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Family Assessment of the Lannisters

California State University, San Marcos N480

Meet Tryion Lannister Tryion Lannister is a 30-year old male who was born with dwarfism. He is the youngest child of Tywin Lannister, the Lord of Casterly Rock. His mother died while giving birth to him. He comes from one of the richest and most powerful houses of the Seven Kingdoms. Tyrion has two older twin siblings, Cersei and Jaime Lannister, who share a secret incestual relationship. He has a strained relationship with his father and older sister, who both blame him for his mother’s death. He is often mocked due to his dwarfism and is nicknamed “The Imp.” He struggles with being accepted by society and his own family members. He is a smart, witty, and educated individual who uses sarcasm, booze, and women to cope with his stressors.

Condition: Dwarfism Dwarfism is defined as having a short stature, or being at an adult height of 4 feet 10 inches or less (Mayo Clinic, 2018). The cause of dwarfism is generally unknown, however genetics often plays a role (Mayo Clinic, 2018). Achondroplasmia is the most common genetic disorder that results in dwarfism. It is caused by mutations in the FGFR3 gene, which is responsible for skeletal development and bone and tissue growth (National Institutes of Health, 2018). Individuals with achondroplasmia are unable to convert cartilage to bone, particularly in the arms and legs (National Institutes of Health, 2018). Other characteristics include having a normal size trunk with short arms and legs, large head, and being of normal intelligence (National Institutes of Health, 2018). There is no clinical treatment to increase stature (Mayo Clinic, 2018). Many dwarfs suffer distorted body image issues and are subject to teasing (Mayo Clinic, 2018). Therefore, it is important to include psychological support when treating patients with dwarfism.

Meet the Lannisters Tywin Lannister is a 60-year old male and the father to Cersei, Tyrion, and Jaime Lannister. His wife passed away while giving birth to Tyrion. He is the richest man in the Seven Kingdoms and is well versed in combat and warfare. He is the Lord of Casterly Rock and is usually away from home. His house servants essentially raised his children. He is a highly intelligent, cold, and heartless individual. He has a deep hatred for Tyrion and uses his other children to gain power for the family name. He takes great pride in his family name and will go to great lengths to preserve it. Jaime Lannister is a 34-year old male and the eldest son of Tyrion Lannister. He is the older brother to Tyrion and twin brother to Cersei. He is the biological father of Cersei’s three children, Joffrey, Tommen, and Myrcella. He has exceptional swordsmanship skills and previously served in the Kingsguard during the previous king’s reign. He is the current Lord Commander, which is the highest military ranking, to the current king. He is the only one in the family who truly cares for Tyrion. He is kind-hearted and does not care for the social stigma associated with his incestual love for his Cersei Lannister is a 34-year old female and sister. the only daughter of Tyrion Lannister. She is the widow of the previous king of the Seven Kingdoms, older sister to Tyrion, and twin sister to Jaime. Her prior marriage was formed as a political alliance. They have 3 children together. Their eldest son, Joffrey, took the throne after his father passed away. Because Joffrey is only 12 years old, she guides and influences his political agenda. Cersei has an ongoing secret incestual relationship with her twin brother, Jaime. She is sadistic and craves power. She will do anything to keep her family’s hold on the Iron Throne.

Family Dynamics The Lannisters are not a normal functioning family. Tyrion, Jaime, and Cersei did not grow up with parental figures in their life. Tywin was an absentee father and never re-married after his wife passed away. He does not show compassion towards his children. Jaime and Cersei are in love with each other, which is a social taboo. The Lannisters lack the traits of a healthy family. They do not communicate, listen, trust, or support each other (Denham, Eggenberger, Young, & Krumwide, 2015).

Duvall’s Developmental Theory According to Duvall’s Developmental Theory, it is assumed that a family progresses through stages in a systematic and predictable manner (Kaakinen, Duff-Gedaly, Hanson, & Coelho, 2015). The theory has 8 stages that a family goes through, with family developmental tasks associated with each life cycle stage (Kaakinen et al., 2015). The Lannisters are currently in the end years of the middle-aged parents stage. Cersei, Jamie, and Tyrion are independent adults. Cersei and Jamie have 3 children together, while Tyrion wishes to start his own family. Their father is still working to fight for their hold on the throne and is not at the stage of retirement yet. The framework also emphasizes that a family will experience stress from both predictable and unpredictable transitions (Kaakinen et al., 2015). However, family members experience more stress during unexpected transitions. Their mother’s death at such an early stage in their lives was not a normative transition. Tyrion never met her and Cersei and Jamie were only 4 years old. Tywin became a single father of three and was also the caretaker of a child with dwarfism. Cersei and Tywin ultimately blamed Tyrion for the death of Tyrion’s mother. Their resentment towards Tyrion continued on for the rest of Tyrion’s life. Since the Lannisters were never able to adapt to this unexpected transition, they were unable to develop a healthy family relationship full of love, laughter, and trust.

Culture & Religion The Lannisters do not hold spiritual or religious beliefs. However, their father is a traditional man and believes that men belong in warfare and women are to be obedient to their husband and bear them children. On the contrary, his children do not hold these same values. Cersei and Jaime Lannister defy social stigmatisms as evidenced by their incestual relationship. Tryion enjoys drinking and spending time at brothels.

Strengths ●

Jamie and Tyrion have a strong sibling relationship. Society labels Tyrion as a “monster” based on his condition, but Jamie accepts him for who he is. Jamie acts like a protective older brother and will stick up for Tyrion when he is being bullied.

Challenges ●

They do not spend quality time together as a family. Cersei and Tywin never accepted Tyrion’s condition. They are embarrassed by his short stature and mannerisms. They do not consider him family. Tyrion struggles with being accepted by society. He is unable to find support from his family members, besides Jamie. He has ineffective coping strategies and uses women and booze to deal with his stressors. There is no compassion or trust in the Lannister family, excluding Jamie’s individual relationships with Cersei and Tyrion. Tywin measures his children’s worth based on what they can do to gain power. Because Tyrion is not accepted by society, he has never been able to live up to his father’s expectations. They lack the ability to cope with stress and crises as a family. After the death of Tyrion’s mother, Tywin became an absentee father. Tyrion’s condition was a burden to him. He also blames him for his wife’s death.

Communication As an overall family, the Lannisters lack effective communication skills. Their communication is not used in a healthy and constructive way. They only communicate to cause emotional turmoil. Tywin and Cersei are not afraid to voice their hatred towards Tyrion. They chastise Tyrion about how ashamed and embarrassed they are to be related to “The Imp.� There are no attempts to reconcile relationships. It can further be seen through their body language about how they feel about one another. During their conversations, they avoid eye contact and have their arms across their chests. As a father, Tywin is very stern and fails to show feelings of love and compassion for his children. He does not smile or laugh during their conversations. He is distant and does not engage in long conversations with his children. Jamie is the only effective communicator among the siblings. He respects and loves his siblings and tries to understand both of their viewpoints. He also expresses his compassion through physical touch, such as hugging.

Family Systems Theory According to the Family Systems Theory, all parts of the family system are interconnected (Kaakinen et al., 2015). Therefore, a change in a family member can impact everyone else in the family as well. When assessing a family, it is important to consider each individual member as well as how the family functions as a unit. In the Lannister family, Tyrion’s dwarfism has created many obstacles for him and his family. Their disdain for him has caused him to feel unwanted and unloved his entire life. He deals with his low self-esteem through alcohol and women. Through this theory, nurses can help the Lannisters maintain and regain stability as a family unit (Kaakinen et al., 2015).

Concepts related to Family Systems Theory All parts of the system are interconnected. ●

Tyrion’s condition has drastically affected him and his family. His condition has caused him to face much prejudice throughout his life. His father was ashamed of Tyrion’s physical appearance and therefore never took on much of a father role. He had difficulty accepting that Tyrion was truly his son. He did not want to be associated with Tyrion and instead focused on working to gain more political alliances for their family. His siblings were also affected because they too did not have a parental figure in their lives. This caused Cersei to further resent Tyrion.

The whole is greater than the sum of its parts. ●

Their family dynamics as a whole have changed. As a family, there is disgust and hate between family members. They are not a cohesive unit and fail to support one another. They do not discuss their feelings in an effective and positive manner.

All systems have boundaries between the system and the environment. ●

Their family has flexible boundaries with the environment. Tyrion often visits different brothels at other kingdoms as a way to deal with his family and internal issues. Their father is also often away to avoid interacting with Tyrion.

Systems can be further organized into subsystems. ●

The Lannister family has many subsystems. They consist of the sibling subsystem between Tyrion and Cersei, the sibling subsystem between Cersei and Jaime, the sibling subsystem between Jaime and Tryion, and the parental subsystem between the siblings and their father.

Problems, Interventions & Outcomes Problem #1: There is a lack of understanding about his condition and Tyrion’s need for emotional support. Besides Jamie, they do not support or love him for who he is. Intervention: Educate the Lannisters about his condition and emphasize how important psychological support is for an individual with dwarfism. Children with achondroplasia are likely to experience more bullying, teasing, and peer rejection than their normal-stature peers, all of which can be experienced as “psychological stress.” Therefore, it is crucial to evaluate the psychological well being of a child with this disorder (Nishimura & Hanaki, 2014). Outcome: The Lannisters will gain a better understanding of his condition in order to come to terms with it by verbalizing their need to provide emotional support for Tyrion.

Problem #2: Tyrion’s condition has caused a lot of strain for the Lannisters. They are not effectively coping with his condition. Tyrion copes through alcohol and women. This causes his family members to despise him even more. Tyrion’s father and Cersei avoid interacting with him. Intervention: Evaluate how the Lannisters are currently coping with his condition. Encourage alternative coping mechanisms, such as referring them to dwarfism support group and communities. When coping with diseases that can alter a child’s body, it can be beneficial to refer the child and family to support groups to foster mutual understanding and support of the condition (Brillante, Gutheri, & Ryzin, 2015). Outcome: The Lannisters will learn how to effectively cope with his condition by verbalizing at least one alternative coping mechanism, such as joining dwarfism support groups.

Problem #3: The Lannisters do not effectively communicate their feelings and concerns about his condition. There is a lot of built up resentment towards Tyrion. Intervention: Encourage the Lannisters to express their past and present feelings and concerns on the impact of his condition.Talking about current experiences of the illness, but also individual family members’ previous experiences of illness can increase family members’ understanding of each other and the situation as a whole (Arestedt, Persson, & Benzin, 2014). Outcome: The Lannisters will verbalize their reassurance that their voices and concerns have been acknowledged. They will verbalize the importance of healthy communication and social interaction among family members.

References Arestedt, L., Persson, C., & Benzein, E. (2014). Living as a family in the midst of chronic illness. Scandinavian Journal of Caring Sciences, 28, 29-37. Doi: 10.1111/scs.12023 Brillante, B., Gutheri, L., & Ryzin, C.V. (2015). McCune-Albright syndrome: An overview of clinical features. Journal of Pediatric Nursing, 30 (5), 815-817. Doi: Denham, S., Eggenberger, S., Young, P., & Krumwiede, N. (2015). Family-focused nursing care. F.A. Davis: Philadelphia. Kaakien, J., Duff-Gedaly, V., Hanson, D., & Coelho, D. (2015). Family health care nursing: Theory, practice and research (5th ed.). F.A. Davis: Philadelphia. Mayo Clinic. (2018). Dwarfism. Retrieved from conditions/dwarfism/symptoms-causes/syc-20371969 National Institutes of Health. (2018). Achondroplasia. Retrieved from Nishimura, N. & Hanaki, K. (2014). Psychosocial profiles of children with achondroplasia in terms of their short stature-related stress: A nationwide survey in japan. Journal of Clinical Nursing, 23, 3045- 3056. Doi: 10.1111/jocn.12531

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Family Assessment of the Lannisters  
Family Assessment of the Lannisters