CHAPTER 41
Family and Systemic Therapies
Background
’No man is an island’ wrote John Donne, and family therapy recognises
this. Whereas psychodynamic therapy and biological psychiatry focus on
the individual’s internal mental processes and pathology as the root of
problems, family therapy arose from the notion that thefamily systemexerts
a strong influence on all members, and that imbalances in the system can
manifest themselves as problems in theidentifiedpatient who is presented
as an expression of the family’sdysfunctionordisequilibrium. Children and
adolescents are especially affected by these processes since so much of their
lives take place within the family context. More recent developments in
family therapy have acknowledged the influence of family belief systems
and the attitudes prevalent in the current social and cultural climate.
People’s way of functioning is affected by their idea of how they should
be. Gender, race and role expectations all influence people’s beliefs and
behaviour, as do a variety of personal and general experiences ranging
from parental demands to TV advertisements. Indeed, because of the
awareness of the interdependence with outside society and its systems,
many practitioners now prefer to reflect their systems approach directly in
their title and call themselvessystemic therapists. A variety of methods have
been developed to make use of these concepts in therapy.
Family systems theory began to develop in the late 1950s and in
the 1960s. It recognised limitations in explanations of human behaviour
based onlinear causality, which focus on actions by individuals, and the
content of what they say and do. As an alternative, Gregory Bateson, an
anthropologist, introduced ideas fromcyberneticsinto family therapy. He
proposed thatreciprocal determinismis at work, and that one needs to look at
process rather than content. This will reveal the interdependence of family
members: one event does not lead to another single event; rather, a change
in one member affects all other members in differing ways, who then
react and impinge upon the first person, and so on. Examination of the
process revealscircular causality. Systems theory and thinking can be ap-
plied beyond the family to inform relations between the individual or the
Child and Adolescent Psychiatry, Third Edition. Robert Goodman and Stephen Scott.
©c2012 Robert Goodman and Stephen Scott. Published 2012 by John Wiley & Sons, Ltd.
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