Systems Therapy

We as humans are part of numerous systems big and small. From our immediate families, to our schools, communities, and countries of origins, the systems we are a part of have a huge impact on us and are incredibly important to include in the therapeutic conversation in order for the therapist to truly know the patient. 

A patient of mine and I used to joke that our therapy room was full of ghosts. We found ourselves spending a lot of time exploring relationships, past and present, and identifying the innumerable ways the patient was impacted by them. Understanding the roots of your own behavior helps with healing and understanding what role you play in relationships. Members of a family unit tend to have roles that are comfortable and serve the family system. Unless disrupted, people have a propensity to gravitate towards those same roles in other systems and relationships. If this role is not serving you, it’s important to identify and understand the roots of these roles in order to do something different.

Generational Trauma

Relevant to a system is the history of those systems and especially generational trauma. If the people that came before you in your family experienced trauma, especially a complex trauma where they felt emotionally, spiritually, or physically in danger for a sustained period of time, there will likely be some impact on later generations. Clear examples of this are families who have experienced war or genocide and families have who experienced sustained poverty and have worried about basic needs. There are plenty of parents and grandparents who are loving and have important strengths but who feel unsafe in the world due to their lived experience. This can impact the direct and indirect messages they send their kids and there can be a trickle down of anxiety and insecurity. 

Culture 

Every family, even aside from countries of origin, has its own cultures, norms, mores, and preferences. Just having a good working knowledge of ethnicities and background is not enough to deeply understand how a patient was raised and what their values are. When I learn about a patient’s past or present, I always ask the patient to make me a fly on their kitchen wall. I want to be in the patient's experience. What did your house feel like? What were meals like? What did you do for holidays? What did conflict look like? What was family quality time? You only know what you know and sometimes something feels so normal that it feels not even worth mentioning. I strive to unearth those nuances in order to draw out the meaning for the patient.

Race

Race and ethnicity is an intrinsic part of someone’s experience and identity. However, even with race, there is plenty of nuance. How do they present? What ethnicity do other people perceive them as? Did they grow up with people of similar backgrounds or were they in the minority? What has their experience been with people of other ethnicities? For our relationship, how does my ethnicity and presentation impact how they feel in our relationship? Race brings its own depth and meaning but this is relevant as well for gender presentation, sexuality, and appearance and body type, as well.

Dystonic Systems

Just as important as how someone identifies in regards to race, ethnicity, gender, sexual orientation, and religious affiliation, it is important how the systems that they are a part of relate to them. Context is central to someone’s lived experience. For example, a gay teenager growing up in a LGBTQA+ friendly area with supportive parents will have a vastly different experience growing up in homophobic systems. When the people and environment are hostile to a core part of who we are, it can have dire consequences on our self worth and sense of safety and security in the world. 

There can be even more subtle versions of this. Even in cases where parents and children are connected by biology, sometimes parents and kids are super different and are a bit of a mismatch. There are times where a connection in interests, temperament, or communication style doesn’t come so naturally and instead it needs to be built. There is no “right” way to parent but sometimes a kid needs something that a parent finds it hard or not natural to give.