Systems Approach To Multiple Family Therapy
The Connecting Link Between Group and Family Systems Psychotherapy
By Helen E. Durkin, PhD
The Origins of Systems Theory
Systems theory had its roots in the 19th century revolution against the long period of Cartesian reductionism. In the decades following the advent of quantum mechanics and relativity theory, a new scientific paradigm began to emerge. Scientists in many countries and from a variety of scientific disciplines gradually began to look at empirical phenomena from the point of view of their organization rather than their content or subject matter. As expected, such a new way of looking at the data produced new hypotheses, new techniques and an impressive amount of new information. For example:
(1) They distinguished between entities which were simply the sum of their parts, which they called aggregates, and "organized complexities" which were the product of their parts, which they called "systems". Systems were defined as an "order of parts and processes standing in dynamic interaction".
(2) Taking a holistic view, They discovered that the parts of subsystems interact to form larger wholes (systems), which in turn interact with other systems to form "systems". In other words, systems of any category are arranged in a hierarchy of interacting wholes. At each of these levels of complexity, unique characteristics are generated. These are called emergent's.
(3) Upon further investigation, they learned that all systems have certain basic structural features in common. That is to say, they are isomorphic.
(4) They also found that systems operate on a principle of multiple causation and interact reflexively rather than on a one-cause--one-effect basis. Each part is influenced by the interrelation among all of the parts.
(5) The emphasis is on the interaction,, that is on the process of exchanging energy and information, rather than on the entity in isolation.
Systems theory is a structural metatheory. Because it had developed at about the same time in a number of different sciences, several different branches of systems developed. All of them are in consensus about the characteristics of systems described above, but each branch also emphasized different aspects and developed special concepts in accordance with its special situations and its goals.
Two of these branches have had an organized effect on group therapy which goes beyond the merely popular tendency to use systems terms like input, output, interface, etc. in a rather vague and loose way. They are Weiner's cybernetics, and von Bertalanffy's General Systems Theory. (It may be important for you to know that unfortunately, the title which von Bertalanffy selected for his particular approach to systems theory is often confused with the rather common use in the literature of the term general systems theory when referring to systems theory in general.)
The Development of A Systems Form of Family Therapy
The first branch of general systems theory to influence the field of group therapy was cybernetics. Cybernetics was originally based on mathematical information and linear feedback theory, as found in the servomechanisms, and was used primarily for engineering purposes. But Weiner had the notion that cybernetics might also be applied to the social and behavioral sciences. Among his colleagues, Colin Cherry translated it into human communication. Gregory Bateson and J. Ruesch were the first to apply it to therapeutic communication. They studied schizophrenia from this point of view and discovered the existence of schizophrenogenic families. Together with a number of other pioneers, including Don Jackson, Jay Haley and others, they built upon this finding to develop a new systems form of family therapy.
This approach was different from Nathan Ackerman's original form of family therapy in that they ruled out analytic theory and technique. They focused on the fact that the family was a system and as such had tremendous influence on its members. In fact, they said that the family was primarily responsible for the individual family members' attitudes and behavior. Therefore, it was the family system which must be treated rather than the designated patient. Clinicians using this approach reported excellent and rapid results. Whether, without investigation of the constitutional factors, unconscious fantasies and motivations, patients could maintain their changed behavior outside the family, remained a moot question. In any case, the new modality could no longer be ignored by either individual or group therapists.
Ludwig von Bertalanffy's General System Theory
Ludwig von Bertalanffy (1901-1972)
Von Bertalanffy constructed an organismic model of living systems which was based on biological research. His embryological studies showed that living systems are autonomous. Because their structure allows them to exchange energy and information across their permeable boundaries, they have the capacity to structure and to restructure, as well as to regulate themselves. Thus, they can maintain their identify in the face of tumultuous environmental stimulation or transform themselves by increasing their input. Von Bertalanffy's emphasis on systems' active and creative, rather than merely reactive, responses affords the therapist a more robust view of groups, their individual members and of their personal organization. He believed that this autonomous model of living systems transcended the long-standing controversy between mechanism and vitalism.
The Importance of Peter Laqueur On Our Task Force
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H. Peter Laqueur, MD, (1909 - 1979)
My preliminary reading had convinced me that systems theory was complemantary rather than contradictory to psychoanalytic theory and that the new way of looking at our clinical data might have important implications for the theory and practice of group psychotherapy. In 1969 I suggested to Dr. Harris Peck, then Chairman of the Long Range Policy and Planning Commission of the American Group Psychotherapy Association, that we form a task force to give the matter serious consideration. He made me the Chairperson an I obtained the names of a number of systems scientists who might have an interest in group therapy and selected a few group therapists who were already interested in general systems theory.
Dave Mendell first suggested that we invite Dr. H. Peter Laqueur to join us because of his substantial experience in this area. Laqueur's experience had convinced him that patients could not be fully understood without knowledge of the way they operated in the many systems of which they were a part. He felt that general system theory provided information which would enable one to correct the clinical errors which derived from the necessarily somewhat subjective interpretations on which all current approaches depended.
I was impressed with Laqueur"s openness, his intuitive clinical skill and his willingness to participate without dominating our project. He contributed a balance to our investigation because of his broad interest in applying general system theory to individual, family, and network therapy, as well as to group therapy.
Laqueur played an important role in our early meetings. I have some notes which he wrote after one of the first organization meetings, held in 1970 at the home of Bill Gray in Newton Center, Massachusetts. He expressed great satisfaction that we had been able to agree on using von Bertalanffy's organismic model rather than the cybernetic one on which family systems was based, "because", as he said, "we would need to elaborate humanistic views just as Auerswald did, in order to deal appropriately with living individual and social systems." He also expressed his interest in having us develop clear concepts based on the common language which General System Theory provides. He not we seemed to be in agreement on the importance of "interface" or "boundary regions" between systems and of the critical function which exchanges of matter/energy and information would play in the application of systems phenomena to the therapeutic group process. He foresaw that it would be more difficult to come to terms with the respective roles that energy and information play in the therapeutic process. His prediction came true. We all agreed that both affective and cognitive exchanges are indispensable in bringing about therapeutic transformations in the group, in its members or in their personality subsystems, but we remained divided about the role of energy.
The Selection Of A Systems Model For Group Therapy
There were several reasons why our AGPA Task Fore chose the general system theory rather than cybernetics as a base for applying the new structural viewpoint to group therapy.
(1) Besides Peter Laqueur, Bill Gray and Jim Durkin agreed with von Bertalanffy that it would be important in working with human and social systems to keep the uniquely human characteristics of our members in the foreground of our thinking. This was readily endorsed by the clinical constituents of our group, which then included Dave Mendell and Myself.
(2) Cybernetics, especially as applied by family therapists, is primarily concerned with the effect of the family system on the behavior of its members. It fails to make use of the obvious fact that the individual members are systems as well, and that their interaction determines the nature of the family system. This point was especially relevant for our task, because therapy groups, unlike families in treatment, start as an aggregate of individuals and the therapist must concern himself primarily with the process of forming new systems. General system theory provides details and new information on this subject.
(3) Family systems theory is even less interested in changing the personality subsystems of the individual members, whereas traditional group therapy has demonstrated that transforming the personal organization of a single group member is of critical importance to therapeutic outcome. Individual change not only brings about new modes of interacting which generate changes in the other members, but also contributes to the transformation of the total group system.
(4) Cybernetics employs a machine model -- that of the steering wheel -- which is adequate to explain the properties of servomechanisms, but is far less likely than the organismic model to do justice to the growth and creativity of human and social systems.
(5) The family systems model relies primarily on the information exchanges as the source of transformation and growth in systems. The organismic model takes into account the energic processes of the biological system as the source of change. While it is simpler to rely on information alone, and the transmission of energy cannot be readily observed, it must be remembered that the development of the new scientific paradigm has gone beyond the 19th century paradigm of objectivity.
After some debate about such questions, we decided to share the process of our explorations with the membership of AGPA, rather than wait until we had definitive answers to them. We held a "think session" in Vermont in 1970, where we had the opportunity to observe Peter and his colleagues at work. Peter's specialty was multiple family therapy and we selected his prize-winning film as the subject for a symposium at the next AGPA conference in 1971. The film followed through a number of related scenes of a multiple family therapy group which had taken place at the Waterbury State Hospital. Our purpose was to illustrate for the audience those systems phenomena which we felt were most relevant for the work of systems group therapists, to give them experience in identifying these, and to consider whether or not they could add to the clinical effectiveness of our present methods. Secondarily, we felt that this film was not only the best and least artificial of those we had examined, but that it would be particularly appropriate because multiple family therapy bridged the gap that existed between family therapy as practiced at Palo Alto and group therapy as we knew it. That gap still exists but there are exceptions. Since that time, for example, Nina Fieldsteel and Harriet Strachstein from the Postgraduate Center of Mental Health and Celia Mitchell of the Ackerman Institute have combined the communications approach to family therapy with the analytic, just as some of our Task Force members are combining von Bertalanffy's organismic model with analytic group therapy.
Peter Laqueur leading a MFT group.
In line with out first objective, the film provided an opportunity to observe, at first hand, a number of systems phenomena as they occurred in the total interaction. Most of these illustrated structural concepts are held by a 1 branches of systems theory. Some of them illustrated concepts or techniques in which family systems therapy specializes and still others illustrated concepts on which general system theory focuses. for instance:
(1) If was apparent that the total group consisted of an hierarchical order of systems at different levels of complexity, including the group suprasystem, family and individuals systems, and personality subsystems. Any one of these might come to the forefront as the members exchanged energy and information with one another (in the form of patterned thoughts and feelings). We also had occasion to note that environmental systems, such as the administrative, training, hospital, and even the community systems, occasionally impinge on the therapeutic group process. When this happened, the therapist shifted his priority from the therapy group to the external situation that was threatening it. One scene showed Peter out in the community serving just that function.
(2) I shall give you an example of a therapeutic encounter among the group members which illustrated both general system and family systems concepts as demonstrated by Peter Laqueur.
An overprotected mother, whose husband seemed helpless in the face of her urgency, engaged in an exchange with an excessively punitive father, whose wife was also passive. They were talking about what to do with her rebellious son, and of course they disagreed about the solution. The encounter gave rise to explosively angry emotions, which seemed to carry right across their interpersonal boundaries and also opened up those of other members, who began to take sides. The incident succeeded in disequilibrating the family systems of the two original participants, as even their passive spouses joined in the interaction.
A variety of different thoughts and feelings were presented for consideration. We saw evidence that some of this input was processed, in that the initial global feelings of the original contestants were modulated and their thinking became less distorted. The two dysfunctional family systems were restructured and their individual members' usually fixed modes of interacting altered. This was an example of transformation. Close observation showed that the other group members who had participated were also influenced to of fact, it was obvious that the incident had an effect on the whole group suprasystem, which moved from sluggishness to lively interaction. It had achieved an increased flux equilibrium which enabled it, in turn, to exert further influence on the members.
In line with our second objective, the audience was given an opportunity to observe the therapist, Peter Laqueur, move freely back and forth as he addressed the group, a family, or an individual without any disruptive effect. He also used a mixture of family, group and individual personality techniques. It was evident that he did not make a rigid distinction between the various systems modalities.
At the beginning he made almost no interpretations, but seemed intent on facilitating the formation of a new group suprasystem by encouraging the exchanges among the group members. In this attempt he employed chiefly the cybernetic technique of deviation-amplifying interventions (positive feedback).
Once the flow of the communications made it possible for the group to regulate its own exchanges of energy and information, Laqueur listened and left the work to the members, who were expected to share his therapeutic function. However whenever he noticed that the boundaries of any one of the systems seemed to be so tightly closed that it interfered with the therapeutic process, Laqueur intervened. For this purpose he sometimes employed the cybernetic technique of negative feedback; at other times he used a general system boundary-opening technique. In other words, Laqueur was quick to deal with what analytic therapists call resistance. He believed that the therapist must be ready to "get in harm's way," i.e., he must be ready to risk the anger which is sometimes the response to negative feedback. Laqueur also said he gave "active transport" to the transmission of information. Here again is evidence that Peter's primary goal was to keep the flow of exchanges between systems moving therapeutically. He did not think it was necessary to adhere to the techniques of either the family or the group modality. He even used what family system therapists might consider a strictly individual analytic technique when on one occasion he tried to facilitate change in the personality structure of a young woman, the daughter of a couple in the group. She had begun to complain about her parents in a repetitive way, and then to resort, as she usually did, to weeping. He recgnized that it was a dead end. He deliberately blocked her automatic behavior, saying, "Stop crying!" Then he added, "Let's see if we can get to the bottom of this instead." She quieted down and accepted his input and that of another young adult in the group who said, "It's the only way her parents will listen. I know because I learned, with the therapist's help, to speak up tine."
Summary And Conclusion
The audience watching Peter Laqueur in action became familiar with a number of system phenomena:
a) the nature of systems as they occurred in the interaction;
b) the process of forming systems as well as their effect on their subsystems;
c) the dual complementary function of boundary-closing to exclude excess input to gain systems stability, and of boundary-opening to facilitate transformation;
e) the relationship between the general terms energy and information, which can be used to describe all systems, and the specific terms emotion and cognition in which energy and information are conveyed in human and social living systems.
Group or Family Systems Therapy?
Multiple family therapy demonstrates that these family and group treatment modalities are not mutually exclusive. Their separate concepts and techniques are combined harmoniously in this instance. Even though each has distinctive features which may make the treatment of choice for regular usage, both are firmly grounded in the structural metatheory which is called systems theory or general systems theory. That fact alone would reduce the gap that still exists between the extremists. Moreover, in viewing Laqueur's work, therapists who espouse either one of these modalities can increase their therapeutic skills by acquiring additional information about the other. For instance group systems therapists can learn that, given certain theoretical modification the cybernetic techniques of positive and negative feedback can be effectively applied to the treatment of living groups. Family therapists, on the other hand, can learn to utilize the general system technique of facilitating the transformation of the personality subsystem* of family members, as well as of the family system itself. It is apparent that interventions at any system level have repercussions in systems at all levels. For these reasons, I believe that multiple family therapy an serve as a link between group and family systems approaches.
In conclusion, I would like to affirm the fact that Peter Laqueur was a creative force in initiating and promoting the new system paradigm in the mental health field across America. We very much appreciated his sojourn with our GST Task Force from 1970 until 1976, when we began to concentrate on developing GST models of group therapy, and thus diverged from his special interest in multiple family and network therapy. He continued in contact with us by responding to our findings and sending us his own latest papers.
I am glad to have had the opportunity to honor his memory.
*If any individual's unconscious fantasies are brought to light , the chances increase that he/she will use new modes of interacting in the outside world as well as in the family circle.
Wolberg, L. r., Aronson, M. L. Group and Family Therapy 1980. New York: Brunner/Mazel, 1980. p.p. 24-31.