Week 2: Part 1 -Family therapy vs. feminist family therapy approach / Week 2: Part 2 -The home based treatment approach/ Week 2: Part 3 -Exercise/ Week 2: Part 4 Reflection Paper

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Title of book: Family Therapy: An Overview (9th Edition) Author of book: Irene Goldenberg, Mark Stanton, Herbert Goldenberg Chapter Title: Chapter 4 Systems Theory and Systemic Thinking Author of Chapter: Irene Goldenberg, Mark Stanton, Herbert Goldenberg Year: 2017 Publisher: Cengage Learning Place of Publishing: United States of America The copyright law of the United States (Title 17, United States Code) governs the making of photocopies or other reproductions of copyrighted materials. Under certain conditions specified in the law, libraries and archives are authorized to furnish a photocopy or other reproduction. One of these specified conditions is that the photocopy or reproduction is not to be used for any purpose other than private study, scholarship, or research. If a user makes a request for, or later uses, a photocopy or reproduction for purposes in excess of fair use that user may be liable for copyright infringement.

LO 1 Describe potential problems with using only the scientific method to explain family functioning

LO 2 Explain systemic functioning using a paradigm or descriptive model

LO 3 Discuss some characteristics of a family system

LO 4 Apply systemic thinking to family therapy

Family therapy is informed by systems theory and systemic

thinking in order to fully understand and provide psycho

therapy to couples and families (Stanton & Welsh, 2012).

A systemic approach stands in contrast to the individualis

tic thinking typical of most people raised in Western society

who were educated in the context of the Cartesian scientific

method espoused by Rene Descartes in 1738 (Capra, 2002).

1 Extending Beyond the Scientific Method

The scientific method begins with a questioning mind that

does not accept anything as true unless there is clear evidence

of its truth and proceeds to break any problem under inves

tigation into pieces in order to understand the components

of the problem and tries to solve it. The reconnection of the

pieces proceeds from those easiest to understand to those most

complex without considering any natural connection between

the parts and concludes when thorough questioning ensures

nothing was left out of the solution. This method led to ma

jor scientific discoveries and the solution of many problems in

medicine, food production, and industry. Most of us in the

western hemisphere were educated to think according to this

method, and we now do so without even realizing we are do

ing so. However, as this method became the standard way of

thinking in Western societies, it resulted in extreme individ

ualism (loss of the natural relationship between parts of the

whole), reductionism (trying to understand complex problems

by looking at parts of them apart from the context around

SYSTEMS THEORY AND SYSTEMIC THINKING

them, resulting in solutions that do not work in real life), linear thinking (trying to understand

problems by simple cause-effect explanations that ignore multiple reflexive influences), and ex

treme objectivism (the idea that knowledge can only come through this scientific method; any

thing subjective is disregarded; Stanton, 2009).

Most of us do not think about how we think-we simply think, not recognizing that we

are using rules about thinking to govern our thought processes. We adopt the epistemology

of our time without knowing it. An epistemology is a set of thinking rules used by groups of

people to define reality or "how we know what we know" (Auerswald, 1990; Stanton, 2009).

Our epistemology determines the information we consider-or fail to consider-and the way

we organize that information. So, for each of us, "reality'' is something we construct based on

what our rules say is real and true. For example, some people think feelings are not objective

reality, so they disregard them. We see this in couples therapy when one partner shares feelings

and the other wants to focus on the "facts." Systems theory challenges family therapists to

consider new ways of thinking so that we might effectively understand and help families.

Family therapy grew out of a movement that saw the scientific method as only one way

to understand problems. These scientists started looking at the whole again, focusing on the

interaction of the parts through communication and other characteristics of systems. They

found that families are organized wholes with members living in continuous, interactive,

patterned relationships with one another that extend over time and space. A change in any

one component inevitably changes any other related components. Beyond the relationships of

its constituent members, the family itself is continuously and bidirectionally linked to larger

systems. The interplay between families and those social systems tells us a great deal about the

level of family functioning. For these early family therapists, systems concepts became a useful

language for conceptualizing a family's interactive process.

I.n this chapter we present a systemic framework-or paradigm-for understanding the

reciprocal interaction between the parts of a system that includes the family system. This

will help you think about what you include or exclude when you think about families. We

describe several key characteristics of systems, and we try to help you shift from understanding

concepts alone to really thinking systemically as a family therapist. We explore the need for

family therapists to help families manage their interactions across multiple settings (school,

healthcare). Finally, we note some critiques of systems theory and suggest ways contemporary

systems theory responds to the concerns.

systemic perspective greatly broadens the context for understanding family functioning by at

tending to the numerous social systems with which it functions. Such a view addresses the multi

ple systems in which families are embedded. In this multidimensional view, attention is directed

beyond the family to "external" factors that may be influencing family functioning (Robbins,

Mayorga, & Szapocznik, 2003). Beyond helping families improve their coping skills, clinicians

with this outlook help empower them to make more effective use of available social and commu

nity services. No longer restricted to the consultation room, services may be delivered at places

more convenient to the family: in schools, homes, community agencies, and elsewhere.

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86 CHAPTER 4

Environmental Macrosystemic

A systemic paradigm

Source: Stanton (2009).

Intra-Individual

Interpersonal

Time

A variety of models have been introduced to facilitate system conceptualization. They

all attempt to demonstrate the complex, interactive, reciprocal nature of systems. Unlike

the traditional American business organizational chart that flows from top to bottom, they

are often circular and dynamic to illustrate that information, power, and influences flow in

many directions simultaneously. One model (see Figure 4.1) notes the dynamic reciproc

ity between individual factors, interpersonal factors, and environmental or macrosystemic

factors over time (Stanton, 2009). Individual factors include such things as personality,

psychobiology, gender, age, ethnicity, sexual identity, attachment, cognitive process and

intelligence, beliefs, values, and more. Interpersonal factors include family development,

family life cycle, family diversity, couple relations, parent-child relations, family strengths,

social network relations, and so on. Contextual factors include politics, culture, healthcare,

religion and religious organizations, media, national ideology, socioeconomic conditions,

physical environment, and more (Stanton & Welsh, 2011). The model provides a basic

mental construct for the family therapist to consider in assessment, treatment planning, and

intervention.

In such models, individuals and families are nested within multiple but independent

social systems that influence how they behave. Bronfenbrenner (1986, Bronfenbrenner &

Morris, 2006) proposes a theo1y of social ecology in which five levels of influence exist, each

level containing and influencing the prior level. Thus, the individual is embedded in his or

her family system, which is embedded in a neighborhood or religious community, which in

turn is part of an ethnic group or social class, and so forth. Depicted on an ecomap (see Figure

4.2), the microsystem level refers to the person and his or her immediate system, the mesosystem

to the relationships in which members of his or her microsystem take part, the exosystem to the

larger systems that affect the individual, the macrosystem, the broad social and cultural forces

that have the most widespread influence on the individual, and the chronosystem, the evolu

tion of interaction among environments over time.

activities organizations

facilities

SYSTEMS THEORY AND SYSTEMIC THINKING

Microsystem

1. Individual (Child/ Adolescent/ Adult)

2. Family 3. School 4.Work

FIGURE 4.2 An ecomap depicting the multiple contexts that influence a person's self-identity and behavior

Source: Based on Knoff (I 986)

Rather than viewing the family as an isolated, encapsulated system, the systemically ori

ented therapist is able to intervene at any level to improve family functioning. As Robbins,

Mayorga, and Szapocznik (2003) illustrate, problems may be addressed to improve the re

lationship among family members (microsystem level), to improve a partner's relationship

with extended family members or community organization (mesosystem level), to work on a

behavior-problem child's parent's connection to Alcoholics Anonymous (exosystem), or by the

therapist serving on a committee to develop treatment practices for victims or perpetrators of

domestic violence (macrosystem). Maintaining an ecological focus widens the lens to encour

age the development of integrated interventions based on ever-broadening social contexts.

Social media influences are an important emerging mesosystemic influence in today's families

(see Box 4.1).

3 Some Characteristics of a Family System

Organization and Wholeness

The concepts of organization and wholeness are keys to understanding how systems operate.

If a system represents a set of units that stand in some consistent relationship to one another,

then we can infer that the system is organized around those relationships. Further, we can say

that the parts or elements of the system interact with each other in a predictable, "organized"

fashion. Similarly, we can assume that the elements, once combined, produce an entity-a

whole-that is greater than the sum of its parts. It follows that no system can be adequately

88 CHAPTER 4

How Digital Media and Social Networking Are Affecting Families

With the increased use of digital technology and social media, families are learning to interact within the broader context of technology as part of the system in which they reside. Bronfenbrenner (see Figure 4.2) identified media as an important meso systemic factor influencing and interacting with fam ilies. Our children, unlike their parents' generation, are not only consuming content but producing it for the world to see. The shift from information be ing shared within the family system has shifted to a broader context of "living out loud" on line. Broad casting feelings and photos via social media sites, coupled with the instant need for feedback and connection, has presented profound changes in family dynamics, blurred roles and communication.

Communication via Technology

In many respects, the use of technology has made connection and interaction easier for families, as they can check in with each other and communi cate from anywhere, anytime. Divorced families or parents on business trips can connect for short periods, increasing communication and connection within the family system. On the flip side, content that was traditionally assigned for one person to see is now public for all and available to a wider audi ence. It may be through a post or "brag" that family members discover "secrets" or recognize a digital cry for help. Hashtags, vague or implicit comments/ images, as well as identification with certain sites and groups give families insight into the inner thoughts and lives of their family members. If an individual is struggling in "real space," it is likely that they are carrying over these challenges or addictions (body image, self-harm, gambling, difficulty with friendship, etc.) into their online lives through online chat groups, how-to videos, and sites dedicated to furthering or stopping the behavior.

With the ease of accessibility through mobile devices, relationships are shifting. Some argue we are alone together (Sherry Turkle, 2011) and dis connected, while others contend that we are more connected than ever (Danah Boyd, 2014). What is clear is that we are digitally tethered to our de vices and to each other. Without context and visual feedback, many conversations lose their context, and misunderstandings transpire, causing fights, cutoffs, and splitting between family members. Geolocation-based services can ease anxiety but at the same time create an unhealthy relationship that follows the child into college and beyond. The need for fast responses also spurs insecurity when someone does not respond immediately. Sending multiple texts in succession, often referred to as textual harassment, happens in both parent-child and romantic relationships and can be viewed as smothering or a form of abuse.

Anonymity

In the past decade, we have seen a shift from real name culture to a culture of anonymity. Without a face on the other side of the screen and apps that

promise to self-destruct and erase, self-regulation decreases, and individuals are more likely to say or do things online that they would not do face to face. Anonymity may contribute to increased use of online pornography or hook-up sites. This can create suspicion, jealousy, and anger in relation ships when it is discovered. Sexting, sending ex plicit or nude images, has created challenges to individuals and their families that are permanent and can lead to family conflict, police intervention, and possible suicide. Reference this article if you want more information on why kids sext: http:// m.theatlantic.com/magazine/archive/2014/11 /why-kids-sext/380798/

understood or fully explained once it has been broken down into its component parts and

that no element within the system can ever be understood in isolation, since it never functions

independently.

A family, like a human body, is a system in which the components are organized into a

whole that transcends the sum of its separate parts . When we speak of the Sanchez family,

SYSTEMS THEORY AND SYSTEMIC THINKING

for example, we are discussing a complex and recognizable entity-not simply the aggregate

of Mr. Sanchez plus Mrs. Sanchez plus the Sanchez children. 1 Understanding the dynamic

relationships among the components (family members) is far more illuminating than simply

summing up those components. The relationships among the family members are complex,

and factions, alliances, coalitions, and tensions exist. Causality within the family system is

circular and multidirectional.

As Leslie (1988) observes, because of the system's wholeness, the movement of each

component influences the whole and is explained, in part, by movement in related parts of the

system. Focusing on the functioning of one element (member) becomes secondary to under

standing the connections or relationships among family members and the overall organization

of the system. As an illustration, Leslie notes that a family with two children does not sim

ply add a new member when a baby is born; instead, the family becomes a new entity with

accompanying changes in family interactive patterns.

Should a 2-year-old start to engage in hostile outbursts, linear explanations might attri

bute the new behavior to jealousy or infer the toddler is reacting to the loss of his mother's un

divided attention, since she now must devote a great deal of attention to the newborn baby. A

systems perspective, on the other hand, might look at how the family has reorganized after the

new birth. Perhaps in reorganizing around the infant, the mother has assumed primary care of

the infant and the father the major responsibility for the older children, while the older son has

been designated a helper to his mother with the newborn. The toddler may have lost his cus

tomary role in the family. From this vantage point, his hostile behavior may be signaling the

family that their reorganization is inadequate or perhaps incomplete in meeting the needs of all

its members. To examine the motives of the toddler alone without addressing the system's in

teractive patterns would be to miss the point that the system requires alteration (Leslie, 1988).

In the same way, it is imperative that the therapist address broader issues-the parent who may

be giving up work to remain at home with the children, the other parent who may work longer

hours away from home in order to compensate for the income loss, the grandparents who may

become involved in caring for the children, the availability of adequate child care, and so on.

Adopting a systems view calls for more than viewing the family constellation in isolation.

Systems theory posits that a family is a rule-oriented entity. The interaction of family members

typically follows organized, established patterns based on the family structure; these patterns en

able each person to learn what is permitted or expected of him or her as well as of others in family

transactions. Usually unstated, such rules characterize, regulate, and help stabilize how-and how

well-families function as a unit. They underlie family traditions and reveal family values, help

set up family roles consistent with these values, and in the process provide dependability to rela

tionships within the family system. Rules frequently are carried over from previous generations

and often have a powerful cultural component. See Box 4.2 for a clinical note about family rules.

1ln some ethnic groups, there is no such thing as a "nuclear family," since family refers to an entire network of aunts, uncles, cousins, and grandparents (Hines et al., 1999). They are apt to live in close proximity, if not in the same house.

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90 CHAPTER 4

Family Rules and Family Dysfunction

When rules are appropriate for the persons involved and not too rigid, modifications can be made based on their subsequent experiences together. If rules are flexible and responsive to new information and carried out while tending to the needs of both, the couple is able to develop a functional division

of labor that is intended to help them pursue the sort of life they wish to lead in the future. If, on the other hand, rules are too rigidly defined and fail to take the needs or specific skills of each participant into account, conflict between the couple is likely to follow, leading to family dysfunction.

Don Jackson (1965a), a pioneer in family therapy, first observed these patterns. He noted

that partners in a marriage face multiple challenges as potential collaborators in wage earning,

housekeeping, socializing, lovemaking, and parenting. Early in the relationship, they begin to

define the rights and duties of each spouse. Such determinations often reflect culturally linked

sex roles, but variations are frequent. Jackson adopted the still-helpful concept of marital

quid pro quo to describe a relationship with well-formulated rules in which each partner

gives something and receives something else in return.

Jackson (19656) also hypothesized that a redundancy principle operates in family com

munication, so a family interacts in repetitive behavioral sequences. Instead of using the full

range of possible behavior open to them, members typically settle on redundant patterns

when dealing with one another. Jackson maintained that these patterns-rather than individ

ual needs, drives, or personality traits-determine the interactive sequences between family

members. Some rules may be negotiable, while others are not. Rigid families may have too

many rules, chaotic families too few. All members also learn the family's metarules (literally,

the rules about the rules), which typically take the form of unstated family directives offering

principles for interpreting rules, enforcing rules, and changing rules.

Some rules are stated overtly-such as: "Children allow parents to speak without inter

ruption"; "Children hang up their clothes"; "Parents decide on bedtime"; "Females do the

cooking and cleaning chores"; "Dad clears the dinner dishes"; "Younger children go to bed

earlier than older ones"; or "Our family does not marry outside our religion."2

Most family rules, however, are covert and unstated. They are inferences that family mem

bers draw from the repetitive patterns in the relationships they observe at home-for example,

"Father is distant due to his frequent absences, so approach Mother if you have a problem";

"Both parents are tired and unavailable, so don't come to them with problems"; "We don't

have crybabies in our family"; and "Stay away from their room on Sunday morning; they like

2A small child visiting a friend for the first time may be bewildered by observing new and unrecognizable family rules. Parents may greet each other with a kiss, not quarrel over the dinner table , or include children in the con versation. The visiting child is sometimes startled to learn that, according to the rules of the host family, it is not necessary to finish all the food on your plate before you are allowed to have dessert.

SYSTEMS THEORY AND SYSTEMIC THINKING

Family Rules

Rules and patterns help each member learn what is permitted and expected in family transactions. Rules regulate and stabilize family functioning. Consider each member of your family in the present, and in dicate in the space provided any spoken and unspo ken rules relevant to each. Some examples include,

Mother

Father

Sister

Brother

You

"Teenage sons should excel at math"; "Teenage daughters should excel in language arts"; "Firstborn sons should enter their father's business"; and "The youngest child is less responsible than older chil dren." How do you think these roles help and hinder the stability and growth of your family?

to be alone." Children learn and perpetuate these rules. In a well-functioning family, rules are

clearly communicated to help maintain order and stability while at the same time allowing for

adjustment to changing circumstances.

Virginia Satir (1972), another pioneer in family therapy, also focused on communication

patterns as she tried to help a family recognize its unwritten rules that caused hard feelings.

For example, some families forbid discussion of certain topics (mother's drinking problem or

father's unexplained absence from home certain nights or brother's inability to read or sister's

sexual promiscuity) and consequently fail to take realistic steps to alleviate problems. Other

families forbid overt expressions of anger or irritation with each other ("Stop! The children

will hear us"; "If you can't say something nice to one another, don't say anything at all"). Still

others foster dependence ("Never trust anyone but your mother or father") or enmeshment

("Keep family matters within the family") and thus handicap children as they attempt to deal

with the outside world.

Satir argued that dysfunctional families follow dysfunctional rules. Consistent with that

view, she attempted to help such families become aware of those unwritten rules that retard

growth and maturity. Once identified, she believed the family could revise or discard rules

that are outmoded, inappropriate, or irrelevant in order to improve the individual self-esteem

of members as well as overall family functioning. See Box 4.3: Thinking Like a Clinician to

explore the rules of your family.

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92 CHAPTER 4

Family Homeostasis or Adaptation? Homeostasis was a cybernetic concept applied to the family by early family theorists. The idea

was that families self-regulate to maintain stability and resist change. Although the result is a

steady state, the process is hardly static. To the contrary, a constantly fluctuating interaction of

equilibrating and disequilibrating forces occurs. Early family theorists and researchers applied

this cybernetic concept to an upset or threatened family system that initiates homeostatic

mechanisms in order to reestablish equilibrium. In their initial formulations-groundbreaking

for their time (although more controversial today)-researchers saw homeostasis as a way for

a family to resist change by returning to its pre-threatened steady state. Most family therapists

today adopt a living systems approach that moves beyond cybernetics to argue that helping

families return to previous balanced states shortchanges them by failing to credit them with

the resiliency and resourcefulness to adapt to a more highly functioning level.

What happens, then, when a family must change or modify its rules? How adaptive or

flexible are the metarules for changing established or habitual patterns in a particular family?

As children grow up, they usually put pressure on the family to redefine its relationships. Many

adolescents expect to be given money to spend as they wish, to mal<:e their own decisions about a

suitable bedtime, to listen to music that may be repellent to their parents' ears, to play computer

games for unlimited amounts of time, to pursue interests other than those traditionally cared

about in the family. They may challenge the family's values, customs, and norms; they insist on

being treated as equals. All this causes disequilibrium in the family system.

In most cases, a system tends to maintain itself within preferred and familiar ranges.

A demand for deviation or change that is too great, too sudden, or too far beyond the system's

threshold of tolerance is likely to meet with counterdeviation responses. In poorly functioning

families, demands for even the most necessary or modest changes may be met with increased

rigidity as the family stubbornly attempts to retain familiar rules.

Family stability is actually rooted in change. That is, to the degree that a family is functional,

it is able to promote appropriate adaptability while preserving a sense of order and sameness.

This may be called dynamic equilibrium. For example, a well-functioning couple dealing with

parenthood for the first time may strengthen their partnership and intimacy as the family

expands to accommodate the new arrival. On the other hand, a less well-functioning couple

may grow apart after the birth of the child, with one or the other (or both) feeling neglected,

angry, and resentful.

Well-functioning families are resilient and able to achieve change without forfeiting long

term stability. An immigrant family, established in their home country but forced to migrate

due to war or other social or political events, may face numerous dislocations (new jobs, new

language, even a new sense of freedom) but still create a stronger bond than before as they

deal with the changing situation.

Feedback, information, and Control Feedback refers to reinserting into a system the results of its past performance as a method of

controlling the system, thereby increasing the system's likelihood of survival. Feedback loops are

circular mechanisms whose purpose is to introduce information about a system's output

SYSTEMS THEORY AND SYSTEMIC THINKING

back to its input in order to alter, correct, and ultimately govern the system's functioning

and ensure its viability. Feedback loops help mitigate against excessive fluctuations, thus

serving to maintain and extend the life of the system. As a simple example of a feedback

loop, think of a person entering a room in which she smells gas. A moment before the air

smelled fresh, and now it doesn't. She takes action by going to the stove and shutting off the

gas and opening the window. These events and actions restore the system to a normal state.

Feedback loops in families occur constantly and in far greater number. They occur both

negatively and positively.

Negative feedback, or attenuating feedback loops, helps to maintain the system's steady

state. New information is fed back into the system and triggers changes that serve to put the

system back "on track." Positive feedback, or amplifying feedback loops, are about changing

the system. New information entering the system leads to further change by augmenting or

accelerating the initial deviation.

Systems require both negative and positive feedback-the former to maintain the status

quo and the latter to accommodate changing conditions. For example, as children in a family

grow into adolescence, they are likely to demand greater independence and self-direction,

temporarily destabilizing the family system through their insistence on rule changes. Adaptive

or enabling families typically attempt to deal with change by renegotiating teenage privileges

and responsibilities and receiving feedback information regarding how easily and appropri

ately the changes are handled. Positive feedback mechanisms are operating here as the family

adapts to change by modifying its structure, and the system's stability is regained. See Box 4.4

Clinical Note for an illustration of the operation of positive and negative feedback.

In a less functional manner, a family whose repertoire is limited to negative feed

back may be inflexible, stifling, and resistant to dealing with changing circumstances. For

example, parents may continue to treat the teenager as a child by refusing to acknowl

edge his or her growing maturity. In a similarly dysfunctional manner, positive feedback,

helping change or modify a system, may reach runaway proportions without the stability

provided by negative feedback, forcing the system beyond its coping limits to the point

of exhaustion or self-destruction; the adolescent does not know how to handle new free

doms and rebelliously defies all family rules. Every family faces life cycle transitions that

require adaptation.

Within a marriage, feedback helps maintain equilibrium, as disturbing or annoying pat

terns are adjusted and new, stabilizing patterns evolve. A misunderstanding can be corrected

and minimized (attenuating deviation) or escalated (amplifying deviation). In the latter case,

an argument may get out of control, becoming increasingly vicious, ugly, or even violent,

reaching the point where neither spouse can (or no longer wants to) control the consequences.

However, the conflict may also be resolved through positive feedback as the couple strives for

a new level of understanding and behavior.

At times, it may be advantageous to propel a family with stagnating or otherwise unten

able behavior patterns to new levels of functioning. In these cases, the therapist may seize the

opportunity of disequilibrium to promote discontinuity and the restoration of family homeo

stasis at a new, more satisfactory level for all.

94 CHAPTER 4

Negative and Positive Feedback Loops

Goldenberg and Goldenberg (2002) illustrate the operation of negative and positive feedback loops in the case of a remarried couple. In the first situation, there is attenuation, or negative feedback:

HUSBAND: I'm upset at the way you talked to that man at the party tonight, especially the way you seemed to be hanging on every word he said.

WIFE: Don't be silly! You're the one I care about. He said he had just come back from a trip you and

I had talked about going on, and I was interested in what he had to tell me about the place.

HUSBAND: OK. But please don't do it again with out telling me. You know I'm touchy on the subject because of what Gina [ex-wife] used to do at par ties with other men that drove me crazy.

WIFE: Sorry. I hadn't thought about that. I'll try to remember next time. In the meantime, you try to remember that you're married to me now, and I don't want you to be jealous.

In a less blissful situation, instead of the previous attenuation, there is amplification, or positive feedback. Remember, positive doesn't necessarily mean good.

HUSBAND: I'm upset at the way you talked to that man at the party tonight, especially the way you seemed to be hanging on every word he said.

WIFE: One thing I don't appreciate is your spying on me.

HUSBAND: Spying? T hat's a funny word to use. You must be getting paranoid in your old age. Or maybe you have something to hide.

WIFE: As a matter of fact, I was talking to him about a trip he took that we had talked about, but I don't suppose you'd believe that. Talk about paranoid!

HUSBAND: I give up on women! You're no different from Gina, and I suppose all other women.

WIFE: With an attitude like that, I'm starting to see why Gina walked out on you.

Positive feedback, while destabilizing, may also be beneficial if it does not get out of control. Con sider a third scenario. Here, the couple expands and deepens their relationship by nondefensively sharing their feelings and reexamining the rules of their relationship.

HUSBAND: I'm upset at the way you talked to that man at the party tonight, especially the way you seemed to be hanging on every word he said. Can

you help me understand what was going on?

WIFE: He said he had just come back from a trip you and I had talked about going on, and I was in terested in what he had to tell me about the place. Maybe I should have called you over and included you in our conversation.

HUSBAND: No need to invite me. From now on, I will come over so I'll know what's happening.

WIFE: I'd like that. Keeping in close contact with you at a party always makes me feel good.

Information processing is fundamental to the operation of any system. If it is faulty, the

system is likely to malfunction. The exchange of information within a family and between

the family and the outside world helps maintain functioning. According to Bateson's (1972)

elegant definition, information is "a difference that makes a difference." By this he means new

(or different) information that effects change within the system. A word, a gesture, a smile, a

scowl-these are differences or changes in the environment comparable to a temperature drop

as environmental input. These differences in turn make a difference when the receiver of the

new information alters his or her perceptions of the environment and modifies subsequent

behavior.

SYSTEMS THEORY AND SYSTEMIC THINKING

A system, as we have seen, is organized into a more or less stable set of relationships. It func

tions in certain characteristic ways; it is continuously in the process of evolution as it seeks

new steady states. Subsystems are those parts of the overall system assigned to carry out par

ticular functions or processes within the system as a whole. Each system exists as part of a

larger suprasystem and contains smaller systems and subsystems.

A family commonly contains a number of coexisting subsystems. The husband and wife

dyad constitutes a subsystem of the family as a whole; so do the mother-child, father-child,

and child-child dyads. In a family, subsystems can be formed by generation (parents), by gen

der (mothers and daughters), by interest (intellectual pursuits), or by function (parental care

takers); see Minuchin (1974). Within each subsystem, different levels of power are exercised,

different skills learned, and different responsibilities assigned. For example, the oldest child

may have power within the sibling subsystem but must cede that power when interacting with

his or her parents.

Because each family member belongs to several subsystems simultaneously, a person en

ters into different complementary relationships with other members. For example, a woman

can be a wife, mother, daughter, younger sister, older sister, niece, granddaughter, and so on,

simultaneously. Membership in subsystems also changes over time. Today, a woman might be

a wife, mother, and sister. In 20 years, she might be a grandmother herself after having lost her

own mother. Within each subsystem, she plays a different role and can be expected to engage

in different transactional patterns. Consider this example: While giving her younger sister

advice about finding a job, a woman is told by her husband to get off the telephone and hurry

up with dinner. She decides how to deal with his demand. Some moments later, she remem

bers not to feel hurt when the children refuse to eat what she has prepared. She even responds

diplomatically when her mother, a dinner guest, gives her advice on how to improve the food

she has prepared.

The most enduring subsystems are the executive, parental, and sibling subsystems

(Hindman, Riggs, & Hook, 2013). The executive husband-wife dyad is basic; any dysfunction

in this subsystem reverberates throughout the family as children are scapegoated or co-opted

into alliances with one parent against the other whenever the parents engage in conflict. The

spousal subsystem teaches the children about male-female intimacy and commitment by

providing a model of marital interaction. How the marital partners accommodate one anoth

er's needs, negotiate differences, make decisions together, manage conflict, meet each other's

sexual and dependency needs, plan the future together, and so on help influence the effec

tiveness of relationships among all family members. A viable spousal subsystem, one in which

the marital partners have worked out a fulfilling relationship with one another, provides both

spouses with the experience of intimacy, support, mutual growth, and an opportunity for

personal development.

The parental subsystem (which may include grandparents or older children assigned

parental roles) has the major responsibility for proper child rearing, nurturance, guidance,

limit setting, and discipline. Through interaction with parents, children learn to deal with

96 CHAPTER 4

authority and power dynamics while strengthening their own capacity for decision making

and self-direction. Problems within this subsystem, such as serious intergenerational con

flicts involving rebelliousness, symptomatic children, or runaways, often reflect underlying

family instability and disorganization. In some families, parents share parental authority

and responsibility with grandparents, or in other cases with relatives, neighborhood friends,

or paid help.

The sibling set represents a child's first peer group. Sibling relationships are typically the

longest-lasting connections we make, extending over the life span (Hindman, Riggs, & Hook,

2013). Through participation in this subsystem, a child develops patterns of negotiation,

cooperation, competition, mutual support, and later, attachment to friends. Interpersonal

skills honed here influence later school or workplace relationships. The influence of this sub

system on overall family functioning depends to a large extent on the viability of all family

subsystems. Spousal, parental, and sibling subsystems stand in an overall dynamic relation

ship, each simultaneously influencing and being influenced by one another.

Other subsystems, most of them less durable than those just outlined, exist in all fami

lies. Father-daughter, mother-son, father-oldest son, and mother-youngest child transitional

alliances are common. Their protracted duration, however, especially if the alliance negatively

affects family functioning, may signal difficulties within the spousal subsystem, alerting the

family therapist to the potential instability of the family system.

A boundary is a metaphoric line of demarcation that separates an individual, a subsystem,

or a system from outside surroundings. Boundaries help define the individual autonomy of a

subsystem's separate members, as well as helping differentiate subsystems from one another.

Within a family system, boundaries determine who is an insider and who remains outside.

The family boundary may act as a gatekeeper, controlling information flow into and out of

the system ("We don't care if your friend's parents allow her to stay out until 2:00 a.m.; in our

family, your curfew is 12:00 a.m."; "Whatever you hear at home, you are expected to keep

private and not discuss with outsiders").

Within a family itself, boundaries distinguish between subsystems, helping define the

separate subunits of the overall system and the quality of their interactive processes. Minuchin

(197 4) contends that such divisions must be sufficiently well defined to allow subsystem

members to carry out their tasks without undue interference, while at the same time open

enough to permit contact between members of the subsystem and others. For example, a

mother defines the boundaries of the parental subsystem when she tells her 15-year-old son,

the oldest of three children: "It's not up to you to decide whether your sisters are old enough

to stay up to watch that TV program. Your father and I will decide that." However, she tem

porarily redefines that boundary to include the oldest child within the parental subsystem

when she announces, "I want all of you children to listen to your older brother while your

father and I are away from home tomorrow evening." Or she may invite grandparents to join

the parental subsystem for one evening only, asking them to check on how the children are

getting along or to advise the oldest son on necessary action in case of an emergency.

SYSTEMS THEORY AND SYSTEMIC THINKING

These examples underscore the idea that the clarity of the subsystem boundaries is far more

significant in the effectiveness of family functioning than the composition of the family sub

systems. While the parent-child subsystem may be flexible enough to include the oldest child,

or a grandmother may be pressed into service when both parents are unavailable, the lines of

authority and responsibility must remain clear. In most middle-class European-American fami

lies, a grandmother who interferes with her daughter's management of the children in ways that

undermine the parent-child subsystem (and perhaps the spousal subsystem in the process) is

overstepping her authority by crossing family boundary lines. Among poor African-American

families, however, active grandparent participation is more likely than not to be the norm, as

grandparents help provide care for grandchildren, adult children, and other elderly kin (Hines,

2011).

An important issue here involves the permeability of the boundaries, since boundaries

vary in how easily they permit information to flow to and from the environment. Not only

must the boundaries within families be clearly drawn, but the rules must be apparent to all.

If boundaries are too blurred or too rigid, they invite confusion or inflexibility, increasing the

family's risk of instability and dysfunction.

A system in continuous interaction with the outside is considered an open system, while

one whose boundaries are not easily crossed is considered a closed system. Open systems do

more than adapt passively to their surroundings; their social transactions are bidirectional.

They initiate activities that permit an exchange with the community because their boundaries

are permeable. Closed systems, on the other hand, have impermeable boundaries. Thus, they

fail to interact with the outside environment, lack feedback corrective mechanisms, become

isolated, and resist change.

An example of such a closed system is a type of religious cult that closes out the world

beyond its borders, specifically to halt the flow of information from the outside world and in

that way to control the behavior of its members. Similarly, totalitarian countries that do not

permit foreign newspapers, radio or television, or access to the Internet also represent systems

deliberately closed to control citizens' behavior.

In family terms, no system is fully open or closed; if it were totally open, no boundar

ies would exist between it and the outside world, and it would cease to exist as a separate

entity; if totally closed, there would be no exchanges with the outside environment, and it

would die. Rather, systems exist along a continuum according to the flexibility or rigidity of

their boundaries. Families that function effectively develop a balance between openness and

closeness, tuned to the outside world to achieve appropriate change and adaptation while

resisting changes that threaten the survival of the system. Such a system tends not only to

survive but to thrive by being open to new experiences and to altering or discarding inter

active patterns that are no longer usable. This is called negentropy, or a tendency toward

maximum order. Such families increase their chances of becoming more highly organized

and developing resources to repair minor or temporary breakdowns in efficiency (Nichols &

Everett, 1986). An immigrant family that immediately begins learning the customs and

98 CHAPTER 4

An Immigrant Family Faces an Intergenerational Conflict

Indira and Sanjay Singh were a sister and brother who came from India to the United States with their parents when they were still of preschool age. Their parents had brought them with the hope that the children's lives would be better than theirs, since neither of the parents had had much education or opportunity in their native land. The parents worked very hard, 7 days a week, in a small clothing store they owned, just managing to make a living; and the children were expected to help out as early as 6 or 7 years of age, just as the parents had done with their own parents. Both children were taught to be compliant with adults, to respect their parents' wishes, and to engage in social activities primarily with family or extended family members. Friends from school were discouraged, and Indira and San jay, now 17 and 14, respectively, were expected to go places only with each other, never alone or with friends. Television was tolerated but monitored by the parents; for example, the children were not al lowed to view scenes of people kissing, which was also not permitted in Indian cinema. When the chil dren objected, the parents reminded them that they were being disrespectful and that if their "inso lent" behavior continued, the parents would move them all back to India no matter what the sacrifice to the family.

Loyalty, respect, and family obligation were essential parts of the family code. As in other In dian families they knew, extended family ties were stressed, arranged marriages were the norm, and

children were expected to obey their parents, es pecially their father. The parents did not under stand why the children wanted to associate with strangers when family members were available. To what class or caste did these strangers belong? What would happen to her father's plans for her marriage if Indira got into trouble or developed a bad reputation as a result of being in bad com pany ? When Indira asked to go to a party with her high school friends, the parents refused, ask ing instead why she hadn't proposed helping out in the store so they could get some rest. Despite her protests that she did help but also wanted to have some fun, the parents threw up their hands in despair and told the children how miserable their ungrateful behavior had made their parents.

A teacher who knew something of Indian cul ture, observing Indira's distress, talked to her about the problems of biculturalism and suggested that such culture conflict was not uncommon between first and second generations in a new country. The teacher suggested family counseling, which the parents first refused to do, expressing shame that intervention by a stranger would be necessary. Af ter the children visited a counselor alone for two sessions, the parents reluctantly came in, and to gether all four began to deal with the differences between countries and to understand cultural expectations.

(Goldenberg & Goldenberg, 2002, pp. 20-21)

language of the adopted land and encourages its children to adapt in a similar manner can

be considered to be acting as an open system. See the case study presented in Box 4.5, in

which a working-class family from India immigrates to the United States, experiencing the

shift from an open system to an insular one until they find ways to adjust to the present

environment.

The lack of such exchanges in relatively closed systems decreases their competence to deal

with stress. They are apt to seal themselves off from all but necessary exchanges with the out

side world; they maintain strict control on who and what is admitted into the home, screening

SYSTEMS THEORY AND SYSTEMIC THINKING

visitors, restricting computer use, preventing contact with social agencies or uncensored

reading matter or television programs, and thus are destined for eventual dysfunction because

of insufficient input. Such closed systems run the risk of entropy; they are prone to eventual

disorganization, particularly under prolonged stress.

For example, recent immigrants or ethnic groups that live in relative isolation,

communicating only among their own ethnic group, suspicious of outsiders, and fostering

dependence on the family, hold on to tradition and avoid change, acting as relatively closed

systems. Parent-child relationships in such families may encounter problems due in part to

culture conflict that may lead to the development of an entropic family.

Families and Larger Systems All families interact with and are influenced by one or more of society's larger systems

healthcare, church, welfare, probation, schools, the legal system. Low-income families,

families with special-needs children, drug abusers, families with members in trouble with

the law, families with schizophrenic members, and immigrant families in particular are

apt to find themselves caught up in dependence on and/or conflict with social and com

munity agencies. Family interventions may involve a case management approach, which

typically includes counseling and family advocacy to link them to available commu

nity resources and services (medical care, job training, legal services) and monitors their

progress.

Home-based services, an extension of a well-established social service tradition, typ

ically are directed at building and strengthening relationships between the family and

the available resources of the community, as part of interventions focused on repairing

adolescent or family dysfunction (Tuerk, McCart, & Henggeler, 2012). Collaboration

is encouraged between the family, galvanizing its strengths, and community caregivers,

who work in partnership to address the needs of the family. In-home therapy is typi

cally short term and intensive and usually focuses on difficult-to-reach, multiproblem

families-substance-abusing adolescents and their families, teenage mothers, families in

which abuse and neglect have occurred, families with severe psychiatric disorders. These

at-risk populations are especially vulnerable to breakdown and in need of social ser

vices; in-home therapy, conducted in the comfort of familiar surroundings, may be less

threatening than entering the community to seek help and may lead to more favorable

outcomes (Gresl, Fox, & Fleischmann, 2014).

The delivery of family services within a school setting is an example of the interlocking

nature of systems. Not only is a child a part of a family that has its own unique structure

and relationship patterns, but the family itself is embedded in its culture, ethnic group,

socioeconomic status, and social history. The child is also a member of a school classroom with

its own structure and interactive processes; that classroom, in turn, is located within a matrix

of a larger school organization. The two major systems in the child's life, home and school,

interface and form a new larger system with its own characteristics, objectives, priorities, and

100 CHAPTER 4

regularities; moreover, home and school systems may deal with one another in complemen

tary or antagonistic ways.3

The school may often be the first to detect a child's emotional or behavioral problem, perhaps reflecting at-home family conflict. In the cases of many low-income, immigrant, or

otherwise closed families, who have difficulty accessing mainstream agencies, school-based

family services may open the gates to needed psychological, medical, or other social services

(Hong, 2006). The family, the school, and the community are all part of this ecosystem

(Stormshak, Posco, & Dishion, 2010).

The family consultant called upon to help assess and treat a schoolchild's behavioral

problem (truancy, dropout, low level of commitment, violence, drug use) needs to adopt a

systemic approach, taking into account the interaction of the two systems (home and school)

before attempting to sort out whether the child is having difficulties in one or both and

deciding how best to proceed (Carlson, Funk, & Nguyen, 2009). He or she must not only

remain aware of the child and the family system but also be familiar with the culture of the

school, school law regarding children with special needs, how this school reaches decisions,

the role of the school board, and so on (Fine, 1995).

Rotheram (1989) offers the following vignette illustrating one type of problem arising in

the interface between family and school:

An angry parent calls the school, complaining that a seventh-grade teacher has given too much homework and is ruining the family's time together over the weekend, asking too much of a young girl. The teacher is righteously indignant and counters that the parents are encouraging dependence and passivity in their child. She refuses to decrease homework. The next week, the daughter makes a suicide attempt, and the family wants to sue the school. (p. 347)

The liaison-consultant called upon to intervene may be a member of the school system, a therapist brought in by the family, or a social services agency representative. Lusterman (1988)

urges "mapping the ecosystem"-evaluating both the school and family before deciding whom to

include (child, teachers, school counselors, parents, grandparents, and so on) in the treatment plan.

In his view, it is necessary from the outset to make dear that the therapist's task is not advocacy for

one group or the other but rather helping create conditions for change. A systems perspective facil

itates the process; if it is carried out successfully, neither party is targeted as causing the presenting

problem, and the interactive process between participants becomes the focus of the joint meetings.

Several promising school-related intervention programs, carefully researched and evidence

based, have been developed, illustrating the emerging social-ecological viewpoint. For example,

multisystemic therapy (Henggeler, Sheldow, & Lee, 2009) is a family-based treatment program

directed at chronic behavioral and emotional problems in adolescents. School-related difficulties

are conceptualized as the result of a reciprocal interaction between the schoolchild and the ma

jor social systems in which he or she is embedded-family, peers, school, and the neighboring

community (Henggeler & Cunningham, 2006). Assessment helps pinpoint the characteristics

3Families and school personnel may agree on the child's problem (e.g., a pervasive developmental delay), particularly if their cultural norms are similar. In other cases, they may disagree; the school may perceive a behavioral problem (e.g., hyperactivity) that the family does not agree is problematic, or the family may report a child's behavior as trou blesome (interrupting others when they are speaking) that the school does not find a particular bother. Families and teachers may misperceive each other's intentions and goals because of cultural differences (Rotheram, 1989).

SYSTEMS THEORY AND SYSTEMIC THINKING

of the schoolchild's ecology (called "fit factors") that are contributing to the maintenance of

the problem behavior. How much of the school problem is associated with characteristics of

the child (low motivation, learning disability, etc.), the family (ineffective monitoring, parental

problems interfering with effective parenting), peers (drug use, support for truancy), the school

(poor classroom-management practices), the school-family link (low trust of each other), and

the community (criminal subculture that does not value academic success)? Identified strengths,

discovered during the assessment, are applied in the subsequent interventions.

The EcoFIT is another family-school model with strong research support. It is family

centered, assessment driven, addresses social interactions that encompass child problems,

focuses on parents' motivation to change, operates within a health maintenance framework,

and is based on a developmental-ecological model that includes culture and context in service

delivery (Dishion & Stormshak, 2009). This program has schools establish a family resource

center and make home visits to parents to engage them. One key goal is facilitation of family

utilization of community resources that fit the family's need.

Family-Healthcare Interventions

Another example of interlocking systems is the relationship between families and healthcare.

A systemic healthcare framework recognizes the dynamic interactions involved in individual

health-illness, including relationships between a patient and significant others-such as family

members, friends, and others-and the relationship with a healthcare team of physicians, spe

cialists, family therapists, and other healthcare professionals (McDaniel, Doherty, & Hepworth,

2014). Medical family therapy, an integrated approach to care, aims at increasing self-efficacy and

meaningful communication for everyone involved (patient, significant others, and the healthcare

team). Family therapists may conduct brief interventions, crisis counseling, or intensive therapy for

patients and families while also facilitating healthcare team interaction with patients and families,

coaching physicians, providing in-service education for professionals and health programs for pa

tients and families, and conducting program evaluation (McDaniel, Doherty, & Hepworth, 2014).

Family Interventions with Other Populations

Substance abuse and chronic mental illness. These two conditions often involve the intersection

of family therapy and community agencies. Models have been developed that help families

identify resources and support. For example, several systemic approaches to the treatment of

substance abuse have been created that demonstrate evidence for effectiveness, including be

havioral couples therapy (O'Farrell & Schein, 2011), brief strategic family therapy (Robbins,

Szapocznik, & Horigan, 2009), functional family therapy (Sexton, 2011), multidimensional

family therapy (Liddle, 2009), and multisystemic therapy (Henggeler, Sheldow, & Lee, 2009).

Stanton (2009) demonstrates how systemic understandings of motivational interviewing, self

help programs, and relapse prevention may be integrated into family treatment.

Marsh and Lefley (2009) describe the social service agency deficits that create signifi

cant stressors for the families of those with serious mental illness. There are several types of

family-focused treatment, including family psychoeducation, family education, family con

sultation, family support and advocacy groups, and family therapy. Families need their own

treatment, at times, for the challenges they face and help in serving the many roles they must

101

102 CHAPTER 4

fulfill around the treatment of the family member with serious mental illness. They suggest

that recovery may be defined as "the process in which people are able to live, work, learn, and

participate in their communities" (p. 743) and note that it is possible today.

Systemic Problems. Finally, in some cases, it is incumbent upon family therapists to look

beyond the dysfunctional family itself to a broader view of social systems around the family.

Otherwise, therapists arrive at "solutions" for the family that, no matter how therapeutically

elegant, are short sighted because they fail to consider cultural, political, and institutional

issues. For instance, the power of organizations in which families are embedded must be

understood, lest the frequent inflexibility of agencies such as psychiatric hospitals, isolating

patients from their families, undo any therapeutic gain. In the case of long-standing poverty,

the relationship with public agencies may extend over generations. Problems may develop

between such families and the agencies as well as between different public agencies. In the case

of wife battering presented in Box 4.6, confusion results from conflicting perceptions by the

various professionals attempting to help.

Using an Ecomap in Family Assessment and Therapy

A family who had initially sought the aid of a family therapist for their son Billy's aggressive behavior re vealed over the course of therapy that Jim, the fa ther, had been physically abusive to his wife, Cathy. Cathy also disclosed to the therapist that when she was a child and young adolescent, her father had sexually abused her. The referring family physician knew only of the problems with Billy. By the time they consulted a family therapist, the Lee family had become involved with five larger systems: Jim in a local hospital group for men who batter their wives; Cathy in a program for women who have ex perienced sexual abuse; Jim and Cathy together in a church counseling program for family violence; Cathy in a women's shelter counseling group; and the entire family in family therapy.

When the family therapist invited the various participants to meet together and coordinate their efforts, differences in approach and funda mental beliefs among the various helpers turned out to be significant . For example, while Jim's group sought the causes of violence within him and from his past experiences, urging a long term group program, the family therapist took a systemic approach, recommended a short-term

approach, and attempted to locate the violence in the context of the couple's ongoing interactions. By contrast, Cathy felt the women's shelter coun selors blamed Jim exclusively and thought he was the only one who needed treatment .

Because competing definitions of the prob lem and approaches to a solution surfaced in this macrosystem, a consultant was needed to help untangle the family member-helper coalitions that had developed. Conflict between specialized "helping" systems may, in many cases such as this one, contribute to or enlarge the very problems the helping systems were created to fix or alle

viate (Imber-Black, Roberts, & Whiting, 2003). In this case, the consultant highlighted their differ ences to the helpers, pointing out the impact of these differences on how the couple interacted. Stressing the macrosystem level, she designed an intervention that made the boundaries between helpers clearer and less rigid. At the same time, couple-helper boundaries were clarified and thus became less diffuse and confusing. The restructur ing allowed the couple themselves to determine the amount and source of help they needed oti a weekly basis .

SYSTEMS THEORY AND SYSTEMIC THINKING 103

4 Systemic Thinking in Family Therapy Practice Systemic thinking is the foundation for the practice of family therapy. It informs essential

features of the therapeutic process, such as the creation and maintenance of the therapeu

tic alliance, family assessment and case conceptualization, the understanding of change in

family therapy, and the selection and delivery of effective interventions (Stanton & Welsh,

2012). For example, family therapy requires the therapist to establish an alliance with mul

tiple individuals at once (Friedlander, Escudero, & Heatherington, 2006). This requires the

therapist to recognize and manage how multiple individuals interact and are impacted by

the evolving alliance, since each person may have different opinions of her or his alliance

with the therapist, as well as perceptions of the therapeutic alliance with other family mem

bers (Knobloch-Fedders, Pinsof, & Mann, 2007). The therapist must see the system and

comprehend complexity to manage this aspect of therapy. Box 4.7 Thinking Like a Clinician

explains important systemic thinking habits.

Systemic Thinking Habits

Understanding key systemic principles is import ant, but it is more important that family thera pists learn to habitually think systemically. This is a comprehensive cognitive reorientation to chal lenge nonsystemic mental models, use systemic paradigms to organize thinking, and operation alize_ systemic concepts into therapeutic problem solving (Stanton & Welsh, 2012). This moves sys tems theory away from abstract theory or reified knowledge or reductionistic techniques to focus on problem origination, problem continuation, and change in treatment (Stanton & Welsh, 2011). Our list of 10 systemic thinking habits is adapted from Sweeney (n.d.), Stanton and Welsh (2012), and Benson (2007).

Challenge men tal models. Family therapists adopt ways of thinking that extend beyond the limitation of common patterns in Western society (typically, the Cartesian model espoused by Des cartes in 1637 that divides problems into parts) to embrace other ways of thinking, such as more ho listic, systemic, metaphorical, and narrative think ing. They choose the mode most suited to the problem at hand.

See the system. Family therapists who see the system shift their focus from the parts alone to

the whole with all its parts. They see networks of relationship and recognize feedback processes as they listen to clients. Many adopt a framework, like the ecomap or the individual-interpersonal macrosystemic diagram, to help them see all the reciprocal elements of the system.

Comprehend complexity. Family therapists avoid the temptation to simplify their understanding of a problem or the means to resolve that prob lem. Simple explanations give way to inclusion of multiple factors and contextual influences. For ex ample, the unemployment of a family member in therapy may not be assumed to be solely an issue of personal motivation; it may include individual issues, but they may be joined by interpersonal factors (such as schedule limitations due to child care), community issues (like the closing of a ma jor local employer), or even the global economy (recession or depression). Complexity recognizes that families may function at the edge of chaos as they experience dynamic change, and treatment must include the relevant influences.

Recognize reciprocity. Family therapists avoid linear thinking (single cause-effect pathways) in understanding complex problems and recog nize causal webs (Plate, 2010). Reciprocity is the

(Continued)

104 CHAPTER 4

concurrent and mutually interdependent interface between individuals (Capra, 2002). For example, parent-child relations are interactive, not linear from parent to child; this is why different children have very different experiences with the same par ent. Family therapists need to learn to recognize and "map" reciprocity because it does not come naturally (Sweeney & Sterman, 2007).

Conceptualize change. Family therapists under stand that systems can destabilize when faced with challenges and the existing family struc tures and patterns no longer work effectively. Rather than return them to their prior state, con temporary family therapy seeks to facilitate posi tive self-reorganization by looking for "leverage points"-the "places in the system where a small change could lead to a large shift in behavior" (Meadows, 2008, p. 145).

Observe patterns and trends. Family therapists know how to identify the underlying commonali ties that occur as patterns of interaction and be havior between family members. These are called homologies, and we must not be deceived by the "cover story" of surface features and miss the un derlying processes (Sweeney & Sterman, 2007). For example, a couple may focus on sexual prob lems or financial disagreements, but the therapist will note the pattern of interaction that cuts across both (such as power dynamics or personality interplay).

Consider unintended consequences. Family ther apists recognize that the variety of factors that in teract in complex systems may result in unintended consequences when trying to solve problems. Such awareness can help the therapist and family

consider the variables and recognize potential un intended outcomes, discussing options to max imize the best result. Therapy that only focuses on solving a single problem without considering long-term consequences may result in what Senge (2006) calls "fixes that fail" because they do not last or result in other problems (p. 399).

Embrace ambiguity. Family therapists develop appreciation for ambiguity because they learn that contemporary views of systems understand they are not entirely predictable and absolute because of multideterminancy (Beitel, Ferrer, & Cecero, 2004). Constructivist or narrative approaches un derstand that the story may evolve or change as families try to make sense of their experience. Ambiguity allows for novel experiences and change.

Shift perspective. Family therapists reject the Cartesian notion of objective external observa tion to determine reality. They value different types of analysis (subjective as well as objective; Capra, 2002) and multiple perspectives (e.g., considering equally the perspectives of all fam ily members involved in therapy; Pinsof & Cham bers, 2009). Family therapists know how to take the perspective of each person and demon strate accurate empathy for each (Stanton & Welsh, 2012).

Factor in time. Family therapists understand that systems demonstrate past, present, and future dy namic influences concurrently (Capra, 2002). For this reason, they consider at least three genera tions of the family when addressing current pre senting issues, often using a genogram to do so (McGoldrick, Gerson, & Petry, 2008).

Assessment should also reflect systemic thinking. As illustrated in Figure 4.3, ecomaps are

useful paper-and-pencil assessment devices for diagramming a family's connection to larger

social systems. Frequently used by social workers and others to map out and coordinate the

helping services a family is receiving (Compton, Calaway, & Cournoyer, 2005), an ecomap

is a drawing of the family's social environment, illustrating its simultaneous connections to

different agencies. A family receiving child welfare services, for example, might be in con

tact with the court system, medical services, church, neighbors, police, attorneys, the school

SYSTEMS THEORY AND SYSTEMIC THINKING

"You do it on your own."

Violence contextual

Maintain marital bond

Sexually abusive

�

Married 10 years

blame- •---

Physically ___ :-::-_::.-,..~.:::-.:.:::_:: __ _ abusive

"Aggressive"

Key-direction of interaction

Violence contextual

"Going for outside help stirs up trouble:'

Conflicting perceptions and interactions in the Lee family case in Box 4.6

Source: Imber-Black (1988), p. 117

system, foster parents, and various childcare agencies; the ecomap offers a "snapshot" of these

relationships at any particular time.

These interlocking programs, if not coordinated, may at times work at cross purposes

and result in conflict between specialized helping systems. Ecomaps help organize and clarify

both the stresses and supports inherent in the family's environment. Ecomaps enable the con

sultant to call upon as many people as possible in the family's network to coordinate the most

workable solutions to the family's current predicament (Gilgun, 2005).

Critiques of Systems Theory Several challenges have emerged regarding systems theory. At the outset, however, we need

to note that many of "these critiques may reflect more on older ideas related to systems that

distorted, reified, or simplified dynamic systems ideas in a manner that eliminated the the

oretical space to modify and adapt the ideas to the reality of the lived experience" because

105

106 CHAPTER 4

"these [older] models were based more on cybernetic ideas and inanimate systems than on

dynamic living systems. Contemporary variations on systemic thinking move away from

that rigidity" (Stanton & Welsh, 2011, p. 22). Contemporary systems theory and thinking

are much more complex than the deterministic circular causality models of the past that

were based on a positivist understanding of behavior. Those models emphasized homeo

stasis and avoidance of change; new models emphasize dynamic equilibrium and constant

change with comparisons to chaos theory (Wadsworth, 2008). Old models were often more

mechanistic and positivistic; new models eschew nonliving ideas about systems and em

brace perspective and narrative interpretation (Capra, 2002). Lebow (2005) notes increased

inclusion of individual problems within systemic context in new theoretical models and

more complex and variable interactive causal influences among components of a system.

Simply stated, contemporary dynamic systems theory moved away from some of the

elements that caused criticism in the past.

For instance, one critique came from feminist family therapists, who insisted that power

within families is typically asymmetrical. They argued that within society at large, different

people have differing degrees of power in altering an undesirable situation. Luepnitz (1988)

suggested that cyberneticists and general system theorists fail to take power differentials

(particularly between men and women) into account in their homeostatic formulations.

While the less powerful may influence the more powerful, the difference between influence

and legitimate power is often substantial. A related argument focused on intimate partner

violence and the "standard systemic couples therapy approach to violence" that appeared

to blame the victim by its emphasis on reciprocal interaction (Goldner, 1998, p. 264).

Goldner, a feminist leader in the Gender and Violence Project at the Ackerman Institute,

stated, "To argue that partners mutually participate in an interactional process does not

mean they are mutually responsible for it, or for its catastrophic outcome" (Goldner, 1998,

p. 264). These arguments make sense, but they are based on old ideas no longer held by

most systems thinkers (Lebow, 2005).

Finally, some postmodernists have been particularly rejecting of the systems metaphor.

They contend that what we believe to be reality is inevitably subjective and that rather than

discover objective facts, we can offer only subjective perceptions of events (Becvar, 2003).

They critique therapists who believe they can objectively and impartially diagnose families

or that they can identify flaws in a family's structure in concrete fashion. Some criticize

systems theorists for reifying concepts-as though families actually possess constructs

(rules, feedback, homeostasis) rather than simply using systems constructs as linguis

tic tools with which to describe and understand families. On the other hand, it might be

noted that contemporary systems models include communication and cognition as part of

system functioning; "The organizing activity of living systems, at all levels of life, is mental

activity" (Capra, 2002, p. 34). Constructivist and narrative models of psychotherapy need

not be understood as antithetical to dynamic, living systems ideas that embrace human

agency in development, socially constructing reality through interaction with one's entire

systemic surround (Stanton, 2009). Living systems models resist reduction to reiflcation or

techniques, answering the critique.

SYSTEMS THEORY AND SYSTEMIC THINKING 107

SUMMARY

Systems theory provides the theoretical underpin

nings for much of current family therapy theory and

practice. It is important for family therapists to see

the system, using an organizing framework or par

adigm to include the relevant systemic factors in

treatment.

The concepts of organization and wholeness

emphasize that a system operates as an organized

whole that is greater than the sum of its parts and

that such a system cannot be adequately understood

if broken down into its component parts. A family

represents a complex relationship system in which

causality is complex and multidimensional. Family

rules, for the most part unstated but understood by

family members, help stabilize and regulate family

functioning. Change is common in families as they

face life cycle adjustments and continue across time.

When changes are called for, negative as well as pos

itive feedback loops may facilitate change and help

restore equilibrium, in the latter case by promoting

discontinuity and the achievement of homeostasis at

a new level.