What does 'systemic' mean?

How is systemic family therapy different from other kinds of psychotherapy? If you wanted a quick answer, my reply would be in numbers.  Most forms of counselling and psychotherapy are about ONE person. In couple counselling, as in couple mediation, there are TWO people.  But family therapy always has at least THREE people in mind, even when there is only a single person in the room.

Once we get to two we are beginning to see a ‘system’, which is a rather off-putting word for a messy collection of thoughts, feelings and actions. Georgie is upset (‘one’). It is easy to see how Georgie’s thoughts, feelings and actions might distress Jack (‘two’). But it is vital to notice that Jack’s distress triggers thoughts, feelings and actions in his mum (‘three’). Round we go.  And then other people are almost bound to be affected – so we often end up not just with one, two or even three but many.

 We need an example. I obviously can’t use stories about my own clients, so instead I offer you a patchwork made from a range of real experiences. Let’s imagine Jenny. She’s twenty, and depressed. Now let’s give her a younger sister, Shelley. The girls’ father died six years ago and they live with their mum, Sara, who is doing two jobs to make ends meet. I'll cll her Mum for clarity. Mum is extremely worried about Jenny, but ever since her partner died she has seen Shelley as a pillar of strength. Then Shelley announces she is planning to move in with her boyfriend. To Mum this feels like treachery. Their anger and conflict brings them to therapy. Over a few sessions the therapist helps the family realise for the first time the enormous pressure that Shelley is under. For one thing, she knows Mum needs her, but she also hears constantly remembers (or seems to remember) the voice of her dead father  telling her to look after the family. In therapy, Shelley learns that Mum does in fact yearn for her to live her own life. Jenny is able to express a long-standing resentment of her younger sister’s position as ‘head’ of the family. Since Jenny is older, shouldn’t it be her?  As usually happens in families, everyone is trying to do the right thing and family therapy helps them see this. Conflicts reduce as these three people begin to share their hopes and fears and to recognize what they need (or expect) from each other.  You might feel that the word system has dehumanising ring, but it does have its uses. It gives us a picture of the way three or four people in a family like this can set off reactions that are either helpful or destructive.