What is family systems theory?

Jessica Kant, MSW, LICSW, MPH

Part 1: what is a system?

While the phrase family therapy may conjure up all sorts of ideas, many of these are based on representations of family therapy in popular culture that are at best, inaccurate. Family therapy is a vast field stretching back to the 1950’s. While many of its original practitioners were classically trained psychiatrists, all of whom would have been trained in psychoanalytic theory as the theory du jour, family therapy as a distinct discipline was actually created in response to the failings of psychoanalysis to rise to the challenges of family work.

The creator of psychoanalysis- Sigmund Freud*— was predominately focused with what we might call “internal” processes. These are those that occur inside the confines of an individual client’s mind. He based his work on the theory that people are shaped by our early childhoods, and that our relationships are critical to the person we become. However, while a psychoanalyst absolutely may ask about your relationship with your mother, it’s not the relationship itself that’s the focus of the work. Instead, analysts look at how that role shaped your understanding of yourself. To do so, analysis created what we call “drive theory”, which stated that there are discrete sections of our mind responsible for different components of the self. The drives of most interest were our most basic and primal: primarily concerned with sex and aggression. Freudians believed that challenges in early life daily activities like toilet training or breast feeding could leave a lasting imprint on children that developed into disorders that Freud referred to as “complexes”.

As Michael Nichols points out in his textbook Essentials of Family Therapy, much of the origin story was a series of fortuitous circumstances that came together to set lay the groundwork for a new idea. In engineering, the move from “machines” to “systems” arose out of the recognition that engineering necessarily involves many separate components, all working together to accomplish a task. Instead of being a collection of components, we say that these are “more than the sum of their parts” and that these parts come together to form a “system”.

But people aren’t machines, and neither are other living things. Systems theory was adopted by biologists very quickly to explain the complex rules that govern the behavior of organisms. Our bodies work by assembling trillions of cells into organs, with each organ connected to the other through a series of vessels and electrical impulses. All these things combined make our bodies, and somehow, us as human beings. This gets even more complicated as we look to multiple-organism systems. As was frequently the case in science at the time, Zoologists took this idea from biologists (who had taken it from engineers) and applied it right away to understanding groups of animals.

As you watch the undulation of the birds, giving the appearance almost of a sentient cloud twisting and stretching, what you are seeing is a constant process of every single one of these birds watching and responding to the movements of other birds. If a bird sees prey down on the road, it may edge away slightly from the flock. The nearest flock members see this, and in turn decide whether or not they’re going to follow suit. If they do, this same process happens recursively throughout the entire flock, and suddenly you see a swarm of birds appear to descend all at once. However, murmurations are comprised of individual birds. Should another bird at the other end of the flock suddenly decide to take flight again, each bird has to make the choice whether or not to follow. This is why murmurations appear to ripple: instead of making a single decision and moving with it, hundreds of decisions are being made and remade as birds watch and respond to their peers. The lack of a central governing structure was surprising to scientists: in point of fact, what you see when you watch a flock of birds fly by in a murmuration you’re actually seeing the result of these decisions being made in real-time. You’re watching an entire society move across the sky and struggle along together for survival.

And, it turns out, this is also how groups of people work.

Despite being some of the best trained and most advanced psychiatrists and psychologists in the world, Jay Haley and his group lacked a theory to explain why patients’ symptoms seemed to be so inextricably linked to the relationships of other family members. This is where the newly minted Systems Theory offered hope. According to Systems Theory, systems aren’t merely a collection of parts. Rather, in order for a system to exist there are rules that govern the structure of the system, and a baseline of functioning is established called homeostasis. However, homeostasis has a dark side: changes to the system must work according to the rules of the system. If they do not, the system will reject them.

One of the things Haley’s team noticed, with the help of Gregory Bateson, an anthropologist, was that communication patterns were sometimes hard to follow. As was common in the day, the therapists would encourage parents to in turn encourage their children to be honest and open about their feelings. When patients did, their symptoms began to resolve a little and progress was made. It turns out it really is helpful to talk about what’s bothering you. But sharing feelings after they’ve not been shared for some time comes with necessary dangers: parents sometimes didn’t like what they heard and rebuked their children accordingly. Haley and Bateson called this the “double bind hypothesis” whereby the explicit message was to share your feelings, while the rebuttal provided an implicit message not to.

While Haley et al were focused on the individual patients who came in with diagnoses of schizophrenia, they were missing the actual role the family members were playing. While schizophrenia is not caused by relationships, problems can be exacerbated by them and get woven into the fabric of the family. Two parents who otherwise struggle to talk to each other may unite to support their struggling son. For the duration of the son’s illness, the parents have something to focus on. When the illness subsides, they lose this point of focus, and arguing resumes. Since the therapist was unable to address other problems in the relationship, the progress the identified patient made represented an accidental threat to this temporary peace. While no one wanted anyone to struggle, the struggle itself came to serve a purpose in the family. Later, this idea would be adopted by Murray Bowen and his idea of “triangulation” (more on this later).

In the above example, the reciprocal relationship between all three family members follows a set of rules, and these rules keep each member locked in a pattern of behavior. For this family, homeostasis involves two parents in a specific role, and an adult child who requires care. These roles constitute their own rules: they were never negotiated out loud, but over time each family member settled into their respective parts. When suddenly the youngest in the relationship begins to make a recovery, they can no longer fulfill the role they were playing in the family as had been established previously. This threatens the roles of the other two members, and soon, all three family members have to find a new way of relating to each other. But this is a lot harder than it sounds. Remember, this is a system, and systems have other rules in the form of norms. If Bateson and Haley are right, there is another rule in this family about direct communication: it’s avoided. Social pressures may make this even worse. For example, if this is a family that values privacy, the likelihood that a third-party will be able to intervene and help the family adapt to this change is slim.

So what happens if he continues to make progress in getting his schizophrenia symptoms under control? Will this change last? This depends. This is where the meat of systems theory comes in: if the stability of what the system feels is normal is threatened, mechanisms are in place to undo the change that brought about the instability in the first place. If both parents are suddenly fighting, this is an upsetting development. If it’s upsetting enough, it may take a toll on the person caught on the middle. Not only that, but the mixed messages about communication might lead to the child caught in the middle stopping the self-expression that was making remission possible.

When that is reinforced by old norms being re-assumed, suddenly everyone finds themselves back where they were in the beginning. From the standpoint of a Systemic therapist, this means that even change for the better takes work. It may be necessary for all three family members to participate in explicit conversations about what their respective roles are, how these roles developed and what they want to do moving forward. It also may be necessary for the parents to do dyad work, strengthening their relationship as well as their ability to co-parent.

A Systemic therapist is someone who views people in their environments, and sees both internal conflicts (those we may call “intrapsychic” or internally-focused) and external conflicts (those that occur in relationships) as having equal weight and value. The advent of Multi-Dimensional Family Therapy (MDFT) and Eco-Systemic Structural Family Therapy (ESFT) brought about the idea of incorporating multiple treatment approaches, often with multiple providers. As a true Systemic approach looks to all contributing factors in a relationship as potential points of intervention, the breadth of interventions available are vast.

*

NB: This is actually in some dispute. Freud was a student of Jean-Martin Charcot, who was one of the first to look at trauma. But with Freud and the Vienna school, psychoanalysis exploded into the mainstream in a way that it had failed to do with Charcot alone.