Lecture 2 core concepts in systemic therapy

MODULE: SYSTEMIC
COMPARATIVE
KEVIN STANDISH
NEWHAM COLLEGE UNIVERSITY
CENTRE NEWHAM COLLEGE

LEARNING OUTCOMES
Describe the family life cycle
 Distinguish the shift from linear to
circular thinking.
 Describe the influence of Bateson
 Describe the core concepts of systemic
therapy: phase 1 & 2




Carr, A (2012) Family therapy:
Concepts, Process and Practice (3rd
edition) London, Wiley Blackwell.
Chapter 1: Goals of family therapy
across the life cycle

The family systems
approach basic
assumptions
 Each

family is unique, due to
variations in personal
characteristics and cultural styles;
 The family is an interactional
system whose component parts
have constantly shifting
boundaries and varying degrees
of resistance to change;

The family systems approach
basic assumptions
 Families

must fulfill a variety of
functions for each member, both
collectively and individually, if each
member is to grow and develop;
 Families pass through developmental
and non-developmental changes that
produce stress affecting all members.

Lecture 2 core concepts in systemic therapy

Family System
 Family structure consists of the descriptive

characteristics of the family: the nature of its
membership; cultural and ideological style.
They are the resources and the perception
of the world that shape the way in which the
family interacts.
 Family interaction is the hub of the
system.
 The process of interaction among family
members determines the rules by which the
family is governed. This is the family’s level
of cohesion, its adaptability, and its
communication style. These interactions
work together to serve individual members
and collective family needs.

Family System
 Family function is the output of the

interactional system. Utilizing the resources
available through its structure (input), the
family interacts to produce responses that
fulfill its needs.
 The family life cycle introduces the
element of change into the family system. As
the family moves through
time, developmental and non-developmental
changes alter the family structure and/or the
family’s needs. These, in turn, produce
change in the way the family interacts.

Family life cycle stage
(simple model)
Unattached
young adult

Family in
later years

Newly
married
couple

Launching
family/leaving
home

Family with
young
children

Family with
adolescents

Principles of family
systems
The family is not just a collection of
individuals. It is a whole larger than
the sum of its parts.
 A Delicate Balance: A change in the
family situation means readjustment
of the total system and can pose
problems and challenges for every
single member.


Principles of family
systems




A Stable But Open System: Every family is
faced with the test of allowing for growth
and change while maintaining the integrity
of the system.
Characteristics of the Family System:
 External and internal family

boundaries;
 Family rules;
 Family role organization;
 Power distribution among family
members; and
 The communication process.

Big concept: The Family is a
System
 The

family system is more
than a collection of
individuals
 It is an organic whole with its
own identity and dynamics
 Members function in the
system differently than they
do in isolation

Family is the system
problem is not “in the person” but
“between persons”.
 problems are created by the
interactions between family
members.
 The therapist is interested in what
happens between family members,
 how they communicate and how
they express their feelings.
 the

Big Concept: Circular
Causality
 Based

on the idea that we are in a
constant feedback loop with the persons
in our lives : “cybernetic loops,” or
“synchronous feedback.”
 Linear causal explanations try to find who
is at fault, or to blame.
 Circular causal explanations try to
understand what each person is doing
that sustains the problem, and what they
can do differently to change the situation.

Circular Causality
Problems are created by a series of
cause to effect events.
 For example:
 Paul is a 12 year old who gets very
angry at home. His parents have been
advised to seek help.
 Linear explanation: Paul has difficulties
managing his emotions and has learnt
that anger is the only response when
he is frustrated (the problem is “in
Paul”).


Circular Causality
 Circular

explanation: Paul gets angry
-> shouts at his dad -> his dad gets
angry -> blames Paul's behavior on
his wife -> he shouts at his wife ->
Paul's mother gets tearful and
depressed-> Paul gets angry to see
his mum depressed -> Paul blames
his dad -> Paul gets angry and shout
at his dad. And it goes round again

Big concept:
Reality is constructed: there is no
truth

Reality is a social concept, fluid, not fix. We
are all in a different chair, so we have our own
perspectives of reality. We perceive things
differently (filters). We have inner belief that
we believe the same thing but there is nothing
such as a reality.
 The therapist has a view of what the problem
is and his view determines how he organizes
the therapy, who is involved and what
intervention he will be doing.


Group Theory:
The Basis for Family Therapy
Group theory provided a foundation for
understanding the family
 Lewin
 group is more than sum of parts
 interaction could be curative
 a focus on the here and now; ahistorical
 Groups are inherently tense as members vie
for freedom and services
 Process dimension became more important than
content: how, not what


How Groups differ from
Families
Group members come to therapy to find a
sanctuary in which to discuss problems vs.
families bring their problems into the office
 Group members can be assured that what they
say in therapy won’t follow them home vs.
families have to live with the consequences of
their disclosures
 Groups are comprised of equals without a past
vs. families are comprised of unequal members
who have a past and future together


Bateson’s Key influences
A Cambridge anthropologist, central aim
was to develop a unified or eco-systemic
framework within which mind and material
substance could be explained.
 formed the Palo Alto group in 1950
 Influenced key family therapy members:
Jay Haley; Don Jackson; John Weakland;
Watzlawick, who formed the Mental
Research Institute (MRI) and brief strategic
therapy


Bateson’s Key concepts
1.




The double-blind theory: schizophrenic
behaviour occurs in families characterised by
rigid and repetitive patterns of communication
and interaction. The double bind involves
issuing the symptomatic child with a primary
injunction, typically verbal, whilst concurrency
issuing a secondary injunction that
contradicts the primary injunction
“I love you but don’t come close for a hug”
Repeated exposure to double binds resulted in
a particular pattern of interaction

The family is a system with boundaries
and is organised into subsystems
3. the boundary around the family set apart
from the wider social system of which it is
one subsystem
4. the family must be semi-permeable to
ensure adaptation and survival
5. The behaviour of each family member,
and each family subsystem is determined
by the pattern of interactions that connects
all family members
2.

6.
7.
8.
9.

Patterns of family interaction are rule
governed and recursive (repeats itself)
Circular causality should be used when
describing family interaction
Family systems attempt to maintain
homoeostasis
within a system one member (the
identified patient) develops problematic
behaviour when homoeostasis cannot
be maintained

Positive and negative feedback is new
information; involves news of difference
and therefore change
11. A distinction is made between first and
second order to change
12. change in one part of the system will
lead to change in other parts
10.

The First Family Therapists:
The Palo Alto Group

 Bateson’s

work with communication in
schizophrenic families led to some of the
first important contributions the the field.
 rules
 Metacommunicaton (report and demand)
 double binds
 feedback, or cybernetics
 homeostasis (Jackson)

Negative and Positive Feedback
When a family’s rules are
challenged, the family usually treats
this challenge as “negative feedback,”
that is a reason to reassert its rules
 Positive feedback is information that a
family perceives as a call to change its
rules.


Families Break down under
Stress
Normal families need help when they
can’t adjust to stress
 Family rigidity, or a refusal to alter
rules, keeps a family from adjusting to
change
 Life changes bring about


 developmental stressors
 environmental stressors

Big Concept:
Families resist change
Homeostasis means that families resist
change
 Direct attempts to foster change will
evoke resistance
 Insight is unnecessary, and can even
get in the way.
 Therapist must take an indirect
approach in order to succeed


Relationships are Symmetrical or
Complementary
Symmetrical relationships have a lot of
similarity and equality -- common
ground, comfortable
 Complementary relationships are
based on differences, opposite
attraction -- not much common
group, very dynamic
 The pursuer-distancer dynamic grows
out of complementary roles


Triangles are a basic structure in
dysfunctional families
 Triangles

form when a person
seeks out a substitute for
relating to a person with whom
he has difficulties
 Cross-generational coalitions
are a triangle between two
generations; that is one parent
joining with a child against the
other parent.

Palo Alto Brief Therapy
School
Based on the idea that families resist
change
 Assumed that a direct approach would
only provoke resistance
 downplayed importance of insight; in
fact, considered insight to be an
obstacle at times


Milton Erickson’s influence on
Jay Haley
Erickson mastered techniques for
circumventing resistance in hypnotic
subjects.
 Symptom prediction, symptom
prescription (paradoxical or strategic)
 Indirect methods
 Reframing


Bowen’s Systems Family
Therapy
differentiation of self is central concept
 triangle is smallest stable unit of
relationship.
 cross generational transmission of
patterns; focused on the family of
origin, not the nuclear family
 genograms as a way of assessing
generational patterns


Origin of Family problems
As already stated, families break down
when unable to adjust their rules to
accommodate new developments
 Family therapists are interested in
what was happening when the
problem arose
 But more interested in what the family
is doing to perpetuate the problem
 The family’s “solution” is often the
problem -- the reassertion of old rules


The attempted solution is often
the problem
The attempted solution maintains the
problem and makes the problem worse.
It’s a vicious cycle. Change must be of
the second order to break the pattern.
 We draw from our past something that
worked before. People with difficult
problems have a hard time in finding a
new coping.
 What’s important is to give up the old
coping: 180° turn is not the opposite but
a significant shift in another direction.


Process is Everything
 As

mentioned earlier, a therapist
must focus on what is going on
between members, not the specific
problem
 If a therapist tries to solve the
problem as it’s defined, rather than
looking at the way the family
sustains the problem through
their interaction, there will be no
progress.

The therapist enters the client’s
world
 Through

attentive observation
of verbal and non verbal
behavior, the therapist tries to
understand the client’s
language, perception, beliefs,
values in order to find
motivation for change.

. The therapist changes the
meaning by reframing









He reframes the problem situation so that the
values and motives of the client will allow him
to accept the change.
He uses the belief system and the social
context of the client to disrupt his pattern.
He changes the perception by reframing.
For instance: “ Anxiety is an important
function. It is your body’s signal that something
is wrong. It’s a protective signal”. What do you
need to do to answer the signal? Learn how to
use it and to lower it.
In understanding the situation, the therapist
assumes that any behavior is protecting a
person in the system. He rewrites the story.

What you do depends on Your
style and theory
Some therapists will openly point out
the problems in relating, in order to
bring about insight.
 Some therapists will actively
manipulate the family (move them
around, get them to interact, etc.) to
bring about change in the
session, without worrying about insight.
 Some will do both.


Readings
Dallos, R. & Draper, R. (2010) chap 1 & 2
 Metcalf, L. (2011) chapter 1
 Sexton (1994) Systemic Thinking in a Linear World
 Flaskas (2011) Frameworks for Practice part 2
 Keeney & Keeney (2012) What Is Systemic About
Systemic therapy
Advanced reading
 Brad Keeney (1983) Aesthetics of change
 Watzlawick, Weakland & Fisch (1974) Change:
Principles of Problem formation and problem
resolution Norton & Company London
 Carr, A (2012) Family therapy: Concepts,
Process and Practice (3rd edition) chap 1 & 2


Lecture 2 core concepts in systemic therapy

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