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3 DEVELOPMENTAL THEORY OF FAMILIES: THE FAMILY LIFE CYCLE by Christian N. Ramsey, dr. FAMILY LIFE CYCLE AND THE FAMILY PHYSICIAN The developmental theory of families that encom- passes the Family Life Cycle has been selected beeaus: (1) the Family Life Cycle provides a predictable, chron- Oingically oriented sequence of events in family life with which family physicians and other health profes- sionals are already familiar, (2) viewing the family through the perspective of family development en- sourages us to sce the family more as a systern of interconnected and inter-related members, and (3) the events of the Family Life Cycle can be related to clinical events and to health maintenance of the family. The Family Life Cycie provides « sequen: dictable'[ormat far understanding the events of family development. Each step builds on and is dependent on the completion of a prior step’ Physicians learn about life cycles by studying parasites in college bio!- OBy courses, An important lesson is that each stage is important to the individual development of the parasite and also is intimately related to the relationship between the parasite and the host (the host-parasite system). The life cycle of-a parasite not only describes the life cycle of the animal but also describes the relationship lo the host organism. In a similar way, the Family Lite Cycle provides a construct for understanding the in- dividual development of famiiy members and the relationship of individual family members to the family . as a whole. From the beginning of time; man has depicted the Sequential stages of life and death through cultural rituals, religion, and art. Our society has placed an increasing emphasis on individual development begin- ning with Freud’s theories of the psyche and extending to the child development theories of Gesell and co- workers (1943), and others. More recently, Erickson’s (1999) description of individual personality growth pointed the way for thinking about adult human life cycles. This was extended by Sheehy (1976) in her book, Passages: Predictable Crises of Adult Life, in wrhich the-adult is seen as making a series of passages from each roie to its succeeding tale. sone fany people have difficulty viewing the family as a system and tend to think of the family more as a sollection of individuals. Family systems theory (see Chapter 2) points out that family functioning is more than the sum of the individual parts. Systems theory iS necessary in understanding family functioning be- cause it has the breadth and flexibility for capturing the interplay of numerous forces within and without the family that affect family development, Under- standing the developmental theory of families encour. ages thinking in terms of family systems. During a life cycle, change occurs in tlie index generation, requiting concurrent change in the preceding ancl succeeding generations, Change in the role of one person requires change in the roles of others within the family system. Functional classifications of the Family Life Cycle de- seribe the evolution of the family system (rom its formation (marriage) to its expansion (childbirth and child cearing) and its contraction. As a family enters the expansion phase, those of the prior generatiun become grandparents and spouses become parents. Each of these transformations requires changes in the roles and identities of the family members and affects the functioning of the family as a whole. The Family Life Cycie can be related to clinical iliness and to health iaintenartte. Since the life cycle consists of a seties of predictable events in the formation and growth of a family, it is possible to postulate the role of the family physician as one of providing health care and medical care for the family as it moves through successive stages of the life cycle. Using such a con- struct, it is possible to relate the development of the family to-a series of expected clinical events surround- ing the formation and expansion of the family. For example, in our society, persons planning to ma maust have a medical examination and certification that they do not have venereal disease. Childbirth typically dictates prenatal care, and entry of children into school requires school physical examinations and imvauniza- fons. Each of these stages of the life cycle, therefore, has clinical consequences. Additionally, there is evi- dence thal some illnesses such as school: phobia are clearly Ned to’ a’ failure to achieve parent-offspring separation during the expansion phase of the Family Life Cycle HISTORY OF. THE DEVELOPMENTAL THEORY OF FAMILY FUNCTIONING In 1948, Evelyn Duvall and Reuben Hill coordinaled a National Confererice on Family Life in which the interdepenlence of indlividtial life cycles was empha- 44 a i 
