Family standing hand-in-hand on the beachFamily systems therapy draws on systems thinking in its view of the family as an emotional unit. When systems thinking—which evaluates the parts of a system in relation to the whole—is applied to families, it suggests behavior is both often informed by and inseparable from the functioning of one’s family of origin.

Families experiencing conflict within the unit and seeking professional assistance to address it may find family systems therapy a helpful approach. 

The Development of Family Systems Therapy

Family systems therapy is based on Murray Bowen’s family systems theory, which holds that individuals are inseparable from their network of relationships. Like other psychoanalysts of his time, Murray Bowen was interested in creating more scientific and objective treatment processes as an alternative to conventional diagnostic frameworks and pathological language. Bowen believed all therapists had experienced challenges within their family of origin and that an awareness of this could help therapists normalize human behavior for people in treatment. 

Bowen introduced family systems theory in the late 1960s after years of research into the family patterns of people with schizophrenia who were receiving treatment and the patterns of his own family of origin.

Traditional individual therapy frequently addresses the individual’s inner psyche in order to generate change in relationships and other aspects of life. Bowen’s theory suggests it is beneficial to address the structure and behavior of the broader relationship system, which he believed to play a part in the formation of character. According to Bowen, changes in behavior of one family member are likely to have an influence on the way the family functions over time.

Family Systems Therapy Approaches

Many forms of family therapy are based on family systems theory. Family systems approaches generally fall under the categories of structural, strategic, or intergenerational:

  • Structural family therapy, designed by Salvador Minuchin, looks at family relationships, behaviors, and patterns as they are exhibited within the therapy session in order to evaluate the structure of the family. Employing activities such as role play in session, therapists also examine subsystems within the family structure, such as parental or sibling subsystems. 
  • Strategic family therapy, developed by Jay Haley, Milton Erickson, and Cloe Madanes, among others, examines family processes and functions, such as communication or problem-solving patterns, by evaluating family behavior outside the therapy session. Therapeutic techniques may include reframing or redefining a problem scenario or using paradoxical interventions (for example, suggesting the family take action seemingly in opposition to their therapeutic goals) in order to create the desired change. Strategic family therapists believe change can occur rapidly, without intensive analysis of the source of the problem. 
  • Intergenerational family therapy acknowledges generational influences on family and individual behavior. Identifying multigenerational behavioral patterns, such as management of anxiety, can help people see how their current problems may be rooted in previous generations. Murray Bowen designed this approach to family therapy, using it in treatment for individuals and couples as well as families. Bowen employed techniques such as normalizing a family’s challenges by discussing similar scenarios in other families, describing the reactions of individual family members instead of acting them out, and encouraging family members to respond with “I” statements rather than accusatory statements.

Family Systems Therapy and the Genogram

A genogram, or pictorial representation of a family’s medical history and interpersonal relationships, can be used to highlight psychological factors, hereditary traits, and other significant issues or past events that may impact psychological well-being.  

Bowen used genograms for both assessment and treatment. First, he would interview each member of the family in order to create a detailed family history going back at least three generations. Bowen then used this information to help highlight important information as well as any behavioral or mental health concerns repeating across generations. He initially believed it took three generations for symptoms of schizophrenia to manifest within the family, though he later revised this estimate to ten generations.

Eight Interlocking Concepts of Family Systems Theory 

Eight major theoretical concepts form the foundation of the Bowenian approach. These concepts are interconnected, and a thorough understanding of each may be necessary in order to understand the others. 

These theoretical constructions include, in no particular order:

  1. Differentiation of self, the core concept of Bowen’s approach, refers to the manner in which a person is able to separate thoughts and feelings, respond to anxiety, and cope with the variables of life while pursuing personal goals. An individual with a high level of differentiation may be better able to maintain individuality while still maintaining emotional contact with the group. A person with a low level of differentiation may experience emotional fusion, feeling what the group feels, due to insufficient interpersonal boundaries between members of the family. Highly differentiated people may be more likely to achieve contentment through their own efforts, while those with a less-developed self may seek validation from other people. A teenager sits on sofa with parents and shows them how to use a laptop
  2. An emotional triangle represents the smallest stable network of human relationship systems (larger relationship systems can be perceived as a network of interlocking triangles). A two-person dyad may exist for a time but may become unstable as anxiety is introduced. A three-person system, however, may provide more resources toward managing and reducing overall anxiety within the group. Despite the potential for increased stability, many triangles establish their own rules and exist with two sides in harmony and one side in conflict—a situation which may lead to difficulty. It is common for children to become triangulated within their parents’ relationship.
  3. The family projection process, or the transmission of a parent’s anxiety, relationship difficulties, and emotional concerns to the child within the emotional triangle, may contribute to the development of emotional issues and other concerns in the child. The parent(s) may first focus anxiety or worry onto the child and, when the child reacts to this by experiencing worry or anxiety in turn, may either try to “fix” these concerns or seek professional help. However, this may often have further negative impact as the child begins to be further affected by the concern and may become dependent on the parent to “fix” it. What typically leads to the most improvement in the child is management, on the part of the parent(s), of their own concerns. 
  4. The multigenerational transmission process, according to Bowen, depicts the way that individuals seek out partners with a similar level of differentiation, potentially leading certain behaviors and conditions to be passed on through generations. A couple where each partner has a low level of differentiation may have children who have even lower levels of differentiation. These children may eventually have children with even lower levels of differentiation. When individuals increase their levels of differentiation, according to Bowen, they may be able to break this pattern, achieve relief from their symptoms of low differentiation, and prevent symptoms from returning or occurring in other family members. 
  5. An emotional cutoff describes a situation where a person decides to best manage emotional difficulties or other concerns within the family system by emotionally distancing themselves from other members of the family. Cutting emotional connections may serve as an attempt to reduce tension and stress in the relationship and handle unresolved interpersonal issues, but the end result is often an increase in anxiety and tension, although the relationship may be less fraught with readily apparent conflict. Bowen believed emotional cutoff would lead people to place more importance on new relationships, which would add stress to those relationships, in turn. 
  6. Sibling position describes the tendency of the oldest, middle, and youngest children to assume specific roles within the family due to differences in expectation, parental discipline, and other factors. For example, older children may be expected to act as miniature adults within the family setting. These roles may be influenced by the sibling position of parents and relatives. 
  7. The societal emotional process illustrates how principles affecting the emotional system of the family also affect the emotional system of society. Individuals in society may experience greater anxiety and instability during periods of regression, and parallels can be noted between societal and familial emotional function. Factors such as overpopulation, the availability of natural resources, the health of the economy, and so on can influence these regressive periods. 
  8. The nuclear family emotional process reflects Bowen’s belief that the nuclear family tends to experience issues in four main areas: intimate partner conflict, problematic behaviors or concerns in one partner, emotional distance, and impaired functionality in children. Anxiety may lead to fights, arguments, criticism, under- or over-performance of responsibilities, and/or distancing behavior. Though a person’s particular belief system and attitude toward relationships may impact the development of issues according to relationship patterns, Bowen held them to be primarily a result of the family emotional system. 

How Can Family Systems Therapy Help?

Family systems therapy has been used to treat many mental and behavioral health concerns. In general, it may be considered an effective approach for those concerns that appear to relate to or manifest within the family of origin. Family systems therapy has been shown to be effective with families, couples, and individuals.

This approach may be helpful in addressing conditions such as schizophrenia, alcohol and substance dependency, bipolar, anxiety, personality issues, depression, and eating and food issues. 

Limitations and Concerns

Though Bowenian family systems therapy is a popular mode of treatment that both therapists and people in treatment have attested to the effectiveness of the approach, at present there is a limited base of empirical evidence backing the approach. Though the evidence base is growing, more data—particularly from objective sources—may help confirm its efficacy. 

A second criticism of the approach is the seemingly unwavering neutrality of its practitioners. Some mental health experts believe that by remaining neutral, unaffected, or silent at all costs, practitioners of family systems therapy may be giving tacit approval to any harmful behaviors individuals in therapy may be exposing themselves or other people to.

References:

  1. Baege, M. (2005). Bowen family systems theory. Retrieved from http://www.vermontcenterforfamilystudies.org/bowen_family_systems_theory
  2. Brown, J. (2008). Is Bowen theory still relevant in the family therapy field? Journal of the Counsellors and Psychotherapists Association of NSW Inc, 3, 11-17. Retrieved from http://www.thefsi.com.au/wp-content/uploads/2014/01/Is-Bowen-Theory-still-relevant-in-the-Family-Therapy-field.docx.pdf
  3. Brown, J. (2012). Growing yourself up: How to bring your best to all of life’s relationships (3-5). Wollombi, NSW: Exisle Publishing. Retrieved from http://www.thefsi.com.au/us/bowen-theory
  4. Family Solutions Institute. (2015.) Strategic & Systemic. Family Solutions Institute MFT Study Guide (Chapter 4). Retrieved from http://www.mftlicense.com/pdf/sg_chpt4.pdf
  5. Introduction to the genogram. (n.d.). Retrieved from http://www.genopro.com/genogram
  6. ​Kerr, M. E. (2000). One family's story: A primer on Bowen theory. Retrieved from https://www.thebowencenter.org/theory/eight-concepts
  7. Winek, J.L. (2010). Systemic family therapy: From theory to practice. London: SAGE Publications, Inc. Retrieved from http://www.sagepub.com/sites/default/files/upm-binaries/29841_Chapter5.pdf