Systems Theory in Action
Introduction to Systems Thinking
Rather than making me choose between behavioral or psychodynamic theories, systems theory offered a bridge between these perspectives and examined how they could work together.
[…]one of the dangers of emphasizing the problems of an individual is that this emphasis can minimize the healing potential of relationships.
What Is Systems Theory?
[…]systems theory can be defined as a set of unifying principles about the organization and functioning of systems. Systems are defined as meaningful wholes that are maintained by the interaction of their parts.
One of my favorite books in graduate school, Thomas Kuhn's The Structure of Scientific Revolutions (1970), outlined the way that scientific knowledge grows, changes, and is discarded over time. He posited that science is guided by a dominant paradigm, which he called "normal science," and noted that scientific evidence tended to be accepted if it fit with current normal science and to be marginalized or ignored if it did not, at least until there were sufficient inconsistent data to push for a reorganization of theory. He called this reorganization a scientific revolution[…]
Context
A group of blind men are studying under a learned religious leader. They are instructed to go and observe as much as they can about an elephant. The seven blind men go in to observe the elephant, and then the teacher returns to quiz them. One of them says, "I know all about an elephant. An elephant is like a tree trunk; an elephant has a 40-inch diameter, it's sturdy, and it's strong." The next one says, "No, no no, you are incorrect! An elephant is like a wall, it's broad, and it doesn't have that circumference. You're right that it's sturdy, but you've got the shape all wrong." Then the next student says, "I don't know how you could be so misguided. An elephant is like a rope, it's full of fibers and it's bristly." So of course, they all start arguing among themselves about the true nature of an elephant. The teacher listens for a awhile, then stops all of them in their tracks and makes one of my favorite statements: "You are all right and you are all wrong. You all describe an elephant, but none of you know the true nature of an elephant. An elephant is all of these things, but none of these things is an elephant."
Multiple Perspectives
[…]any understanding of reality is always limited by our own individual context[…]
[…]to truly understand a problem in context, it is imperative to listen to the perspective of each person involved in the problem.
Meaningful Wholes
When I have a student who has a hard time seeing one of the two images, I try to have them identify one piece of the drawing, knowing that then the context will shift around it and that the perspective will then become whole. If they are able to see the old woman, for example, I might focus on having them see her nose as the young woman's chin. Rather than simply focusing on the new whole (it is a young woman; don't you see her?), the ability to start with a key part of an object and then build a new whole seems central to our perception. This focus on other parts of the whole helps us to modify what we see as a figure (in the foreground) and what we see as ground (in the background.) I find this shift in figure-ground perception similar to what happens in psychotherapy, as clients attend to the things that they find most significant and important. Looking at issues from multiple vantage points often allows a significant change in perspective, as the perception is organized into a new whole. Once the shift takes place, it can also be surprisingly difficult to return to the original perception.
We all know about that type of synergy that occurs in some groups, where a certain mixture of people creates a feeling or atmosphere that couldn't be predicted by knowing the individual members.
Contextual Connections
But seeing the client or client system as an open system, as well as taking the time to focus on various elements of context, is a worthwhile antidote to the limitations caused by our biases. Taking this idea one step further, we also see that psychotherapy itself is a contextual process. I especially enjoy the work of Michael Karson (2008), who uses his knowledge of performance theory to explore the ways that clinicians use their role to either maximize or limit their effectiveness in the room. Applying a systemic lens, Karson notes that dyadic therapy is in essence a couples therapy experience, as the context of the interaction is created by what both parties bring to the relationship. An open systems view highlights the fact that both client and therapist are changed by their work together.
Seeing Problems in Context
According to Bowen, systems work best when they explicitly value the needs of both the group and the individual and when they have group norms that allow communication about these needs.
Belonging and Identity, Thinking and Feeling
Bowen stated that individuals who are differentiated have the ability to experience both closeness and individuality and to utilize both thoughts and emotions in processing their experience. […] Bowen described someone as being differentiated if the individual had an established, separate identity and simultaneously had intimate connections with others. […] More specifically, for Bowen, a healthy system will promote differentiation by providing opportunities for closeness and connection and also be valuing the unique identities of each group member.
The more a person feels grounded and accepted in a secure relationship, the more she will be able to express and be true to her identity. Similarly, the more a person has developed a distinct and congruent identity, the more he will be able to experience authentic intimacy.
According to Bowen, when some kind of conflict exists between two people, this conflict will naturally raise some type of anxiety. In relationships between individuals who are differentiated, this anxiety can be tolerated because it can be both felt and understood. In addition, because both parties agree that they will respect the needs of the individual and the needs of the relationship, it will ultimately be safe to address the conflict directly.
Without differentiation, however, the conflict becomes more dangerous because it threatens either the loss of self or the loss of relationship. So instead of addressing the conflict directly, it is easier to find a sense of pseudo closeness by bringing someone else into the conflict. The anxiety of the original conflict is then reduced because there is a sense of fusion with the like-minded person and a sense of cutoff from the conflictual partner, and the system once again rests in a steady state.
Causality
The Need to Know Why
Traditional laboratory science looks for the best explanation for phenomena, which leads to an emphasis on singular causality.
Many Paths to the Same Destination
The principle of equifinality shows that a child's problem can result from a variety of starting points and that within an open system it is likely that several factors have contributed to the problem. This realization can both cut through defensiveness and help parents understand that improved parenting can be part of the solution to the child's problem.
Blame and Responsibility
Current family treatments for schizophrenia highlight the importance of reducing negative expressed emotion, which highlights a circular causality model (C.M. Anderson, 1986). Within this model, families learn that as there is increased symptomatology in the system, family members may all experience greater anxiety and affect. If this affect is expressed directly, it is likely to exacerbate psychotic symptomatology, which in turn generates greater negative affect. By reducing these negative affective chains, families with schizophrenic members reduce distress as well as psychotic symptoms. Rather than blaming the family for the symptoms, this approach highlights the ways that family members can escape patterns of negatively triggering one another.
Shared Responsibility is not Equal Responsibility
[…]this distinction between contributing to a problem and being responsible for a problem can frequently be a useful clinical discussion.
There is a similar challenge in helping couples recover from affairs. To begin the healing process, it is frequently necessary for the person who had the affair to be fully accountable for betraying the relationship and causing the breach in trust (Pittman, 1989). By taking complete responsibility for having the affair, the partner who violated the relationship can begin to regain the trust of the wronged partner and in that process can often restore a sense of integrity in owning the wrongdoing. As the work continues, it may also involve looking at problems in the relationship for which both members were responsible. There is a delicate balance between allowing the affair partner to take responsibility for the affair and helping both partners own problems in the relationship.
Explaining Vicious Cycles
[…]Patterson recognized that operant and classical conditioning go hand in hand in these situations. He pointed out that when negative behavioral cycles persist, family members become aversive stimuli for on another (Patterson, 1970). The classical conditioning that occurs further solidifies the operant conditioning; for example, as parents feel upset by their child's behavior, they feel anger and anxiety, and the mere presence of the child elicits a painful negative emotion. Trying to avoid that feeling, parents keep an emotional distance from the child that is also experienced negatively by the child. When given requests or directives, the child is not motivated by a positive relationship to comply. Instead, the request is perceived negatively and ignored until the parent becomes frustrated enough to pay a great deal of attention to the child. When the parent is acting in some extreme manner, the child finally complies. This prototypical example shows that the parent has trained the child to ignore requests initially (reinforcing the behavior after many requests), while the child has trained the parent to go to extremes to get his attention. In addition, the outcome of this cycle is that each party feels anxious and upset in the presence of the other. Patterson points out that the key behavioral efficacy that each party has in this cycle is aversive control (Patterson, 1993).
Creating Positive Cycles
In several well-replicated studies, Gottman documents the importance of the balance between positive and negative interactional cycles. Again highlighting the complementary nature of operant and classical conditioning, Gottman notes that positive and negative affective cycles tend to be self-reinforcing. In addition, Gottman stresses the power of negative interactional cycles. Overall, it takes five positive interactions to counteract the effect of one negative interaction. Gottman's more recent work helps us understand why couples can become so stuck in either positive or negative cycles. He notes that in happy couples, a negative interaction frequently does not start a negative cycle. He calls this phenomenon the ability to up-regulate positive affect during conflict.
Further, in my experience, the emphasis on multiple and circular causality is a huge component of successful therapy because it replaces blame with responsibility. This shift from shame and defensiveness to genuine regret and accountability is equally helpful in working with individuals, couples, or families. Most of us harbor primitive and profound wishes to be completely blameless in our life's problems and simultaneously fear that we are totally at fault for our own misery. To be able to step back and acknowledge that there are numerous contributors to our problems takes the idea of context a step further…By recognizing multiple contributions to a problem, we can move away from a posture of blame to create an atmosphere of understanding and problem solving. In addition, by adding the concept of circular causality, we see that frequently the pattern created in a negative cycle keeps a problem locked in place. To be able to say, "You have developed a pattern in which you bring out the worst in each other" is not only less blaming; it also offers a focus on problem behavior rather than problem people.
Communication
Observing Communication
In looking at human communication, Watzlawick noted "the impossibility of not communicating." Watzlawick notes the omnipresent and ubiquitous nature of human communication in this statement, in that all of our actions or inactions convey some type of meaning, which will be interpreted by those around us.
The report function is generally thought of as the explicit message being expressed, and the command function describes the implicit message, especially the implicit message about the relationship between the sender and receiver.
Message Sent and Message Received
In my experience, because we often confuse the two ideas, we often end up arguing about whether someone has a right to an emotional reaction. Even if my partner did not intend to insult me, the impact that I felt as his reaction was real, and there was no benefit in trying to deny the way that his comment hurt me.
Systems Theory in Action^pg. 52
Functions of Communication
Within human relationships, communication can be used to solve problems or to create emotional connections. While both purposes of communication are legitimate, problems can occur when partners differ in how they value each function.[…] Of course, these types of communication are not mutually exclusive, as often good problem solving creates bonds, and emotional connections promote better problem solving. Yet in my clinical work, this distinction helps me understand the way that couples and families are often completely out of sync with one another, talking with two different agendas without even realizing that they are unwittingly working at cross purposes.
Correcting Misunderstandings
It is incredibly useful to know how to slow down the communication sufficiently to clarify each person's basic intent. When the goal of communication is to resolve conflict, it is essential that each side of a conflict is correctly identified and understood. When the goal of communication is emotional connection as well as problem solving, the opportunities for miscommunication increase even further.
Destructive Communication
While double binds have since been described in slightly different ways by other systems theorists, Bateson described a double bind as having three key components: First, the communication must occur in an emotionally important, connected relationship. Second, there must be a conflict between the meaning of the report function of the communication and the meaning of the command function of the communication. Third, the rules of the system must be specific that the mixed message can't be address directly. This type of communication sets up the proverbial "stuck between a rock and a hard place" kind of feeling, since the discrepancy between the levels of communication is felt but must be denied, as the relationship is too important to just leave. It is worth noting that the act of therapy is designed to surface and address mixed messages. The act of exposing the conflict doesn't resolve the conflict, but an open acknowledgement of the conflict in itself defuses the double bind.
The act of attending therapy is inherently geared to addressing double binds by directly challenging the prohibition against confronting the mixed message.
Enhancing Authenticity
[…]Whitaker rejected the idea that theory was useful in the practice of therapy, instead seeing the use of theory as a way to become distant from experience. In an almost pure expression of communication theory, Whitaker believed that being genuine and honest in the moment was the ultimate healing force, and he strove to jolt his clients out of their complacency and emotional dishonesty.
Whitaker felt that family beliefs and expectations constrained individuals from being true to themselves and that problems were compounded when families didn't know how to express or resolve conflict. For Whitaker, human relationships were inherently passionate and therefore naturally full of conflict, competition, and hatred, as well as joy and excitement. It is in denying and turning away from these intense feelings that we create problems for ourselves and for our families, according to Whitaker.
As a therapist, Satir practically oozed empathy, and some of her techniques seemed to almost parody our notions of using affect in therapy. In one family therapy video, she holds the hand of a mute, disengaged adolescent and intones, "Your hand is soft and warm. I like holding it. Your hand feels very nice to me." While this focus on human affection might seem contrived, for Satir the emphasis on the unexpressed need for compassion, validation, and appreciation is almost always beneficial.
Communication Builds Attachment
It is now well documented that the bond between an infant and her caretaker develops through interactions that take place between them. As the caregiver feeds, changes, holds, and gazes at the infant, the infant experiences a sense of well-being, feeling both calmed and soothed by this positive attention. In turn, the infant's response to the caregiver can create a reciprocal positive experience. As the baby is calmed and soothed, the caregiver experiences a sense of efficacy and competence in providing love and care to the infant. When this circular interaction goes well, both parties create a positive, safe, and responsive environment for the other.
Of course, any interaction is going to include problems, and part of what attachment theory helps us understand is the mechanism for reconnecting when there has been a rupture in the attachment. Even when the infant is very young, there will be times when the connection feels too close or too intense, and the baby will need to turn away from the comfort of the caregiver. Similarly, the caregiver sometimes disappoints the baby by being less responsive or available than the baby needs. The ability to tolerate the frustration inherent in these moments of broken connection is at the root of developing a truly secure attachment. However, it is just these small breaks in connection that can sometimes cause more extreme reactions and lead to insecure attachments. For example, when a parent overreacts to a baby's need for a break or for space, the parent may actually feel a sense of rejection from the baby. In this case, the parent's hurt or anger is experienced by the baby as disapproval, which then causes internal discomfort for the child. This sense of being out of sync with one another can escalate as each party becomes more desperate to engage the other, or the relationship may become disengaged as they retreat from each other. These negative interactions create anxiety and alienation rather than fostering coherence and affect regulation.
[…]Johnson notes that our communication often obscures rather than clarifies our message. Particularly when we react from a position of insecure attachment, our ability to express what we feel is limited or compromised. While we may be engaged in expressing ourselves, what is often expressed is the defensive surface layer of an experience. By getting underneath the defensive secondary emotions to explore the primary affect in a situation, Johnson makes room for that deeper feeling of being more thoroughly understood.
Communication Creates Attunement
For the first part of the interview, the therapist is trying to help the client gain insight into the patterns that have led to his problems and to his distress. As Buirski explores the client's history and description of relationships, he becomes internally frustrated with the client's lack of insight and inability to build off the therapist's suggestions. From the therapist's description of his own experience, we know that he is feeling ineffective in working with the client. The client makes a statement that disparages coming to therapy, lamenting that "you have to go see a doctor to help you get interesting?" Buirski responds, "I guess your feeling is then that you're a pretty nice guy but not an interesting one." While the content of the response is neutral, Buirski is aware of his negative internal experience. The client says, "It's sad to say I think you're, uh, I, that's, uh, I think you're right about that." The client experiences Buirski's negative reaction, and Buirski correctly identifies the client's painful feelings in his response. Buirski is touched by the client's openness after his remark. He is more congruent in his communication and the client responds by being more authentic. he shifts the focus to connecting to the client's felt experience and the interview becomes more successful and satisfying. The client also seems more emotionally available and shares deeper and more vulnerable thoughts and feelings.
Although both object relations theory and intersubjective theory are based on the importance of circular interactions, an intersubjective theorist sees his role as being present and engaged enough with the client to provide an experience of affective attunement.
From a theoretical perspective, the intersubjective therapist would say that clients are always looking for affective connection rather than problem solving, regardless of the report function of their communication. Yet from a systemic perspective, it was the inconsistencies and mixed messages that kept the interview from moving forward in a productive manner. Similarly, when the therapist aligned the implicit and explicit messages of the communication and provided consistency between content and affect, the client experienced the therapist as genuine and began to experience his own story as one that made sense. This required a therapist willing to examine himself from multiple perspectives, rather than claiming and hiding behind the role of doctor.
