What are the differences between Systems Theory and Cause-and-Effect Thinking in Therapy?
James* came into therapy after being arrested for driving under the influence of alcohol. His M.D. told him he’s probably an alcoholic.
Celia wants help due to conflict with her husband, Tomas.
Art is in therapy because some days he’s too depressed to get out of bed.
Marjorie is upset that she can’t stop thinking about her ex-husband, despite being divorced from him for over six years.
The Smith’s scheduled an appointment to discuss their oldest daughter. Lorena, 22, is still living at home and refuses to get a job or attend college. Years ago she was diagnosed with Bipolar Disorder.
Five different reasons for being in therapy. Or are they?
According to Murray Bowen: “When anxiety increases and remains chronic for a certain period, the organism develops tension, either within itself or in the relationship system, and the tension results in symptoms or dysfunction or sickness. The tension may result in physiological symptoms or physical illness, in emotional dysfunction, in social illness characterized by impulsiveness or withdrawal, or by social misbehavior.” Family Therapy in Clinical Practice, p. 361.
Traditional therapy espouses cause-and-effect thinking. Examples are:
James is an alcoholic because his father was an alcoholic. He might even have a (as yet undiscovered) genetic predisposition to alcoholism.
Celia has conflict with her husband because she had a mother who did not meet her emotional needs. Therefore, she is very needy with her husband.
Art is depressed because he has Major Depressive Disorder, which is caused by irrational thoughts he keeps having (“I’m a loser”, “Everything’s Hopeless”, etc.)
Marjorie can’t stop thinking about her ex-husband because she has abandonment issues caused by her own parents’ divorce when she was eight years-old.
Lorena’s low functioning is caused by her Bipolar Disorder, because there is something wrong with her brain chemistry.
“The (systems oriented) therapist thinks of symptoms in terms of disordered family relationships and of therapy as a way to help the family restore relationships and achieve better communication or a higher level of differentiation.” Murray Bowen, FTCP, p. 188
Systems Theory was developed after years of study of human families. Systems thinking emphasizes what human beings have in common with all forms of life, as well as what sets the human apart; the ability to utilize the intellect to moderate automatic emotional reactivity. Advantages to Systems thinking over individual or traditional approaches include:
- Any motivated family member can come in for therapy to work on the “family problem,” even when it appears as though the problem resides “in” or is “caused by” another family member.
- Problems in the past don’t “cause” dysfunction in the present. Instead, patterns of interaction can get stuck over time and passed down over multiple generations. These patterns can be modified in the present.
- People don’t have to think of themselves as limited by nebulous factors such as bad genetics or brain chemistry. (Is disordered brain chemistry the cause or the effect of the problem? Probably both. Can changes in the family system affect brain chemistry in an individual? A lot isn’t known yet, but the suspected answer is, “yes”.) Even in cases where there is an identified medical or genetic condition (Parkinson’s, M.S., Fragile X Syndrome, etc.) people can work on optimizing quality of life and, ideally, minimizing symptoms.
- There are no good guys and bad guys in family systems. “Symptoms are the manifestation of a distraught family that becomes focused in one individual.” (Murray Bowen, The Origins of Family Psychotherapy) Everyone is doing their part to maintain the problem, and anyone can step up to improve it!
- Therapy is predicated on the guided efforts of an individual to harness the innate adaptive potential of the individual bringing it under control of the intellect to some degree (paraphrased from Catherine Rakow). What this means is that any person can choose to work on self, in good times or bad, leading to personal growth, improved family relationships, and, ideally, a decrease in symptoms in the family.
*None of the people named here represent actual individuals