not be called interventions or inputs, but rather “perturbations”.

As fluctuations occur in the intergenerational relational system, they can be amplified to produce confusion or chaos.  This chaos will eventually give way to a new order as the family changes.  The new organization in the family can be seen as an ongoing coevolution of the generations.

… most of life is handled most of the time by most people at an unconscious level. … this deliberate not knowing is a benevolent example of the extraordinary human skill we possess of not letting beliefs and values interfere unduly with the conveniences of everyday living.

[ page 82 – begins a series of the absurdities mentioned above — humorous, but ] read in isolation they can seem insensitive or just plain silly.  It is not likely to be effective with the humorless, and it may backfire with the hostile client.

“Let’s make it easy on ourselves.  What are the things we should not talk about today?  Who in particular should not talk about which things?  we will need to discuss whether we have agreement on the reasons why certain persons should not talk about particular things today.”

“Who would like to talk about something inconsequential today and save all the good stuff for next week, when it will probably be raining?”

“you know when I think about it, what’s really so wrong about devoting your first 50 or 60 years to pleasing your parents?  I mean, the chances are you’ll still have 15 or 20 good years to devote to yourself.  That way everybody can be happy.”

Chapter 7: The Rehearsal: Preparing the client for Political Renegotiations with Parents

The climax of the initiative toward discovery is, of course, the presentation to parents of the detailed prepared agenda.  … It is not unlike the discover phase in a legal proceeding, except that the intent is benevolent and collaborative, not adversarial.

[ P. 104 –  have a long “Discussion” with parents on tape where they are not present. ] the primary purpose of the exercise is to achieve what has been traditionally called catharsis.

Initiating Negotiations.  … this may, for example, take the form of addressing parents by their first or given names. … yet it is not unusual for both generations to find this gesture disturbing and disrespectful.  … It is no more than an effective warning shot across the bow, signaling that some kind of engagement is about to begin.

Chapter 8: Scheduling the performance and Contract Negotiating with the Players

[ p 116 – This chapter outlines the structural format / layout of the actual FOO session with parents. ]

Ground rules:

  • Taking the fifth: While the client has given himself or herself permission to ask any question of any sort on any topic, the parent has a right to decline to respond to any question.  At that point, the client is permitted one follow-up question.  That follow-up question is “Can you tell me why you do not want to respond to this question?  The parent can then choose to respond or to decline to respond to the follow-up question also.  If the parent declines, then the matter is closed and the client will immediately move on to the next question.
  • Two-Way Street: Even though the client has the edge of prepared questions, the parent has an equal right to pose any question of any sort at any time to son or daughter.  Son/daughter has the same right to the 5th above.
    The parent will not be asked to do anything that son or daughter is not fully prepared to do also.  In this way, a conscious effort is made to establish a strong sense of mutuality and reciprocity from the very beginning.  this is not just an inquiry into the lives of individuals; this is the unfolding of the story of this family.
  • Confidentiality: Both parties are free to repeat to any other person at any time any comment that they make themselves, about themselves, or any understanding they come by about themselves.  On the other hand, all parties commit themselves not to quote any OTHER person speaking on any subject without specific permission.

Chapter 9: Writing the Script: The In-Office Agenda for the Primary Triangle – Part 1. The parents Speak.

[ This chapter contains samples from various interviews of different families.  There are a great many questions that can be gleaned for personal use from the examples here. It also presents the outline of the FOO interview.  Your own questions are suggested to at least follow this general outline format. ]

(The Questions can be found here.)

Chapter 10: Writing the Script: The In-Office Agenda for the Primary Triangle — Part 2.  the client Responds and the Consultant Reflects

The discovery, declaration, and celebration of differentness, in detail, and in direct eye-to-eye contact with parents, is an important an historic act of differentiation of the self within the family of origin.

The commitment to wed the drama of differentiation of self with an adult intimacy and sense of belonging within the family of origin constitutes the novelty of the personal authority theory and method.

there is no one from whom parents would rather hear acknowledgment and validation than their own former children. … Other than the spouse, there is no one else in whom the parent has such an enormous emotional investment.

[ p 162 – re-language your questions (to make them less judgmental) ]

Chapter 11: Performing Outdoors: New Life at the Graveyard — Renegotiation with a Deceased Former Parent

Important human relationships do not terminate with a participant’s physical death.  Relationships continue to live where they have always lived, that is, in the survivor’s mind and imagination.

The only really essential precondition [to success with FOO work with the deceased] seems to be adequate motivation and courage on the part of son or daughter.

In dealing with a surviving parent, it is rarely, if ever, ultimately fruitful to express rage directly to the person of the parent. … From a political and hierarchical perspective, to become enraged means to loose power, presence, and position — that is, authority.  Most of the time, expressing rage is a child-to-parent transaction, so that the client has for now forfeited the standing of peer in the relationship.

[When only one parent is still alive ]  For a variety of reasons, including the fact that this is an ongoing relationship with an unwritten future, it has proven more conducive to renegotiate with the deceased parent first.

[In therapy,] everyone stays mindful of the fact that the purpose of the first visit is to get to the last.

[In visiting a grave site, ] if the client actually parks and gets out of the car, the visit is not likely to be uneventful.

Chapter 12: Production Problems: Limitations to the Method

[The chapter deal with parents where there are severe psychological, alcohol or other addiction problems that interfere with the client’s ability to do the FOO work with them directly ]

… the client needs to conduct himself or herself throughout these proceedings in such a way that he or she will achieve a fair balance between personal interest and the interest and well-being of the parent.

[p. 185,  regarding psychologically rigid parents, the client ] can also reassure parents that this conversation is not about determining who is right and who is wrong on any given matter.

[ p 186, with divorced parents. ]  Moreover, the agenda includes many additional and specific questions about the character of the failed parental marriage. … The client will ask the parent if he or she now believes that this outcome could or should have been avoided.

[ p 187, reasons that restrict the client ]

  • psychotic-level problems
  • very anxious or dependent client
  • a socially isolated client
  • physical health problems that significantly restrict his/her life and activity, especially if genetically determined.
  • financial dependency upon the parents.
  • clients with intensely held religious or ethical values may believe that this kind of work is forbidden (Ephesians 6:1-3, Exodus 20:20)
  • clients committed to the posture of being emotionally cut off from the family of origin.
  • Cases where the “marriage” via triangulation to parents is stronger than to the spouse
  • clients committed to “not knowing” what is really going on
  • potentially, those who have been significantly abused as children
  • preposterously pretentious, psychologically sophisticated people, including some psychotherapists.

Families have enormous resources to provide nurturing and healing relationships for one another when they are encouraged to maximize the assets, minimize the liabilities, and mobilize the goodwill.

[p 189 –  contrary to the vie that the parent always remains the parent (age, generational relationship), author believes that stands as a barrier to peerhood in relationship.]

[on intergenerational intimidation]  Even the temporary loss of parental approval and goodwill can be experienced as rejection and, therefore, as life-threatening.  Anxiety about rejection conjures up the child’s earliest and most primitive fears about abandonment and exposure and, therefore, death if he or she is not accepted and nurtured by parents.  consequently, any questioning of ongoing family politics and dynamics that might incur such a risk is frequently experienced as suicidal behavior.

… any criticism of family values and beliefs may be experienced not simply as an attack upon parents but as an attack upon one’s inner self.

Part-III: Personal Authority contextual Issues

Chapter 13: Personal Authority: The Personal Story

[ The author’s personal FOO story ]

[p 200] … in my theoretical view resolving intimidation is presented as the sine qua non of personal authority in life.

In time I came to view personal authority (which, of course, includes control of one’s thinking process) as an antidote and an alternative to fear.

I discovered that, paradoxically, one can only leave the family of origin emotionally by going back into the very hear of the family and learning to be comfortable there.  A potent sign of “having left” is therefore, the freedom to be present voluntarily and joyfully.

“The resistance to the past is the voice of the past” (Boszormeny-Nagy & Ulrich, 1981)
There is considerable plausibility to the idea that one cannot come to feel very much better about one’s self than one comes to feel, in the last resort, about one’s parents.  It is, therefore, of compelling psychological importance to rehabilitate the parents as fully as possible within one’s own mind and heart.  If nothing else, this is simply enlightened self-interest.  In embracing the parents and putting them close to one’s heart one is embracing the parent within the self.  One is, therefore, integrating within the self system crucial, if previously rejected aspects of self (Rogers, 1951)

[ p 203 – authors initial poor tact with parents, followed by ] “I’m in trouble and I need your help.  I have some questions to ask, because I believe the information will help me.”

Managing one’s life is a full-time job.

[ p 207/8 – when children come to aid of aging, ailing parents…. that’s OK! ]
The adult who has already given up the parent as parent, is now much less likely to be internally or externally cajoled into “playing parent” to an aging or ailing parent now ready to “play child” in complimentary fashion.  … the more involuntariness and obligation characterize an intergenerational relationship between adults, the less will the generosity and spontaneity of love and tenderness be present.  [ do it because you want to, not because you have to. ]

Chapter 14: Personal and Professional Authority in Professional Life

The context of professional life frequently provides an opportunity for further resolution of the important issue of personal authority as it expresses itself through crises in professional identity.  … Personal authority and professional authority go hand in hand until eventually work is much less a matter of doing than a way of being, as they fuse together.

Chapter 15: Personal Authority, Professional Authority, and Physical Health

there is increasing evidence of the effects of positive and negative emotions on the patient’s immune system.

patients with an internal locus of control do better when given more responsibility for self-management, patients with an external locus of control do better when there is more active guidance from health professionals.

Family therapy theory has taught psychotherapists to place the individual in the context of the family and has taught that the family, as a system, is essentially an emotional system.

body and mind have been divided and separated in theory, practice, and education.  This is an unfortunate situation with astonishingly deleterious consequences.

[ p 229 – a list of uncommon questions from doctors that  WOULD be asked based on author’s :call to consciousness”

Health is a kaleidoscope of moving variables.  .. The patient is encouraged to place health experiences squarely within the emotional life and to be attentive to the unceasing dynamic dialog between mind and body.

[p 232] to the extent that a persons gives up personal responsibility for any experience in life, to that degree the person looses a subjective sense of freedom and of self — in short looses personal authority.

[233] there is the universal reluctance in human beings to be “conscious,” meaning to be attentive to what one is thinking and feeling at any given moment.

[235/6]  “The dominant concern of the first-year resident in family medicine is to manage not to kill anybody.”  … medical students are usually … in their middle or late 20s as residents.  … the key sequences in the development of personal authority do not occur until the 30s and early 40’s

Chapter 16: personal Authority and Gender differences: Typecasting

[240] Implicit in the PAFS theory is the belief that gender differences are significant and that they are socially constructed in a historical context.

[241] Gender, like age, is integral to the identify of the individual and to the organization of the family.

…  until very recently we have pretended that, or acted as if, the social injustices of patriarchy stopped just short of the nuclear family’s door. (Goldner, 1988)

[244] For a couple to raise children successfully, it was assumed that hierarchies and boundaries had to be established and maintained.  The gendered hierarchy of family life thus either remained invisible or was accepted as part of the natural order while the generational hierarchy was not only recognized but proclaimed normal and healthy.

Because men are frequently detached from the responsibilities of the home, they miss out on the rewards of parenting, the closeness and affiliation with children, and the feeling of attachment that caring for a child or spouse can bring.

[245] feelings are disguised as the rational becomes more highly valued.

[246] Rachel hare-Mustin: Alpha bias describes work that finds significant differences between men and women; Beta bias describes work that minimizes the differences between men and women.

[247] Miller concludes that because women’s focus and being are based in relationships, autonomy creates the fear of separation and aloneness.  For men, autonomy is a natural outgrowth of their socialization in the dominant group.


Chapter 17: Beyond personal Authority


Part-IV: Personal Authority Research


Chapter 18: The Personal Authority In the Family Systems Questionnaire: Assessment of Intergenerational Family Relationships





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