Some families and couples come back. Some never want to leave. Some want a longer term relationship and some want regular top-ups over a number of years. This is not unhelpful dependency, rather it is a sophisticated reckoning of how autonomy and dependency are different sides (aspects) of inter-personal trust. It is in the longer term that relationships of more deeply felt trust can emerge, and it is in this realm of deeper trust that more is possible. In the short term of course, much can happen in effective systemic couple and family therapy to improve emotional life: for example, family members address and heal unresolved hurt and loss; they develop their capacity for comforting, interactive arousal regulation and self-soothing; they shift from traumatic states of mind to an integration of thought, feeling, action and intention expressed as more coherent communication of wants and needsāthus leading to more effective problem solving; and they develop their capacities for play and reflective curiosity about the states of mind of others. But some of us cannot achieve this level of change in the shorter term. Some of us simply need longer.
In this chapter, I shall explore some of the reasons why relational change might need to occur at a slower pace , the nature of the emotional danger and risks experienced in the therapeutic work , and the resolution of traumatic states of mind. For example, beliefs about oneself and others can become rigid and unyielding in traumatic states . This is because they are reinforced both through a lack of an effective challenge to these beliefs and also, paradoxically, through unsuccessful attempts not to repeat in the future and for the next generation what was experienced as unhelpful in earlier life. The understanding of the rigid application of corrective and replicative scripts in family life will be at the heart of this chapter. Importantly, I have asked two families to contribute their thoughts about their experiences of longer term systemic therapeutic work. Their participation and reflections will underline the need for research into the efficacy and effectiveness of longer term systemic psychotherapy with couples and families.
The Emergence of Systemic Family Therapy
Systemic couple and family therapy emerged and evolved in the second half of the twentieth century in response to therapeutic requests for relational change . Individual therapeutic work, whilst effective, sometimes met insurmountable challenges in the push for individual change, such as the unbalancing of complementary power relationships, resulting in family members striving for a return to a more known and predictable status quo, and/or a relational context that could neither welcome nor support individual change. Unacknowledged fears and anxieties about the impact of individual change on family membersā relationships simply got in the way of desired progress. Thus was systemic therapy bornāin the attempt to work with social and emotional relationships and contexts to support the emergence of change in the face of both non-conscious and conscious fears and anxieties about the meaning and impact of difference. Thus theory developed to explain and formulate in practice why change is feared ; and how oppressive contexts can make desired change difficult e.g. economic and social exclusion, the experience of not belonging, a lack of social support, and so on. Although systemic therapy was positioned in practice as short term in relation to the dominance of psychoanalytic and behavioural approaches at the time, theoretically it always recognised change was a continual, dynamic process mediated by the need for some stability and predictability in relationships i.e. according to how we manage and cope, individually and relationally , with life cycle events, both expected and unexpected, and with our family and social circumstances. This leaves the theoretical door open for the recognition of the challenges of change and for the unspoken, unsayable and often different needs, hopes and desires of family members, and thus why, in some instances, and for some couples and families, overt change might need to take longer.
The Inter-Related Levels of Change
Change is formulated in systemic practice at four levels : (a) behavioural changeāa recognition that repeated sequences of interaction become patterned, habitual and taken-for-granted, such that curiosity is not brought into play about how these patterns developed, or what maintains them; (b) cognitive changeāthe beliefs, ideas, values and meanings held at a group level that underpin family membersā intentions and behaviours with one another; (c) emotional changeāthe history of attachments in the family system, the development of empathic attunement and reflexivity in relationships, safety and protection, comforting and soothing, interactive regulation of arousal, unresolved hurt and loss, and so on and (d) contextual changeāexploring and illuminating the social. economic and political discourses, events and circumstances that can both facilitate and hinder change and development, and working with networks of social support in family, professional and community sytems to promote wellbeing for all. Systemic theory integrates and formulates information across all four levels of change whilst encouraging a āhelicopter viewā of family circumstances with a constant focus on the relationship between content and process in our everyday interactions. The development of a compassionate and non-reactive āobserving positionā in relation to ourselves, our loved ones, and our challenges , dilemmas and resources and opportunities for change is the hallmark of systemic therapy, both in the short and longer term.
Many of the pioneer systemic family therapists were originally psychodynamically or psychoanalytically trained. For example, Minuchin worked in Israel as a child psychotherapist with children of the holocaust before moving to the USA and working to empower young, black, impoverished mothers and their wayward sons. In another example, the early Milan team developed their approach to systemic therapy in the context of slow, regular monthly meetings with their careful, cool work with families with long standing developmental difficulties i.e. eating disorders that emerge in adolescence and continued voraciously into adulthood, and long term experiences with psychosis. In both these examples, there was a recognition that for some families, and for some entrenched difficulties, there was a need to pace the work differently.
Inter-Generational Patterns of Attachment : Looking Up and Down the Generations
How do we look forward into the future? And how do we look into the past? Where do we see influence and legacies of developmental experiences, and on what are our hopes for a preferred future based? When we work therapeutically with parents and children, and couples, of any age, asking questions about the relationship between the respective grandāparentsā relationships can bring out stories about the parentsā childhood experiences and thus prompt a consideration of how their own children experience their relationship as a mother and/or a father. For example, we might ask parents or partners: How would you describe your parentsā relationshipācool, warm, distant, passionate, loyal, any conflicts/conflict resolution and so on? What differences do you see, if any, in the relationships between your motherās parents versus your fatherās parents? In what ways are either of your parentsā relationships similar to your own? The resulting reflections open a discussion of inter-generational corrective and replicative scripts i.e. those practices of care giving and care receiving in close relationships that we intentionally try to repeat, or to change for the next generation as parents in our turn, or for ourselves and our partners. The conversation can then explore these intentions and their perceived impacts and outcomes in family life: for example, What have you tried to make similar or different to either of these relationships? What do you value versus feel critical about in either of your parentsā relationships? However, therein lies a paradoxāwe are often trying to make better an aspect of care giving and care receiving for which we hold no workable mental representation ourselves. If it was not done for us, if we were not comforted and held, for example, we might not know well how to do it, what it feels like and looks like, and so on. It may take time to learnāto develop new neural pathways and behavioural patterns.
We explore the influence of these inter-generational patterns on the parentsā relationship with their own childrenāwe ask questions that invite the parents to consider how their own experiences have consciously or non-consciously influenced and shaped their relationships with their children: How do you see your relationship (mother and father in turn) with your children? How are you different with your children to how your parents were with you? Do you think you are closer or more distant to your children than your parents were with you? What do you hope your children will learn from you for the benefit of their future relationships? As we walk around in the recollections and sense memories that are stimulated in these conversational moments, we can invite partners and family members to listen whilst one is speaking, and/or we can encourage a dialogue. Such conversations can be poignant, and often need to proceed slowly and gently, or they can be touched on in a regular way during the meetings. Either way, we are trying to create safe spaces where family members can order and re-order their experiences, without fear of censure. It is in our constant validation of their intentions to make things better for their relationships and for the next generation that inter-personal trust deepens.
Patterns of Inter-Generational Trauma in Families
The experience of inter-generational trauma in families can lead to rigidity in responding, despite positive intentions to make things better. In the face of relational danger , when the need for safety and protection is high, family members might become emotionally overwhelmed which can lead to chaotic behavioural responding and too much unpredictability in parentsā availability, on the one hand, and on the other hand, it can lead to increasingly escalating and rigid attempts to protect and be safe through the repetition of solutions that do not work. The irony lies in family members knowing that their rigid attempts to control safety and manage fear do not work, yet not knowing what else to do. People can often articulate this dilemma with frustration, distress and despair. At the heart of both these patterns of responding i.e. chaotic and unpredictable attempts to maintain safety, and the rigid application of a ānarrowā solution, lies the intention to make things better and to do things better than in previous generations. And herein lies the rub, unprocessed trauma experiences and responding constrain the integration of experience and the development of reflective functioning in the context of those experiences. Family members are like pioneers in these moments. They do not hold mental...