Systemic & Family Therapies

Systemic theory begins with a refusal to locate the problem inside a skull. A family is an organised system whose parts are interdependent; it has rules, most of them unstated; it seeks homeostasis; and the behaviour of any member is intelligible only in terms of the whole. Move one part and the others compensate — which is why the recovering member of a family is so often followed by a newly symptomatic one.

Circular rather than linear causality

Structure: the vocabulary that transfers

Subsystem

Spousal, parental, sibling. Problems frequently arise when subsystems are confused — when a child is functioning in the parental subsystem, for instance.

Boundary

The rule governing who participates and how. Rigid boundaries produce disengagement; diffuse boundaries produce enmeshment; clear boundaries permit both closeness and autonomy.

Hierarchy

Who has authority. Inverted or absent hierarchy in a family with children is among the most reliable structural findings in symptomatic families.

Alignment / coalition

Who is with whom, against whom. A cross-generational coalition — a parent allied with a child against the other parent — is the classic pathogenic structure.

Triangulation

A third person drawn in to stabilise a two-person conflict. Bowen’s central concept: two-person systems are unstable under stress and reliably recruit a third.

Bowen’s differentiation of self

The capacity to maintain a sense of self while remaining emotionally connected to others — to think one’s own thoughts in the presence of family anxiety. Low differentiation produces fusion or reactive cutoff, which look opposite and are the same thing. Bowen held that differentiation levels are transmitted across generations and that the therapist’s own differentiation is the main instrument of the work.

The symptom is functional for the system. This is the tradition’s most powerful and most dangerous claim: powerful because it explains why symptoms resist individual treatment and return after it, dangerous because applied carelessly it makes a suffering person responsible for stabilising everyone else.

Attempted solutions as the problem

The MRI insight, and the most practically useful idea in the field: the problem is maintained by what is being done to solve it. Reassurance produces more anxiety; pursuit produces more withdrawal; monitoring produces more concealment. Interrupting the solution is often sufficient.

Where symptoms cluster

• At life-cycle transitions the family has not renegotiated — a child leaving, an illness, a retirement, a remarriage
• Where a couple’s conflict has nowhere to go and a child absorbs it
• Where hierarchy has collapsed or inverted
• Where boundaries prevent age-appropriate autonomy, or fail to provide age-appropriate protection
• Where a loss or secret has never been metabolised and organises the family’s emotional life silently

Different schools locate the lever differently, and knowing which lever you are pulling is what distinguishes systemic practice from generic family meetings.