What is "Family of Origin" Work in Therapy?
You're searching through therapist bios and you keep coming across the term "Family of Origin work" or "FOO Work". But what does it actually mean? In this post, we try to de-mystify what Family of Origin Work means and how it might be relevant in your therapeutic journey.
To start, Family of Origin (FOO) is a term used by therapists to refer to the primary caregivers an individual had when growing up, whether they be related, adoptive, foster, or any other type of guardianship or caregiver relationship. As you might have guessed, Family of Origin work shows up in therapy sessions quite often. You are probably doing some FOO work in your own therapy or even on your own, without even realizing it!
Some clients seek a therapist to help them through these specific kinds of issues, but most clients end up realizing their family of origin work is a more central issue to their lives than they might have thought at the outset of their therapy journey. Either way, there's a reason for the centrality of this kind of work in therapy. There are few things in our lives our families of origin don't impact, for the simple reason that they are our first relationships and first experiences of the world.
As an illustration, I like to use Dr. Emily Nagoski's metaphor of a garden. Each person is born with a garden; some plants are already planted in this garden at birth--without your say so--things like a sensitive nervous system, a predisposition for anxiety, depression, addiction or even a good memory, natural resilience, and other strengths. There are some seeds that have been planted generations before you and there will be some species of weeds that everyone inherits in the garden they are born with. As you mature, you begin to choose how to tend and manage this garden, what weeds you pull, and what plants you want to start growing instead. In therapy, FOO work involves being aware of what's in your garden--what was there before you had a say--and creating intention around how you want to address, manage, or change what your garden looks like as an adult. As the metaphor implies, it can be hard, messy work. That's a major reason it can be helpful to have a therapist with you while you're doing family of origin (FOO) work.
Here are a few topics that are involved when we use the term "family of origin issues". Some of these (or all of these) may or may not be relevant to you and you might find you resonate more with some than others.
Attachment & Self Worth
Developmentally, we are dependent on our caregivers for a significant portion of the early stages of our lives. We need caregivers to survive. And depending on the caregiver, we learn we can trust our needs to be met most of the time or we learn that we cannot trust others to meet our needs most of the time (or something unpredictable in between). This sets the stage for the type of attachment styles we develop and further impacts the way we relate to others and the world around us. We derive meaning from the way our early caregivers interact with us. Our families or contexts in which we are raised give us our earliest experiences in which we learn if we are valuable, special, and matter to someone...or not. We learn how to gauge our worth or seek connection: if it is inherent or earned with achievements and accolades, athletic prowess, and academic success. We might earn it through being a "good girl/boy/child" or an accommodating and pleasing child. We might learn what is "good" and what is "bad" in our family, and so begins our relationships with shame/guilt and ultimately, our relationship with ourselves.
In therapy, identity and self-work can look as different as the clients who walk through the office doors (or open up their laptop screens) for session. Topics such as inner child work, self-differentiation, setting boundaries, re-storying old narratives, redefining and reframing values and qualities, and attachment work all address how you are relating to yourself and the world around you via the lens of your FOO and learned attachment styles.
Family Roles
Some of the most relevant FOO work I do with clients involves understanding how the roles they played in their family growing up (and now) impact their life in other areas outside of their family of origin. For example, a client might come in wanting to work on people pleasing and how detrimental that has been in her career and friendships because she's finding it very difficult to speak up for herself and ask for what she wants and needs. After a few sessions discussing her family of origin, she might realize that it all started in childhood trying to please her parents, playing peacemaker during their divorce, or caretaking their emotions. Because we are so dependent as children on our caretakers, we often will do anything to keep them around and keep our attachment to them -- even if it costs us significantly. This is how family dynamics and environments shape us. This client learned as a child that to keep her caregivers close and happy, she needed to emotionally caretake and please them to get connection. After learning this and having it reinforced over and over again in her own family, this client continues playing this role in her other relationships, but with different outcomes. Where it served her in her FOO, it does not serve her in her friendships or professional relationships. Bringing awareness, through therapy, about how these old family roles play out in current day-to-day life can help change these patterns.
Conflict & Communication
In my work with couples, conflict and communication challenges almost always trace back to differences in family of origin: my family avoids conflict and brushes things under the rug; your family likes to hash things out right here and now until someone is right and someone is wrong. My family is soft-spoken and everyone gets a turn to speak; your family is loud and boisterous and people must fight to be the loudest in order to be heard. My family does not talk about emotions; your family can't stop talking about their feelings and opinions. It goes on and on. Our families teach us certain implicit and explicit rules, especially rules around communication and conflict. Family rules are often informed by culture, religion, class, beliefs, or value systems. We learn somethings are off-limit, while others are dinner-table conversation appropriate. Often times, we are punished--usually with shame or guilt--when we break these spoken and unspoken rules, which leads to internalization of these rules and other shame-based narratives.
FOO work around conflict and communication patterns starts with acknowledging the rules you have learned and continue to abide by--usually without awareness! This new awareness then leads to decisions about what type of communication patterns and approaches to conflict you want to plant in your garden in the stead of the ones you inherited/learned.
Generational Legacies & Intergenerational Trauma
We now know that intergenerational trauma, trauma that happened to your ancestors and predecessors, can make its way into your own DNA and body (even your dreams). Some people inherit gardens loaded with intergenerational trauma caused by various stressors or challenges such as poverty, racism, sexism, homophobia, etc.--trauma and stressors they might never have experienced for themselves, but are nonetheless taught in subtle and powerful ways to the next generation. For example, hyper-arousal is a common symptom that arises after a traumatic event, where you are on alert for threats, scanning your environment constantly, or anticipating worst case scenarios at all times in order to prepare for or prevent bad things from happening. This symptom, while a typical response to trauma in someone who has experienced trauma, can be taught and passed down by vigilant parents, teaching their kids not to trust others or themselves, making the world feel like a constantly dangerous place where there is no room for rest or relaxation because one must always be on guard for the worst to happen. While this may serve an important purpose or reflect a true reality of danger, depending on the environment in which one finds themselves, the chronic stress of being in a state of hyper-arousal and threat does significant damage to the mind and body. It can be difficult for those taught this state of being to challenge it in favor of taking time to rest, relax, be taken care of by others, and to appropriately depend on others when called for. Working through intergenerational trauma with a therapist looks a lot like naming legacies you've inherited, understanding the impact of systems larger than you and your family, externalizing the blame in order to foster compassion, understanding, and validation, as well as working to challenge and heal some of the perpetuated suffering.
Gender, Power, Money, Sex, & Relationships
Our families teach us our earliest values and beliefs, before we even have a chance to form our own opinions and worldviews. In our families of origin we learn about gender, power, money, relationships, and sex. We learn that gender can mean who cooks and who works. We learn that gender can mean equality and fluidity. We learn that it can mean who is powerful and who is powerless. We learn about money and what financial security or insecurity feels like. We learn to see the world as a place of abundance or scarcity. We also learn how to share affection, what love looks like, how to act in relationship, and how to treat others. We learn what is "normal" in terms of displays of affection and physical touch. We learn what is not okay in terms of sexuality, bodies, and acting on our desires. FOO work in therapy can involve unpacking our biases and beliefs around concepts like these in order to have more agency and choice in how we relate to others. With awareness we can have more say in how we move through the world.
Our earliest experiences with our families of origin shape our biases, tendencies, and what we consider "normal." These experiences make up our gardens. As adults, through the therapy process, we learn what does or doesn't serve us anymore: what might need to be uprooted and unlearned like racism and sexism or what needs to be planted and learned like how to communicate vulnerable emotions to a romantic partner or how to accept one's sexuality. In therapy, FOO work can help unpack our earliest messages around influential constructs and breakdown old narratives we continue to perpetuate, but that don't actually serve us or fit us anymore, so that we can learn to live in ways that support our wellbeing individually and relationally.