Systems Theory

Had its origins in 1940s. Looked at all systems, from simple machines, jet
engines, amoebas, and human brain, are all systems, an organized assemblage
of parts forming a complex whole. According to Systems Theory; the
essential properties of an organism, or living system, are properties of the
whole (which none of the individual parts have). They arise from the
relationships among the parts. The whole is always greater than the sum
of it’s parts. Thus, it would make little sense to try to understand a child's
behavior by interviewing her without the rest of her family.

Ludwig von Bertalanffy coined and defined general systems theory:

"Any entity maintained by the mutual interaction of its parts, from atom to
cosmos, and including such mundane examples as telephone, postal, and rapid
transit systems. A Bertalanffian system can be physical like a television set,
biological like a dog, psychological like a personality, sociological like a labor
union, or symbolic like a set of laws...A system can be composed of smaller
systems and can also be part of a larger system, just as a state or province is
composed of smaller jurisdictions and also is part of a nation…"

In Biology and in social groups, you have an open system and a closed system.
Where an open system functions on a continuous exchange interacting with its
environment. Open systems can sustain themselves by continuously exchanging
resources with their environment. Another property of living systems is that they
don't just react to stimuli; they actively initiate efforts to flourish.

Machines on the other hand, which are an example of a closed system, have a
finite fixed result. In an open system, such as people and nature, the result is
endless, it has many different ways of reaching a goal and goals might even
change, living organisms are active and creative. They work to sustain their
organization. Machines on the other hand are fixed.

Evolution of family therapy

Family Therapy is not just a set of techniques, it’s a whole new approach to
understanding human behavior as fundamentally shaped by its social context.

It is a system of interconnected lives governed by strict but unspoken rules. It is

fundamentally organized by interpersonal context.

There is a transaction that occurs unlike just an interaction. Billiard balls interact-
they collide and alter each other's course but remain essentially unchanged.
People transact, they come together in ways that not only alter each other's
course but also affect internal changes.

A Rogerian might look for low self esteem and want to focus on having positive
experiences reach their full potential. A Freudian might look for repressed anger.
Behaviorists might look for a lack of reinforcing activities. Family members had
no place in the work of client-centered therapy. Family therapists on the other
hand consider how problems may be, at least in part, a product of the
relationships surrounding them.

The influence of Social Work:

Mary Richmond (1917) in her classic text, Social Diagnosis, prescribed
treatment of "the whole family" and warned against isolating family members
from their natural context. Richmond’s concept of family cohesion had a
strikingly modern ring, anticipating as it did later work on role theory, group
dynamics and of course structural family therapy. According to Richmond, the
degree of emotional bonding between family members was critical to their ability
to survive and flourish

"She recognized that families are not isolated wholes (closed systems), but exist
in a particular social context, which interactively influences and is influenced by
their functioning. She graphically depicted this situation using a set of concentric
circles to represent various systemic levels from the individual to the cultural.
Her approach to practice was to consider the potential effect of all interventions
on every systemic level, and to understand and use the reciprocal interaction of
the systemic hierarchy for therapeutic purposes.

Among the social work contributors (later on) were, Virginia Satir, Ray Bardhill,
Peggy Papp, Lynn Hoffman, Froma Walsh, Insoo Berg, Jay Lappin, Richard
Stuart, Harry Aponte, Michael White, Doug Breunlin, Olga Silberstein, Lois
Braverman, Nancy Boyd-Franklin , Steve de Shazer, Peggy Penn, Betty Carter,
Braulio Montalvo, and Monica McGoldrick,
As early as 1938, Nathan Ackerman (child psychiatrist, psychoanalyst) went
on record suggesting the value of viewing the family as a unit when dealing with
disturbance in any of its members. He recommended studying the family as a
means of understanding the child instead of the other way around. By the 1950’s
he began family treatment. Ackerman urged therapists to become emotionally
engaged with families and to bring dormant conflicts into open discussion. By
challenging avoidance and emotional dishonesty. He never lost sight of the self
in the system.

Adler introduced Child Guidance movement in Vienna, (1943), childhood

psychological problems were due to mother over protectiveness.(1948) Frieda
Fromm-Reich-mann coined one of the most damning terms in the history of
psychiatry, the schizophrenogenic mother, pathological parenting that produced
schizophrenia. Although a terrible idea, it opened up the conversation about
familial relationships but it was still seen as secondary and treating the patient
was most important.

Gregory Bateson: Schizophrenia project in Palo Alto, CA. (1952) Got a grant to
study the Nature of communication. He wrote about two levels of
communication-report and Command. Every message has a stated content,
and a second message which is called metacommunication (which is covert
and unnoticed). Essentially, the report is what is said, and the command is how
it is said or the underlying rules and dynamics of the relationship that frame the
message.

In 1953 Jay Haley and John Weakland joined Bateson and developed a
communication theory that might explain the origin and nature of Schizophrenic
behavior, in context of families. (Although never studied them communicating
with families.) In 1956 they introduced the concept of the Double Bind. Should
not be confused with contradiction. We are all caught in a double bind every
once and a while and a person with schizophrenia has to deal with it all the time.
Example of mother visiting son in hospital. "He hugs her, she stiffens, he
retreats, she asks him if he doesn't love her anymore, he blushes, she tells him
not to be so easily embarrassed and afraid of his feelings". They assumed that
psychotic behavior might make sense in the context of pathologic family
communication. “Crazy” patients were an extension of a “crazy family
environment”. Double Bind has 6 Characteristics:
1. 2 or more persons in an important relationship.
2. Repeated Experience
3. A primary negative injunction such as don't do X or I will punish you
4. A second injunction at a more abstract level conflicting the first, also enforced
by punishment or perceived threat
5. A tertiary negative injunction prohibiting escape and demanding a response.
Without this restriction the Victim won't feel bound
6. Finally, the complete set of ingredients is no longer necessary once the victim
is conditioned to perceive the world in terms of double binds, any part of the
sequence becomes sufficient to trigger panic or rage.
but they were wrong….

Bateson group: who fell upon family therapy after interviewing families of
schizophrenic patients. Discovered that there is no such thing as a simple
communication: Every message is qualified by another message on a higher
level. Haley explored how covert messages are used in the struggle for control
that characterizes many relationships. Symptoms he argued represent an
incongruence between levels of communication

(1957) Theodore Lidz-

Challenged the notion of the mother's role in developing schizophrenia and
suggested it was the Father who impacted the children. Later finding and
focusing on the marital relationships and coming up with two general types of
marital discord
Marital Schism: husband and wives chronically undercut each other's worth and
competed openly for their children's affection. (a combat zone)
Marital Skew, involves serious psychopathology in one partner who dominates
the other.

Pseudohostility: distorts communication and impairs realistic perception and

rational thinking about relationships. The schizophrenic family becomes a sick
little society unto itself.

In the 50’s there is an increased interest in the facade of togetherness that

masked conflict and blocked intimacy. Such families were so preoccupied with
fitting together that there was no room for separate identities or divergent self
interests.

John Elderkin Bell: (1950's) will not hear this name so much because he did not
write many books or open clinics, Bell's ingenious approach to family therapy
involved a step-by-step plan of attack to treat family problems in stages. It was
an outgrowth of group therapy and was aptly named "family group therapy".
Three stages designed to encourage communication among family members and
to solve family problems. It relied primarily on stimulating open discussion to help
families solve their problems

Don Jackson, (Don and Ackerman made the first family Journal)
one of the family therapy theorists, rejected psychoanalytic concepts that formed
the basis of his early training. He was interested in the analysis of
communication. By 1963, Jackson's model of the family involved several types
of rules that defined the communication patterns and interactions among family
members. Jackson described families as homeostatic units. Jackson
illustrated how patients' symptoms preserve stability in their families. He helped
coin the term symmetrical and complementary relationships. Complimentary
being like puzzles, one is strong the other is weak. Symmetrical relationships,
equal in all parts.

Families who come to therapy can be seen as stuck in a narrow range of options,
or unnecessarily rigid rules. Because the rules in most families aren't spelled
out, no one ratifies them, and they’re hard to change. Given the assumption that
symptoms are homeostatic mechanisms, even positive change can be a threat to
the defensive order of things.

Another member of the Palo Alto group was Virginia Satir. Interested in
communication but added an emotional component to it. Satir saw troubled
family members as trapped in narrow family roles, like the victim, placater,
defiant one, or rescuer, that constrained relationships and sapped self-esteem.
Satir was a humanizing force in the early days of family therapy, when many
were so enamored of systems metaphor that they neglected the emotional life of
families.

Carl Whitaker
He believed stress is necessary for change. he never had a strategy or used a
technique. He didn't so much push families to change in a particular direction as
he challenged them to open up -to become more fully themselves and more fully
together.
1946-55 became chairman of the psychiatry department in Emory Unv.
died in 1995.

Salvador Minuchin
structural model. He noticed two patterns common to troubled families.(1960)
Some are enmeshed-chaotic and tightly interconnected. Others are disengaged
-isolated and seemingly unrelated. Both types lack clear lines of authority.
Enmeshed parents are too entangled with their children to exercise leadership
and control. Disengaged parents are too distant to provide effective support and
guidance.

Murray Bowen
was a psychiatrist who specialized in schizophrenia. Bowen had a theory which
is why so much has been built on his theory.
1946-Menninger Clinic where he studied mother's and their schizophrenic
children. Mother child symbiosis. which led to his concept of differentiation of
self. (Autonomy from others and separation of thought from feeling.)
Moved to NIMH where he developed a project to hospitalize whole families with
schizophrenic members. Later included the role of fathers, and led to the
concept of Triangles. When he worked with families he was struck by their
intense emotional reactivity. Bowen felt the family's tendency to pull him into
the center of this undifferentiated family ego mass.

*Break*
sociogram

Schools of Family Therapy:

Systemic Family therapy: Many therapists and techniques fall under this
umbrella. There is more flexibility in the therapist’s role in the session. It is
essentially a contextual approach. Treating and seeing families in the context of
where they are coming from. Disrupt unhealthy interactions, or patterns of
dysfunction. Allowing new ways of relating to emerge

Strategic Family Therapy: Strategic approaches captivated family therapy

from the mid 1970 to med 80s. Part of the appeal was their pragmatic,
problem-solving focus, but there was also a fascination with strategies that could
outwit resistance and provoke families into changing.

Jay Haley: key figure in developing strategic family therapy: Studied under
Bateson, Erickson, Minuchin and believed that it was far more important to get
patients to actively do something about their problems rather than help them to
understand why they had these problems. The therapist is highly involved
and takes the lead. It is up to the therapist to figure out the problem, tell
the patients what the problems are and direct them to a clear goal. It is a
problem solving family therapy approach. Change does not occur
through insight, but through carrying out the direction given to them.
They keep trying until it works.

Behavioral family therapy approach: The therapist is involved. A

historical, concerned with how, when, where, and what, rather than why.
Behaviors are determined by consequences then by antecedents.
Increase positive behavior, symptoms are learned responses caused by
dysfunctional reinforcement. Time limited, symptom focused
Structural Family Therapy: Structural therapy offers a framework that
brings order and meaning to those transactions. Using the concept of family
structure enables therapists to intervene in a systematic and organized way.
What structural family therapy adds to the equation is a recognition of the overall
organization that supports and maintains those interactions.
Salvador Minuchin, Harry Aponte: The therapist takes an active role in the
session. Structural therapy refers to the identification of codes that
regulate human behavior. Codes that relate to boundaries, alignment and
power. Abuse of power, rules, roles, and boundaries. Looking at
Hierarchy.

Video of structural family therapy with Harry A.

A Contextual Family Therapy approach: The therapist is not as active.

There is more of an acknowledgement of the transferential issues,
psychoanalytical approach, fairness and family equality, trust, loyalty.
Seeking to uncover family “obligations”.

Psychoanalytic Family Therapy: Many were psychoanalytically trained.

Systemic therapists focused on the outward expression of this inner life,
family interaction and communication, but psychoanalytic therapists
probed beneath family dialogues to explore individual family members'
private fears and longings. Therapist is not as active.

Ackerman Communications approach: Therapist very involved and

places themselves in the session as part of the family. Focuses on clear
communication, congruent messages. Very dynamic and humanistic.

Experiential Family Therapy: Emerged from the humanistic wing of

psychology
Carl Whitaker, Virginia Satir

Object relations family therapy: Therapist is active and participates and

helps integrate new information. A psychoanalytic approach that focuses
on the family by listening and responding to unconscious material,
interpreting, developing insight and working in the transference/ counter…
towards understanding growth.
Video (Family Systems theory)
Bowenian Family Therapy approach: Direct style. Therapist very
involved.
Video of Bowenian Family therapy: Philip Guerin