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Systemic ApproachesSystemic Approaches: Cybernetic systems

IntergenerationalBowen, Framo, Papp, McGoldrickFocus on multigenerational patterns

StructuralMinuchinFocus on family structure and rules that organize familyinteractions

StrategicHaley, Madandes, MRI (Watzlawick, Fisch), Milan team(Cecchin, Boscolo, Prata)

ExperientialSatir, WhitakerEmotional family system; humanistic integration

Postmodern TherapiesGrew out of Cybernetic System Therapies(especially Strategic forms)

Philosophically distinctDo not use systems metaphorDoes not define “normal” family functioningFocus not on “family” but on construction of meaning

PostmodernSolution focusedNarrativeCollaborative

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Common SystemicAssumptions

Family as a “system”Greater than the sum of its partsRules for interacting

Symptoms serve a purpose: maintainingfamily homeostasis

Individual behavior (pathology) always “makessense” in the context of the system

Non-blaming PerspectiveCircular causality: ABThese patterns often become exaggerated: nag-withdrawal cycle or purser-distancer

Family Life CycleFamily Life Cycle

MarriageFirst childChild(ren) school agedChild in adolescenceFirst child leaves homeEmpty nestAging parents

Each stage requires that closeness and distance bere-negotiatedFamilies get stuck when unable to adjust structure todemands of life stage

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Structural AssessmentStructure: “Rules that govern interactions:Subsystems

Spousal; marital; sibling; gender; special interest,etc.Problem subsystems: Covert coalitions

BoundariesEnmeshed (diffuse)Disengaged (rigid)Clear

HierarchyParent/child

Structural InterventionsEnactments

Ask family to enact problem interactionTherapist intervenes to facilitate restructuring ofsystem

Challenge Family AssumptionsQuestion assumptions that reinforce structure

Affective Intensity“When did you divorce your husband and marryyour son?”

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Systemic/MRI AssessmentProblem: The attempted solution

“More of the same”Interactional View: Problems arise from interactionalsequenceMeta-communication: Report and Command

Communication about how to interpret the content of themessage.Always a comment about the relationship

Double Bind CommunicationEx. “Be spontaneous”Two injunctions that contradict each other

First Order and Second Order ChangeFirst order: Same structure; different playersSecond order: Change structure of system

Systemic (MRI) Assessment4 Step Procedure

1. Define problem and how it is a problem2. Determine which solutions have been tried and

outcome of attempts (look for more of the samepatterns)

Why hasn’t it gotten worse?3. Obtain a clear description of concrete change to

be achieved.Carefully trace entire behavioral sequence: person Adoes x; B does y; C does Z; A responds x; B respondsy, etc.

4. Formulate plan to produce change thatrepresents shift from more of same pattern

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Systemic/MRI InterventionsReframing

Change conceptual or emotional context to allowfor new interpretation of the “facts”

Problem child who gives parents cause to rally together

Prescribe symptomCreates therapeutic double bind by makingspontaneous/uncontrollable behavior deliberate.

Making the covert overOften using behavioral tasks to highlight covertalliances, etc.

More Systemic Interventions

Circular Questions (Milan)Questions that highlight relational patterns

Hypothesizing (Milan)Directives and Assignments

Rather than literally solving problems,directives highlight problematicinteractional patterns

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Bowen/Intergenerational

DifferentiationAble to distinguish self from others; thoughtfrom feelingGoal of therapy to increase differentiation

Analyze multigenerational patternsGenograms

Experiential Family Therapy

Satir and WhitakerFocus on emotional patterns in family

SatirSculpting: Non-verbal technique toillustrate emotional climate of family

WhitakerTherapy of the absurd: Used affectiveintensity to intervene on stuck relationalpatterns