Psychology
Whatever Happened to Family Systems Psychotherapy?
A convergence of factors have marginalized family systems ideas in psychology.
Posted June 11, 2021 Reviewed by Ekua Hagan
Key points
- Family systems ideas in psychotherapy were big in the 1980s and 1990s, but seem to be disappearing in the field.
- In 2001, "Family Therapy Networker" magazine changed its name to "Psychotherapy Networker," and received flack for "abandoning" systems ideas.
- Systems ideas in psychology have fallen out of favor due a convergence of a variety of social and financial interests.
Beginning with the March/April 2001 issue, a magazine that was originally produced for the followers of the new family systems psychotherapy models changed its name from the Family Therapy Networker to the Psychotherapy Networker. The magazine had started 20 years earlier in January 1982. What happened?
The editor of the magazine then, who recently passed away, was Rich Simon. In the March/April issue of the magazine in 2012, he related the fascinating history of why this happened in an essay called "Still Crazy After All These Years? A Look at 30 Years of the Networker."
The emergence of family systems therapy
Back in the 1980s and 1990s, there was an explosion of new ideas about how to get psychotherapy patients to change both their behaviors and negative moods that went well beyond the three basic paradigms or schools of therapy at the time: psychodynamic, cognitive-behavioral, and emotion-focused. Over 200 different schools were developed, although most of them were just variations on the existing schools. The Milton Erickson Foundation in Phoenix, AZ sponsored several “Evolution of Psychotherapy” Conferences in which the leaders of the various schools came to argue with each other in front of large audiences.
Family Systems therapy was the most noteworthy of the new models because it was seemingly the first to recognize that since human beings are among the most social of all organisms, perhaps looking at herd behavior might tell us more about human beings than just looking at them in isolation.
Of course, even within systems therapy, there were quite a few widely varying ideas about how to proceed with psychotherapy clients. In the beginning, the Networker profiled the colorful characters who were devising them: Salvador Minuchen, Jay Haley, Murray Bowen, Mara Selvini-Palazzoli, Virginia Satir, Ivan Boszormenyi-Nagy, and Carl Whitaker.
Of course, just like within all of the earlier schools, there was plenty of nonsense within the movement. Some theorists imagined a sort of Zen perspective in which the idea that we had individual selves to call our own was an illusion. They became like extreme behaviorists, who instead of viewing humans as rats in a physical maze, viewed them as rats in a family homeostatic maze — with no ability to think for themselves.
Others started explaining real brain diseases like schizophrenia on the basis of family double binds, which themselves were very common in the families of people without any schizophrenic members. Still others viewed the dynamics of any particular family as if they had just popped into being as is, without reference to the cultural milieu in which they developed. Even Murray Bowen, who developed a three-generational model, mostly looked only at who was enmeshed or at odds with whom, without specifying over what behaviors they were enmeshed or at odds about.
Rejection of family systems ideas
According to Simon, feminists started complaining that women seemed to be getting the brunt of the blame for, as well as the responsibility for changing, the family dynamics — especially when patients with histories of child abuse became brave enough to come forward. The latter issue also led to a reaction in which people were accused of having “false memories” (and which some thought were being prompted by therapists treating suggestible clients). Other elements of society were also upset with the so-called “abuse excuse” in which victims were seemingly encouraged to see themselves as permanently damaged victims who took no personal responsibility for themselves or their circumstances.
A confluence of converging forces such as those just mentioned, along with financial interests like managed care and pharmaceutical companies who wanted to sell more pills, came together with a fury. Longer-term treatments were no longer being covered by medical insurance, which only covered symptomatic treatment. Bogus “medical necessity” criteria were used to drastically cut down the number of sessions therapists could administer. Drugs were pushed even for diagnoses for which there was no good evidence that they worked at all. “Major Depression” became just “depression.”
“Biological” psychiatrists, who were not even aware of the latest discoveries in neuroscience, pushed a disease model for everything. In reality, science has clearly shown beyond a reasonable doubt that the structure of the “plastic” human brain is in part determined by interpersonal interactions and that most of what we do is learned and then done automatically in response to environmental clues without any conscious deliberations.
Simon added that they did take a lot of flack after the magazine got renamed for “abandoning” systems therapy, but, “…as we saw it, we were just creating room for a bigger, more diverse 'blended' family of therapeutic approaches.”