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Psychoanalysis began with the treatment of neuroses (hysteria). Despite its widening application to borderline and narcissistic disorders, it remains the treatment of choice for higher level neurotic conflicts. While the psychoanalytic understanding of pregenital disorders is well established, the treatment of them by classical analysis remains problematic.
Patients with largely pregenital disorders have been viewed as suffering from developmental arrest, often with incomplete differentiation of self- and object representations. Inevitably, these patients have been and often continue to be enmeshed in poorly differentiated families with severe disturbances in communication. Such families, with their inadequate ego boundaries and centripetal, symbiotic tendencies, have tended to be viewed, in emerging family approaches, as "collective patients."
It is not surprising that family therapy, unlike psychoanalysis, began with the study and treatment of the psychoses and of other pregenital disorders. The various schools of family therapy have usually de-emphasized the psychology of the individuals within these less differentiated "family systems." The generally fixed family structure observable within these families has influenced family therapists to introduce "homeostasis" as one of their first