In 1968, Nathan Ackerman conceptualized a destructive triangle. Ackerman stated “we observe certain constellations of family interactions which we have epitomized as the pattern of family interdependence, roles those of destroyer or persecutor, the victim of the scapegoating attack, and the family healer or the family doctor. Ackerman also recognize the pattern of attack, defense, and counterattack, as shifting roles.[8]