ABC-X model of stress and the ACE model Essay

ABC-X model of stress and the ACE model

The development by Reuben Hill of the ABCX Model to provide a framework for understanding how families respond to and deal with crises was a landmark in Family Crisis Theory. The ABCX Model offers a context in which to discuss crises, the resources families bring to bear in response to crises, how families define or develop an understanding of crises, and the nature of crises and their impact on families. Building on that conceptual framework, Hamilton McCubbin and Joan Patterson developed the Double ABCX Model, which utilizes the basic framework of Hill’s original model while expanding the scope of the model to provide a contextual framework for events and circumstances that arise afterwards as a result of the crisis. In the following paper I discuss a significant crisis that affected my family, and examine the nature and details of the crisis through the lens of the Double ABCX Model.

Background

In an article entitled “The Double ABCX Model of Family Stress and Adaptation: An Empirical Test by Analysis of Structural Equations and Latent Variables,” Lavee, McCubbin and Patterson (1985) used the Double ABCX Model as a framework to examine how families death with the absence of male spouses and fathers during the Vietnam War. Among the events and circumstances the researchers considered were how wives and mothers responded to and coped with the stressor of absent husbands as they faced the demands of raising families, gaining and maintaining employment, navigating the demands of military bureaucracy in order to secure paychecks and benefits, and myriad other responsibilities and challenges associated with the particular stressor of having spouses serving in active duty overseas.

While the specific details of this study are only generally applicable to my circumstances, there are some areas of significant overlap. The most obvious correlative factor between the study and the circumstances of my family history is in the absence of a father in my household for most of my upbringing. Although the lack of a father during my childhood was not due to military service, many of the responsibilities and challenges that I, my mother, and my siblings had to contend with were similar to those faced by families who must contend with having a spouse –specifically a father- away on active military duty. At the same time, many of the stressors with which my family had to contend were compounded by the lack of the kind of social and economic support system available to spouses of military personnel. In short, we faced all of the challenges of having an absentee father with none of the social or economic benefits available to families of military personnel. Moreover, the hardships and challenged I and my family faced as I was growing up were exacerbated in recent years by the sudden onset of a major health crisis for my mother; this crisis would prove to be among the most significant crises my family ever faced, and would reshape the way our family functioned and redirect the course of our lives.

Applicability of the Circumplex Model of Family and Marital Systems

The family unit is not unlike a living organism, families and the dynamics of the relationships between and among family members are not static, but rather are constantly evolving and shifting over time. Using the Circumplex Model as a framework in which to examine my own family structure, it is possible to see how the primary dimensions of the model –cohesion, flexibility, and communication- are also constantly evolving and changing as circumstances arise and stressors are dealt with. While the precipitating event of my mother’s health crisis would, of course, pose significant problems and challenges for my family, I can also see how those challenges and stressors affected our family systems in ways that were both positive and negative. As the only female out of five siblings, my relationships with my brothers were shaped by the challenges my mother and the rest of us faced as she raised us as a single parent. Other factors bearing on our family stems include our mixed racial and ethnic makeup, and the normative expectations imposed on females by the traditions of my ethnic and cultural background.

Prior to the precipitating crisis of my mother’s health issue, our family cohesion ran to the low end of the five levels of cohesion. While we were not entirely disengaged, the circumstances of growing up as the only girl in a single-parent family served to reinforce a fairly significant level of autonomy among all my siblings and a disconnection between me and the rest of my family. Our family flexibility hovered between moderate-to-high and extremely-high or chaotic. My brothers were often left to fend for themselves as my mother was tasked with doing what she could to provide for the family economically, and this lack of structure underpinned later issues and problems for some of my brothers, including alcoholism and other behavioral issues. The challenges and demands of life at the lower end of the socioeconomic scale meant that mere survival was paramount, making it difficult for the family to function as a healthy unit. Not surprisingly, communication issues within my family were often notable, and the communication divide between myself and my brothers was exacerbated by the expectations and demands placed on females of my cultural and ethnic background. As I see it, I was often not taken seriously by my siblings, and the circumstances and events of my upbringing did not adequately prepare me for the demands of adulthood in general, or the specific demands I faced as my mother’s health declined so rapidly in recent years.

Applicability of the Lipman-Blumen Scheme

The primary family crisis in consideration within this discussion is my mother’s declining health, specifically the onset of renal failure. This stressor is, in a sense, both internal and external; the medical condition may be classified as internal to the family, but the capacity and resources with which the family dealt with the stressor, and the effects it had on the circumstances of all of our lives, are all connected to and affected by a range of external factors as well. The stressor-pileup associated with this crisis included a number of significant issues, from subsequent financial disarray and homelessness to the problems with my older brother’s alcoholism and problems and stressors related to the extended family, employment and educational opportunities, and a number of major and minor issues.

The crisis is a pervasive event, in that the effects on my mother’s health were both debilitating and permanent. This is not the sort of crisis from which one can recover and return to family circumstances and dynamics as they once were; the ways in which the family responded as individuals and as a unit have come to redefine the structure and function of our family, for both good and ill. The fallout from this crisis has been felt by close and extended family members as well as by my friends and those of my siblings and my mother. The onset of the crisis was quite sudden; although my mother had suffered from some other health issues, her renal failure arose virtually overnight. The degree of severity grew from great to greater as my mother’s health declined rapidly over the course of the first few hours in the hospital. The intensity of the crisis did not diminish when she was released from the hospital; rather, it simply served to establish a “new normal” of what amounted to a permanent crisis mode for our family.

The prognosis for my mother is grim; she will never be able to walk or take care of herself without assistance, so it presents a long-term stressor for our family. The onset of the crisis was random; neither my mother noir the rest of the family could have foreseen this health crisis nor prepared for its aftermath and its effects on our family. There are a number of other health issues associated with my mother’s renal failure, such as congestive heart failure and permanent damage to several organs. Although she survived the initial crisis, her health has continued to decline since the onset of this crisis. She is unable to bathe or feed herself, and can no longer be left alone for any length of time. According to her doctors, her health issues were not triggered by any specific events or circumstances, and are simply the natural progression of underlying conditions. The circumstances of her health crisis and its effects on the family are all defined by scarcity; scarcity of time, scarcity of financial resources, scarcity of emotional resources, and scarcity of a social and familial support system. This crisis is not solvable; my mother’s health will continue to decline, and the only resolution to this crisis will be when she succumbs to the complete failure of her biological systems.

Applicability of the ABCX Model

According to Hill (1958), the letter “A” in the ABCX model represents the terms “crisis-precipitating event” and “stressor;” both terms refer to “a situation for which the family has had little or no prior preparation and must therefore view as problematic.” The onset of my mother’s renal failure certainly fits the parameters of a “stressor,” as our family was caught completely off guard by her health problems and was completely unprepared to deal with the challenges it presented. The stressor imposed significant hardships on our family, as we were not financially equipped to handle the responsibilities of maintaining a home or paying bills with my mother being unable to work and requiring constant care. Further compounding the problem was the lack of emotional resources our family would have needed to adequately deal with the fallout of her declining health.

These resources, or lack of resources, comprise the “B” in the ABCX Model. The relative level of dysfunction in our family left us poorly prepared to deal with the crisis. Coupled with this lack of emotional and familial resources was an even greater lack of financial resources; with my mother unable to work we found ourselves homeless in the aftermath of my mother’s renal failure. This forced us to seek support from social-welfare organizations and from members of our extended family, but it also placed significant strains on the interrelationships between me and several of my siblings. The letter “C” in the ABCX Model relates to how families define the precipitating event or stressor; Hill (1958) states that whether families view such events as crises or challenges will significantly determine the overall response to the event and will also shape the ways that the family deals with such stressors I the future. Families that view such stressors as crises will, according to Hill, be more crisis-prone in the future.

Finally, the “X” in the ABCX model denotes the event itself; there is no question that our family defined my mother’s health issues as a crisis, as opposed to merely a challenge. Our responses to the crisis as individuals and as a family led to significant and permanent repercussions for our interrelationships and the ways in which we personally dealt with the crisis. My relationships with two of my brothers appear to be irreparably broken, and one of my brothers fell even deeper into the pit of alcoholism after my mother’s health crisis. At the same time, however, the challenges and responsibilities we faced prompted me to find inner reserves of emotional strength I did not know I possessed, and I have found myself taking on the role as the head of the family in the hole left by my mother’s inability to care for us or for herself.

Applicability of the Double ABCX Model

Where the ABCX Model ends with the definition and effects of the crisis, the Double ABCX Model goes further, and examines the immediate and long-term aftermath of the crisis. The Double ABCX Model recognizes that the primary crisis is exacerbated and affected by subsequent cruises and challenges that result directly or indirectly from the primary crisis. Part of this framework includes the “pile-up” of additional stressors. In this model, the letters a, b, and c represent the same factors ascribed to A, B, and C in the original model; this section is now viewed as the “precrisis” component. The letter “X” represents the crisis itself and the subsequent pairings aA, bB, and cC are designated to represent the post-crisis components of the model: aA is the pile-up; bB denotes existing and new resources; cC denotes the redefined perceptions of the crisis after consideration of aA and bB; and xX denotes the degree of adaptation or maladaptation of the family to the post-crisis circumstances. In short, the Double ABCX Model charts the entire course of events and circumstances before, during, and after the crisis and provides a framework for examining how well the family adapted to the challenges posed by the crisis.

The pileup of stressors for our family included the serious financial hardships associated with the crisis, and the lack of help from within the immediate family and from our extended family. Communication within our family was already strained before the crisis, and this only grew more problematic in its aftermath. Before the crisis I was already one of the primary earners and financial contributors in our family; after the crisis I was forced to become the primary breadwinner. After a period of homelessness we were able to make the transition into a new home, and I assumed the role of head of the household. This role challenged many of the normative expectations for females within my cultural and social background; this and other boundaries were broken and reestablished along entirely new lines in the post-crisis period. The postcrisis period has been largely defined for me by the ambiguity of intrafamily and social boundaries and roles that are being rewritten and redefined as I go forward.

The circumstances of the crisis, along with the relative lack of existing resources, assured the necessity of finding new resources to cope with the post-crisis pileup and subsequent challenges. As it became clear that the burden of leading the family was now going to fall on my shoulders, I sought the assistance of outside resources offered by friends and other social support systems. My brothers largely abdicated their responsibilities to the family, which caused a significant breakdown in family cohesion and led to a nearly two-year period where several of us did not speak to each other at all. I was determined to overcome the post-crisis challenges, and I sought help from social welfare programs and other forms of assistance as I found a new home for our family. I also worked full time while I pursued my educational goals.

My physical and emotional health was affected during the post-crisis period; among other problems, I was faced with a worsening of chronic asthma. My resentment of some of my siblings prompted me to avoid communication with them, but also fueled my motivation to overcome the challenges our family faced. At first, as the stressors piled up, I was unaware of the outside resources that were available to help our family, as we had never before turned to a support network outside the family before the crisis. It was up to me to figure out what sort of programs were available, and ultimately I was able to get assistance in finding a new home and in paying for part of my education. At times the stress of dealing with the pile-up seemed overwhelming, but it was during this time that I realized how I could rely on my close friends for emotional support as I navigated the new challenges I faced.

I was not the only one who had to consider how to redefine my own role within the family; my mother also had to adapt to the changes brought on by the crisis. She was used to being completely independent and to making decisions for herself and her family, and now she had to learn to deal with the fact that she was no longer able to make such decisions or either care for herself. This was not an easy transition for her, and it often placed a significant emotional strain on the relationship she and I had. My brothers also had to come to terms with the fallout from the crisis in their own ways, while I had to deal with the resentment I felt for them and their lack of responsibility post-crisis.

 The xX Factor

It has now been several years since my mother’s renal failure, and the effects of that crisis and the subsequent pile-up of stressors has irrevocably altered the course of my life. With the benefit of hindsight I am able to see, however, that many good things have come from the crisis, and in some ways our family is now stronger than it once was. Each of us –I, my siblings, and my mother- views her health crisis as a turning point in all of our lives. Although the strains of the crisis initially drove me and two of my siblings apart, we have in recent months been able to communicate with each other again. The nature of our interaction has changed, however, as I am no longer bound by the normative expectations that bound me when I was younger. I have emerged from this crisis as a stronger individual, and I have also learned to better understand my own limitations and to know when and how to ask for help when I need it.

To a great degree, each member of my family has had to find a way to heal from the effects of the crisis, and each of us has had to define for ourselves what the crisis meant to our family and how we would all move forward. It appeared for some time that the pile-up of stressors after the crisis would be so great that they would completely tear our family apart, but over time we have all come to terms with the “new normal” of our circumstances. I have earned a new measure of respect from my siblings, and I have also made it clear that I have high expectations of all of them. We continue to struggle with many of the challenges imposed by the crisis, and we still have a long road to travel as we meet the demands that continue to be imposed by my mother’s health issues. Each of us has been marked by this crisis in different ways, but on the whole, we have each worked to adapt to the stressors and to come together again as a family.

References