Book Recommendations, Family Issues

Taking the Systemic View

When therapists introduce ourselves to potential new clients on intake, we should talk a bit about how we operate, not just in terms of our focus modalities (“I do EMDR,” “I do CBT,” “I do short-term, solution-focused therapy,” etc.), but also the larger-scale perspectives or foundational theories that direct our work. For me, this involves talking about Systems Theory, a frame of reference in which the client(s) in the room are viewed as being the therapeutic focal point of a number of “interrelated and interdependent parts” that all manage, for better or for worse, to have an impact on each other — perhaps in the present or immediate sense, perhaps in a long-fingered reach from the past.

Wikipedia has a very sciency description of Systems Theory:

A system is a cohesive conglomeration of interrelated and interdependent parts that is either natural or man-made. Every system is delineated by its spatial and temporal boundaries, surrounded and influenced by its environment, described by its structure and purpose or nature and expressed in its functioning. In terms of its effects, a system can be more than the sum of its parts if it expresses synergy or emergent behavior. Changing one part of the system usually affects other parts and the whole system, with predictable patterns of behavior. For systems that are self-learning and self-adapting, the positive growth and adaptation depend upon how well the system is adjusted with its environment. Some systems function mainly to support other systems by aiding in the maintenance of the other system to prevent failure. The goal of systems theory is systematically discovering a system’s dynamics, constraints, conditions and elucidating principles (purpose, measure, methods, tools, etc.) that can be discerned and applied to systems at every level[…].

I’ve written in the past in reference to Murray Bowen as the grandfather of Family Systems Theory, the cornerstone of the AAMFT approach to individual and interrelational psychotherapy. He effectively synthesized a number of slow shifts in psychoanalysis away from a purely medical model of “patient-focused” attention that left the family or broader social factors “outside the immediate field of theoretical and therapeutic interest”:

Individual theory was built on a medical model with its concepts of etiology, the diagnosis of pathology in the patient, and the treatment of sickness in the individual. Also inherent in the model are the subtle implications that the patient is the helpless victim of a disease or malevolent forces outside his control.” — Murray Bowen, Family Therapy in Clinical Practice, Jason Aronson Inc., 1985; pg. 148

In his own practice, Bowen explored with his clients the sense of their own agency within the family system, and while there is certainly a sense of powerlessness for many in the face of ancient and traditional family dynamics and power struggles, Bowen noticed some interesting processes in operation for the individuals within the system. These distill to eight core concepts of Bowen’s Systems Theory, as it applies to psychotherapy within a family or broader social network:

  1. core emotional system
  2. differentiation (or not) of the individual (in most cases, specifically the client)
  3. triangulation
  4. cut-offs
  5. projections
  6. multigenerational transmission of values and expectations
  7. child/sibling positions
  8. general emotional processing beyond the core system

When I get a chance to do the quick family of origin snapshot with new clients, I’m essentially looking for information on some combination of these points. In family systems theory, even though there may only be one client in the room, to some extent we treat the family as the core emotional system — not that we’re trying to treat or fix the family as a unit, but we are trying to understand the client in front of us from the perspective of the system in which they developed. Every one of us carries from our earliest relational models a set of implicit understandings about “how people work,” “how relationships work,” what SHOULD be important or valuable to us — these invisible values, and the expectations or entitlements we attach to them, are often instilled in us by our families, starting well before we have language; we see this kind of multigenerational transmission process starting in parents with new babies who might be highly anxious about their parenting, especially when that anxiety is something learned from or triggered by THEIR OWN PARENTS’ influence on the new family.

We use system theory to look at system harmonics and cacophony, those places where the individual elements in the system are synchronized and resonate well together, or the places where something has disrupted one or more members of the system and there is discord or disruption, often felt throughout the system in a ripple effect (if we mix Systems Theory with a little Chaos Theory, we can have a really interesting conversation about “the butterfly effect“, in which small triggering events can have huge, often not-entirely-predictable impacts elsewhere in the system… something that can definitely occur when we talk about making changes to a complex relational system).

Differentiation is often a significant disruptor to the family system. An individual decides to step away from the invisible “value mass” of family behaviours and expectations, to “become their own person”, and in doing so, relinquishes their responsibility to fulfill whatever role the system has implicitly imposed on them, sometimes to the disappointment or outrage of other members of the system. From a counselling perspective, we often find our clients struggling against a system-wide reaction to their change process, hearing little more than a “change back!” hue and cry that is all about the other members of the system confronting their own personal and herd-level anxieties. Differentiation is often the most disruptive systemic process for the simple reason that it illustrates to other members of the system that it can be done. In basic terms, differentiation is the process by which an individual reprioritizes the individual as at least equal to, if not above, the larger systemic unit. Psychoanalysis, and later other modalities like Gestalt therapy, elevated the focus on the individual above all else, encouraging distinction or separation from the broader family unit if the system was felt to be infringing on the individual to be themselves in a healthy way.

Family systems being the complex herd mentalities they are, however, many individuals who felt fused into their systems could only achieve the break by effecting a complete cut-off from the family system. Bowen and his fellow clinicians noted, however, that cut-off often created as much anxiety in the individual (and in the family system) as it seemingly addressed for being IN the system. He discussed this in therms of fusion: being emotionally bound up in the system’s values didn’t necessarily change with cut-off, because the emotional fusion is still present, even if interactions with other family members is not. Differentiation as a distinct process allows the individual to remain present within the system but with an ability to hold themselves at a safe distance from engaging in the normal family politics and dynamics; they hold more of an observational capacity, not necessarily strictly neutral but certainly with a very different form of engaging in ways that don;’t leave them feeling compelled or emotionally hooked into the system in the usual ways. Often when I’m working with clients who have emotional boundary issues with family or intimate partners, this winds up being an area of considerable focus: how do we find ways of remaining SAFELY engaged but not so severely fused into the machinations of that invisible family value mass?

One of the most important tools we introduce up front to clients struggling with systemic issues is observation. We invite and assist the clients in learning to take a step back and simply watch what goes on in the family in both crisis moments and in the smooth-sailing ones. We help them discern when triangulation occurs, often taking the form of two sides in a dispute or power struggle trying to get a third party “on side” with their perspective, or having one member of an unstable partnership introducing focus on or input from, a third person/factor (child, external adult, work, therapist…) as a way of distracting from tension in the troubled dyadic connection. It’s a truism that a two-legged stool is inherently unstable; it needs at least three legs to bear weight effectively. Tension between a partnership will run high as long as the participants have only the relationship to focus on, but as soon as there is a third target for focus by at least one partner, tension will decrease at least in the short-term (even if that third-party focus takes the form of new babies or pets, workaholism, addiction, or infidelity, until those triangulated factors start to introduce their own disruptive problems into the system).

By encouraging clients to observe and witness the systemic dynamics in action, we allow for a differentiated analysis of those observed behaviours. Rather than simply engaging by unthinking default in them as a form of self-protective “herd camouflage”, we challenge the client to consider the guiding compass question, “What kind of person do I CHOOSE to be here?”, and consider what other behavioural options might be open to them in the moment. They may continue to choose the traditional engagement, but to do so now by CHOICE rather than habit returns a sense of agency to the individual, a small kind of power that allows them to stay within the system but with a subtle shift in their engagement with that system. This is the key to Bowen’s family system: the power and agency of choice is within the CLIENT’s purview, unlike within the older psychoanalytic model that pitched the client as a helpless victim of the family’s effect on them. IN the systemic view, we acknowledge and clarify the family’s impact on the client in the room, AND we also work to shift the client’s own sense of differentiated SELF within the system.

There are many different ways we can also approach helping the client discern what is valuable within the family system to retain and honour, while also allowing them to retain some emotional distance from the weight of the projections of those values. Many clients struggle with the family’s projected expectations based on traditional gender roles, or the position of birth order in families with multiple children (the eldest son, the mother’s helper, the baby of the family, the archetypal “rebellious middle child”, to name a few of the still-common sibling position factors we encounter). Immigrant families often bring cultural factors into the system that can be difficult to process when growing up in a new context. Ongoing shifts in gendered role modelling mean “traditional” relationship roles of “bread-winner” or “home-maker” are being disrupted in some generations but not in others, creating tensions in a multigenerational family model. Different education or employment opportunities have shifted considerably between generations as well. Trying to walk a fine line between “becoming one’s own person” and “remaining a part of the family” is a struggle faced by many people (perhaps nowhere so poignantly, even brutally, by our transgender clients) as they come of age, or face challenges and transitions their own families may not have faced before.

From a systemic view, our job as therapists is to hold space in our process for all these known and impactful factors in our clients’ complex lives. A systems therapist will often tell you, there may only be one person in the room with us, but there is an invisible presence of many more, evidenced in the clients’ own behaviour models and value systems. Our work becomes rooting out the effects of those systemic dynamics, helping the client observe them when they are in operation, and creating space within the client to choose who and how they wish to be within those systems. We also implicitly create permission for the client to honour what they value in the system, and find ways to shift, unhook, or outright jettison those aspects or values that no longer work for them effectively.

For more information on the core concepts of Bowen’s Family Systems Theory (in much easier language than Wikipedia’s version manages), I recommend Roberta Gilbert’s The Eight Concepts of Bowen Theory: A New Way of Thinking About the Individual and the Group.

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