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Systems Practice, Vol. 10, No.

2, 1997

Systemic Therapy: An Overview

Simanta Roy-Chowdhury l
Received September 2, 1994; revised January 20, 1995
An outline is given of the historical development of systems ideas within the field of
therapy. A history of systemic therapy is provided, from the early days of the Mental
Research Institute to recent influences upon therapeutic practice. Key applications of
theory are described and current areas of debate are highlighted.
KEY WORDS: systemic therapy; family systems therapy; Milan group; Mental
Research Institute (MRI); constructivism; social constmctionism.

In the 1950s the predominant models within psychiatry for psychotherapeutic
practice were based upon psychoanalysis. The psychopathology of the individual
was taken as the focus for assessment and treatment. The early pioneers of the
systemic family therapy field departed from the prevailing orthadoxy in shifting
the focus of analysis from the individual to the family. At that time there were
some attempts at translating principles and practice from individual psychoanalysis to the realm of work with families (e.g., Ackerman, 1958), with limited
success. There began a search for alternative models that might define and guide
clinical practice. The break with psychiatric thinking was given impetus by the
diversity of professional and academic backgrounds of those who took up this
In 1958, Gregory Bateson, an anthropologist, together with John Weakland, Don Jackson, and Jay Haley, was conducting research in Palo Alto, California, on the communication patterns of families in which one member had
been diagnosed as schizophrenic. The following year, Don Jackson established
the Mental Research Institute (MRI) for research and treatment of families. A
year later Nathen Ackerman, a child psychiatrist, founded the Family Therapy
Institute in New York. These researchers and clinicians shared an interest in the
~The Psychology Department, Mental Health Unit, Chase Farm Hospital, The Ridgeway, Enfield,
Middlesex EN2 8JL, U.K.
0894-9859/97/04004)127512.50/0 9 1997PlenumPublishingCorporation



applications of communication and systems theories, and mathematical and

cybernetic models, to families.
Watzlawick et al. (1967) have elegantly summarized much of this early
work. The principles and procedures outlined in their book are predicated upon
Bateson's belief that individuals can be understood only within their ecological
context. Couples and families form self-regulating systems in which the behavior
of each person affects and is affected by the behavior of others. All behavior
within a relational context has a communicational value, the meaning of which
can be understood only within that context. Ideas of linear cause and effect are
misplaced as each part of the system interacts with others in recursive loops of
communication. When one member of a family becomes "symptomatic," this
too can be understood as a communication which has particular meaning within
the system. The person who develops a symptom may be seen as providing
stability, most particularly at a time of change and transition.
The MRI group drew heavily upon metaphors from game theory, often
describing patterns of communication as moves and maneuvers in a game aimed
at asserting dominance and control. "Pathological" communication was often
paradoxical in nature, simultaneously providing contradictions between different
levels. There might be inconsistencies between messages delivered at the digital
and linguistic level and those at the analogic and paralinguistic level. Hence
treatment of"symptomatic families" was through the use of countermaneuvers,
including the use of paradox, where the therapist would also make use of mixed
messages in order to achieve change (this therapeutic strategy is elaborated upon
below). Before looking at the ways in which these ideas have been taken up
and modified over the years by systemic therapy theorists, it is worth noting
briefly connections with strategic and structural schools.
Strategic family therapy is the most direct descendant of the ideas and
methods for working with families that emerged from the MRI, with various
modifications called "brief" and "solution-focused" therapy (de Shazer, 1987).
Within this school the therapist continues to apply strategic maneuvers, including
the use of paradox, in seeking to find ways of breaking problem-maintaining
transactional patterns. The therapy is usually focused upon the present, the
development and enlargement of "solutions," and is of relatively short duration.
In 1967 Jay Haley left the MRI and joined Salvador Minuchin at the Philadelphia Child Guidance Center. Haley brought his interest in power and hierarchy to Minuchin's developing structural model of family therapy. Minuchin
and his collaborators viewed problems as arising due to "dysfunctional" family
structures with inadequate or inappropriate boundaries and hierarchies between
individuals and subsystems (Minuchin, 1974). A normative view was taken of
family functioning, with the therapist highly active in blocking and reshaping
transactional patterns.

Systemic Therapy: An Overview


Returning now to the principal narrative, the development of the systemic

model of therapy, we must make the journey from the United States to Italy for
the next chapter of the story. In 1967, Mara Selvini-Palazzoli founded the Milan
Center for the Study of the Family. She formed a study group with three other
psychoanalysts, Prata, Boscolo, and Cecchin, which met once a week to see
and talk about families and to read and discuss the work of writers in this
emerging field of therapy. They were heavily influenced by the ideas coming
out of Palo Alto and indeed were visited on a number of occasions by Paul
Their book, Paradox and Counterparadox, published in 1978, developed
and fleshed out a number of themes in their work to be found in an earlier paper
(1974). Taking as their starting point the premise that a family is a rule-governed
system regulated by feedback from transactional patterns between its members,
the Milan group detailed a number of therapeutic maneuvers designed to impact
upon the "family game." Central to these techniques were the use of "counterparadoxical interventions" designed to place the family in a bind which can
create change by transforming transactional patterns, thus removing the homeostatic function of the " s y m p t o m . " An example of this is that, within a system
where there is a strong belief that professionals outside the family invariably
give bad and incorrect advice, the prescription of no change by the therapist
creates a bind. This may lead either to a direct change or to a change in the
belief. In order to create a context for the delivery of such a message, the use
of positive connotation was added to the therapeutic repertoire. All members of
a family, including the symptomatic member, would be praised for their part in
maintaining the status quo before the advice might be given for no change to
occur, thus conferring equal validity to polarized views often held by family
members. Ritualized prescriptions were given as a means of breaking into and
highlighting problematic elements of transactional patterns. A particular sequence
of behaviors to be followed at arbitrarily selected times might be prescribed; for
example, the disciplining of a child by one parent on odd-numbered days and
by the other parent on even-numbered days.
The next major shift in the thinking of the Milan group was heralded by
the publication of their paper, "Hypothesising-Circularity-Neutrality: Three
Guidelines for the Conductor of the Session" (Selvini-Palazzoli et al., 1980),
following a period of reanalysis of Bateson's ideas. With this paper the authors
marked out a territory which was distinct from the strategic methods of the MRI
and brought together a coherent framework for a therapy based entirely upon
systemic principles.
The therapist and his or her team would meet before seeing a family and
draw up a systemic hypothesis from the referral information. The hypothesis
sought to link together information concerning relationships to provide an expla-



nation for the problem within the context of the family system, its presentation
at that particular time and in that particular manner. Ideas might also be generated concerning the relationship to the referrer (Selvini-Palazzoli et al., 1980).
The hypothesis guides the interviewer, enabling him or her to maintain a
systemic reality which is " m e t a " to the linear reality of the family. The therapist
asks questions concerning relationships and interrelatedness. The authors give
details of a number of categories of questions which aim to develop a systemic
map of the connections between family members and, hence, make a difference
to their linear thinking. This map may or may not substantiate the hypothesis,
and it may be that the therapist must revise his or her hypothesis in order better
to accommodate information generated by the interview. Questions are asked
roughly equally of all family members, giving the impression of impartiality or
neutrality. A break would be taken by the therapist before delivering an intervention which would seek to bring together thinking concerning the family
system and might include positive connotation, a reframing of the problem, and
a prescribed ritual. The team would have a postsession discussion.
Following the elucidation of principles of their systemic model for therapy,
the four coworkers separated in 1980. Selvini-Palozzoli and Prata moved more
into the area of research, seeking to control and manipulate therapy variables
within an empiricist tradition. Their work has not been as influential or widely
read in the field as that of Boscolo and Cecchin, who devoted their energies to
teaching and further developing their ideas.
The principles of therapy developed by the Milan group were incorporated
into the working practices of therapists around the world. Inevitably the ideas,
when translated into different settings by professionals in various fields, stimulated debate and dissent. In keeping with the theoretical diversity and eclecticism of earlier formulations, much of the impetus for change came from areas
of discourse not normally occupied by mental health practitioners. Of particular
significance was the work of two Chilean biologists, Humberto Maturana and
Francisco Varela.
2. T H E M O V E T O C O N S T R U C T I V I S M
Maturana and Varela's (1987) neurophysiological experimentation led them
to the conclusion that what is seen by an organism is determined primarily by
its internal neurophysiological organization rather than external stimuli. Within
this view an organism is an autopoetic system which may engage in "structural
coupling" with other organisms, but for which the nature of the information
derived from such an interaction is dependent less upon the nature of the stimulus
than upon the internal organization of the organism itself. Translated into human
interaction, this would mean that one person is unable to predetermine the impact
that his or her communication will have upon another person; instructive inter-

Systemic Therapy: An Overview


action which seeks to create a particular understanding or elicit a particular

response is not possible.
During the early 1980s these ideas gained currency among systemic family
therapists. In conferences held in 1983 and 1984 therapists came together with
thinkers such as Maturana and Varela and grappled with the implications of
these ideas for existing theory and practice. The debate was joined by Brad
Keeney (1983) with the publication of his influential book Aesthetics of Change.
There began to emerge a consensus, or to use the jargon of the time, a "consensual domain," and a theoretical framework emerged which came to be known
as second-order cybernetics or constructivism (yon Glaserfield, 1984).
In laying out before the reader some of the strands of thought that have
contributed to this position, I would like to emphasize its nonunitary nature. I
see constructivism in systemic therapy as a loose affiliation of ideas concerning
theory, metatheory, and practice, which lend themselves to a synthesis with
preexisting theory and practice. It is an expansion, an enlargement, of what has
gone before, and not a coherent new template for clinical practice.
A central tenet of the constructivist position is that it is impossible to
determine objective truths in therapy. One works with subjective versions of
reality, held by both therapist and therapee, in order to create a consensual
domain within which therapeutic talk can take place. An implication of this
perspective is a democratization of the various views held by participants in the
therapy process. The therapist is unable to occupy a position " m e t a " to the
family and, indeed, is a part of the therapeutic system. This shift in thinking
has been described as a move from the family as an observed system to an
observing system, in which the therapist is a participant-observer.
As such, the therapist and, if present, therapy team are interested in not
just the influence of the therapist upon clients, but also the influence that clients
exert upon the therapist. A new term entered the systemic therapy vocabulary-to organize--and the question of how the therapist's thinking and behavior was
being organized by family members began to he asked. The language used to
describe therapy changed and became more egalitarian, less hierarchical. The
therapist was dislodged from a position of detached impartial observer to participant-contributor, albeit one who brought particular knowledge and experience to bear.
Maturana's idea of the impossibility of instructive interaction, coupled with
Bateson's (1972) belief in the epistemological error involved in one part of a
system seeking to control another, has contributed to the creation of a therapy
that is less strategic. The wish to create change may remain, but there is less
conscious purpose in endeavoring to bring about particular changes through the
application of particular techniques. Cause-and-effect analyses, that procedure
A brought about change B, were abandoned in favor of a model of change that
was more haphazard and unpredictable. The job of the therapist became the



creation of a context for change within a therapeutic conversation, but not the
creation of change along predetermined coordinates.
The nature of change itself also began to shift. Cognitive psychology had
provided some of the impetus for the move toward constructivism, and accordingly, views of what it is that changes in therapy moved from an emphasis upon
behaviors to an increased interest in beliefs, ideas, and values. Indeed, Hoffman
(1988) saw this as extending to an interest in " a shared unconscious . . .
(s)ymbols, dreams, stories, trance" (p. 124). This change of emphasis has had
two important consequences which have been taken up by writers in the field:
(i) the development of a view of systems not confined to patterns of interactions,
but including linguistic and meaning systems, and (ii) a resurgence of interest
in individual narratives within systems.
In 1991, Leppington noted the remark made by certain commentators in
the field of systemic therapy that " i f you take a tea break you're likely to miss
two paradigm shifts in the literature." Certainly there has been a good deal of
lively debate over theory and practice in the decade since a constructivist position
for therapy began to be advocated. Here, I want to indicate some of the positions
taken within this debate, which seem to me to have moved forward thinking in
the field.
The repercussions of an observing systems approach to therapy have been
considerable, and have led to suggested modifications of many of the central
principles developed in Milan. Therapist neutrality has come to be seen as
neither desirable in theory nor achievable in practice. This idea has been reframed
(or perhaps clarified) in terms of multiple-engagement, of multipartiality, and
influentially, by Cecchin (1987), of curiosity. A stance of curiosity allows the
therapist to remain engaged with, and not detached from, clients, while drawing
from them interconnecting patterns of multiple descriptions.
The inhibiting effects of holding a predetermined hypothesis have been
discussed, and such hypothesizing has been abandoned by some (e.g., Anderson, 1987) in an attempt to stay more connected to feedback from clients and
to relinquish agendas set by therapists. The need for end-of-session interventions
has been questioned: a more flexible engagement with clients has been advocated, where interventive engagements are made throughout the session and
included within the questioning (Tomm, 1987).
Tom Anderson (1987) and his colleagues in Norway have been at the
forefront of innovative developments in practice that flow from a constructivist
stance. They pioneered the idea of the reflecting team, which involves team
discussions that take place in front of family members and the therapist. This
practice completes a loop between observers and observed, positions the therapist with the family within the therapy system, and at the same time breaks
down barriers of secrecy and hierarchy between therapist and therapee.
The principal metaphors used to describe systemic work with families had

Systemic Therapy: An Overview


previously been derived from machinery and cybernetics, and hence patterns of
interactions between family members were construed within physicalistic models.
These explanatory frameworks began to be seen as too objectivist, implying as
they do an "out there" pathology in need of correction (a sort of recalibration
of parts of the system which have become faulty), to be in tune with secondorder sensibilities.
The work of Harlene Anderson and Harold Goolishian (Anderson et al.,
1986; Anderson and Goolishian, 1988) has been important in bringing metaphors
derived from linguistics to bear upon thinking in the field. Their view of systems
is revolutionary in that it is predicated not upon structures within social systems,
but upon systems of language and communication within which participants
seek to construct meanings and an understanding of themselves and others.
Within this context the therapy system is a problem-organizing, problem-dissolving system, where subjective and intersubjective meanings are orchestrated
by the therapist. If analyzed in this way, the system ceases to be structurally
bound by its participants, but is inclusive of all descriptions and explanations
that have been generated in talking about the problems. The therapist creates
change through bringing forth fresh narratives within which the problems are
no longer embedded.
There is another change worthy of note that came with the introduction of
constructivist ideas. Earlier models of systemic therapy have been critiqued in
terms of their dismissal of the "felt experience" of those who seek help, in
favor of an exploration of transactional patterns between people (Treacher, 1992).
The theoretical journey from mechanical to linguistic systems has been accompanied by a fresh interest in subjective experience or personal narratives. Stephen
Frosh (1992) has described this in terms of offering a language with which to
plot the internal coordinates of change for individuals within a linguistic system.
3. F R O M C O N S T R U C T I V I S M T O S O C I A L C O N S T R U C T I O N I S M
In recent years there has been a shift in the terms of the discourse, from
constructivism to social constructionism. This shift has been only partial and
incomplete, with some writers continuing to refer to constructivist ideas, but
others citing influences from social constructionism, and still others using both
sets of ideas together or even interchangeably (e.g., Real, 1990). Possibly this
has been due to certain overt similarities between models of therapy drawing
upon constructivist and social constructionist thinking, notably with regard to a
belief in the centrality of language to the therapeutic endeavor and a disavowal
of a single objective reality. However, there are important differences. Social
constructionism sits within social psychology as a system of thought that locates
the individual, and groups of individuals (e.g., families), as formed from and
by a myriad of societal contexts, _with norms and values understood and defined



through linguistic signifiers, It is a view of the person in a state of flux from

time to time and place to place.
Social constructionist discourses have offered systemic therapy an escape
route from the "anything g o e s , " postmodern relativity which might conceivably
lie at the end of the constructivist road. They permit the evolution of a therapy
which can take account of the diverse influences upon personal and interpersonal
narratives, be they historical, social, cultural, political, biological, or genderrelated. The stories told in therapy can be contextualized within the many overlapping grand narratives within which our lives are embedded and have acquired
4. C O N C L U S I O N
My own view is that the point currently reached by systemic therapy theory
and practice is one of considerable heuristic utility. A social constructionist
discourse, rooted as it is within a social psychology tradition, provides a theoretical base upon which to build a therapy which allows individuals, couples,
and families to make sense of their lives, and of the dis-ease which brings them
to therapy. This therapy, which is just beginning to be described [notably
McNamee and Gergen's (1992) excellent volume of papers] provides practioners
with a narrative with which to address those who criticize the process of therapy
for its arrogance and potential for abuse (e.g., Masson, 1990; Treacher, 1992),
its eurocentricism (e.g., Boyd-Franklin, 1984), and its lack o f gender sensitivity
(e.g., Goldner, 1985; Ussher, 1994). Social psychology also provides frameworks for meaningful research designs which have hitherto been noticeable by
their absence within the field of systemic therapy. I very much look forward to
future developments in an area of therapeutic endeavor where continual flux has
been the norm.
Anderson, T. (1987). The reflecting team. Dialogue and meta-dialogue in clinical work. Family
Process 26, 370-379.
Anderson, H., and Goolishian, H. (1988). A view of human systems as linguistic systems: Some
preliminary band evolving ideas about the implications for clinical theory. Family Process 27,
Anderson, H., Goolishian, H., and Windermand, L. (1987). Problem determined systems: Toward
transformation in family therapy. J. Strat. Syst. Ther. 5, 1-13.
Bateson, G. (1973). Steps to an Ecology of Mind, Paladin, St. Albans.
Cecchio, G. (1987). Hypothesising, circularity and neutrality revisited: An invitation to curiousity.
Family Process 26, 405-413.
de Shazer, S. (1987). Brief therapy: focused solution development. Family Process 25, 207-222.
Fmsh, S. (1991). The semantics of therapeutic change. J. Family Ther. 13, 171-186.
Goldner, V. (1985). Feminism and family therapy. Family Process 24, 31-47.
Hoffman, L. (1988). A constructivist position for family therapy. Irish J. Psychol. 9, 110-129.

Systemic Therapy: An Overview


Keeney, B. (1983). Aesthetics of Change, Guilford, New York.

Leppington, R. (1991)~ From constructivism to social constructionism and doing critical therapy.
Hum. Syst. 79-103.
Masson, J. (1990). Against Therapy, Collins, London.
Maturana, H., and Varela, F. (1987). The Tree of Knowledge, New Science Library, Boston.
McNamee, S., and Gergen, K. J. (eds.) (1992). Therapy as Social Construction, Sage, London.
Minuchin, S. (1974). Families and Family Therapy, Tavistock, London.
Real, T. (1991). The therapeutic use of self in constructionist/systemic therapy. Family Process 29,
Selviui-Palazzoli, M., Cecchin, G., Prata, G., and Bosco|o, L. (1974). The treatment of children
through brief therapy of their parents. Family Process 13, 429~142.
Selvini-Palazzoli, M., Cecchin, G., Prata, G., and Boscolo, L. (1978). Paradox and Counterparadox, Jason Aronson, New York.
Selvini-Palazzoli, M., Cecchin, G., Prata, G., and Boscolo, L. (1980). Hypothesising-circularityneutrality: Three guidelines for the conductor of the session. Family Process 19, 3-12.
Tomm, K. (1987). Interventive interviewing: Part II. Reflexive questioning as a means to enable
self-healing. Family Process 26, 167-183.
Treacher, A. (1992). Family therapy: Developing a user-friendly approach. Clin. Psychol. Forum
#48, 26-30.
Ussher, J. M. (1994). Women's conundrum: Feminism or therapy? Clin. Psychol. Forum #54, 2-5.
yon Glasertield, (1984). An introduction to radical construcivism In Watzlawick, P. (ed.), The
Invented Reality, Norton, New York.
Watzlawick, P., Beavan, J., and Jackson, D. (1967). Pragmatics of Human Communication, Norton, New York.