General systems theories emerged in the biological and social sciences following World War II. This led to the conceptualization of the individual as an interdependent part of larger social systems. Systemic therapy does not focus on how problems start, but rather on how the dynamics of relationships influence the problem. The therapist’s goal is to alter the dynamics of the relationships rather than to focus only on the behavior or internal dynamics of individuals.
For example, if a child is having temper tantrums, attention would be given to the stage of family development, the quality of communication between its members, and the clarity and flexibility of family roles. In the family, the executive subsystem is that of the parents; the sibling subsystem is that of the children. Invisible boundaries–unspoken rules about who does what with whom–are drawn around each (and around the immediate family itself) so that each subsystem can carry out its family-stabilizing tasks while remaining connected to the others.
One of the most common family problems is a weak boundary between subsystems. A woman making several calls a day from work to instruct her teenagers on how to dress for school, what to say when they turn in homework, and so forth indicates over-involvement with the sibling subsystem; a man who calls or visits his mother every time he argues with his wife shows a weak boundary between the immediate and extended families.
In therapy it’s quite common to see a little boy suddenly make everyone laugh at precisely the moment the therapist is asking the uncomfortable parents how their marriage is going. Without knowing it, the boy, usually prompted by some subtle signal from his parents, protects the family by taking the heat off them and their fragile relationship. The therapist, seeing the family operating as a whole (self-preservation through distraction) rather than as isolated individuals (Mom, Dad, the son), might then comment.
In alcoholic families the member who drinks controls the whole family with his/her behavior. His/Her unavailability, bad health, violence, unpredictability, and self-contempt distort every interaction between family members. The whole family learns to adapt itself to his/her drinking with maneuvers like denial, bailing him out of jail if he drinks and drives, calling in sick for him if he’s hung over, walking carefully when he’s drunk and angry, unconsciously nominating one child to stand in for him and parent the family.
Family therapists use the term IP, meaning Identified Patient, because a dysfunctional family member generally means a destabilized family system. Whatever its components, unresolved stress between parents reverberates down through all family interrelations and normally results in coalitions, emotional parent-child alignments against the other parent and perhaps other children. For example a mom is a verbally abusive, so when she explodes, dad and brother console one another and perhaps agree that she’s nuts.
A linear approach would emphasize mom’s upbringing and lack of anger management skills and thereby ignore the coalition process itself and reinforce its tendency to scapegoat, whereas a systems approach would focus on the present-time context of mom’s explosions, looking at the interactions leading up to it and encouraging dad and mom to work out new, non-escalating ways to talk and negotiate. Perhaps the couple could enter into couples therapy, rather than blaming her or him or failing to confront, and thus defuse alliances forming elsewhere in the family.
When a couple in session argues about how it started, the therapist can let them know that there is more interest in where it’s going: “How will you resolve this here? ” With specific reference to alcoholics, many have inherited biological and family stresses and have low self-esteem and other dynamics which can all play a part. What counts for the alcoholic isn’t looking for causes so much as cutting the feedback circles that maintain drinking.
A good clinician will refer the client to AA, consider hospitalization, assess for suicidal intent, advise a physical, ask about weapons in the home, and work on both family and individual levels with interventions aimed at interactions (arguments, nagging, money problems, abuse) that presently maintain the alcoholism. A typical situation as described by Neil Jacobson in 1995, an un-intense family with a cool emotional atmosphere unconsciously selects a member to turn up the heat; brother and sister start fighting.
This turns into an argument between the parents, the drama escalates, and then, before it gets too hot, a child who plays the role of family ambassador calms everybody down. In that family, the bias, the emotional level setting, is too low. Many drug and alcohol counselors know that when one member of the family stops drinking or using, the family will subtly try to push him back into his old vices, not because they want him sick, but because families, like other organisms, naturally resist changes that might further destabilize the system.
So one day the husband says to his abstaining wife, “Why not skip your AA meeting tonight so we can catch a movie? ” Or the mother of a teen who’s quit using congratulates him on finding a job, in a restaurant with a bar and grill. Introducing positive feedback (system-changing) loops into these families might include warning them about enabling, relapses and resistance to change and examining what family members gain from having a malfunctioning member (control?
A scapegoat? Distraction from other conflicts? Someone to rescue? ). Constructive intensity might re-calibrate the bias and make explosions unnecessary. Battery normally begins with emotional or verbal abuse (name-calling, shouting, intimidation, shaming) and escalates over the years from pushing and shoving to beatings and even murder. Abuse gives rise to more abuse, violence to more violence: destructive synergy.
In theory of constructive synergy, however, a batterer uses a batterer’s group to learn and master rage-control techniques; those enhance his self-esteem; his wife praises his efforts and trusts him more; he feels good about that and shows her more empathy; the two get problems out on the table instead of hiding them; both grow; their affection deepens; their children carry the resulting relationship blueprint into their own relationships.
Therapists begin this process by helping clients consciously relate and capitalize on growth-producing thoughts, feelings, and interactions (“Now that you stopped drinking, he feels safer telling you about his sadness; you empathized, so he is listening to you more often and with greater care… good work! How will you keep this going? “) Even twins eventually take different roads, grow into individuals with their own insights and values, habits and preferences. Jacobson, 1995) Consciousness guarantees that what we choose to make of our original conditions is more important than the conditions themselves. The abuse survivor who owns the pain moves on; the one who won’t becomes a chronic victim and will probably get into re-victimizing situations. Therapists who realize this assume that a client can and should take full responsibility for the work of healing no matter how dangerous or abusive that client’s environment may have been.
Families are likeliest to be conflicted and symptomatic when key horizontal transitions like marriage, the birth of children, children going to school, children moving away from home, changes of jobs, et cetera coincide with a resurfacing of stressors like old emotional baggage. For example, a workaholic husband driven to succeed by high internalized standards (Rogers’s “conditions of worth”) that equate esteem with production (vertical stressor) puts in even more overtime to stuff the loneliness he feels when his eldest son leaves for college (horizontal stressor). Jacobson, 1995) Worried about his health, escalating stress, and increasing distance from her, his wife suggests that they see a family therapist. Part of the therapeutic agenda would include giving the family tools for negotiating the “empty nest syndrome” while helping the husband get in touch with his mourning, examine his expectations of himself, and reconnect with his family.
Teaching family members how to use “I” statements and listen empathically demonstrate first-order changes that enhance the family’s current functioning. Coaching a widow through the loss of her husband, helping a couple let go of the last child to leave the nest, and restructuring an alcoholic family to eliminate drinking are second-order changes that alter the family fundamentally, bringing it to an entirely new structure and psychological place.
Yes, there really are families–and extended families and neighborhoods and even companies–that work this way: members are clear about what to expect from one another and neither intrude nor distance themselves, they speak openly and affectionately to one another, they know who’s in charge of what, they know and can talk about what is permitted and what is not, their roles and favorites are flexible and changing, and they feel comfortable and safe getting problems and hurt feelings out in the open where everyone can work on them. When enough families succeed at this, perhaps the systemic impact on whole nations will become irresistible.