• Richard Routledge

Why Family Therapy?

We never experience problems that are completely disconnected from a larger social context. Yet, more and more, our society encourages us to think of ourselves as autonomous individuals. Family therapy can help us reconnect and understand important relationships and help us realize our interdependence.

One of my earliest exposures to family therapy occurred shortly after my undergraduate training in Edmonton. I was invited to sit with several other, more experienced team members behind a one-way mirror and observe the interactions among a mother, father, adolescent daughter, younger brother, and therapist.


The ‘concern’ in this family was the teenage daughter, who had been diagnosed with schizophrenia. Over the course of the hour I noticed certain family members seemed to be communicating with certain other family members in such a way as to place them in a double-bind: that is, a ‘darned if you do, darned if you don’t’ paradox. Often the paradox was subtle.


Sometimes, there appeared to be a contradiction between the verbal and nonverbal components of the same message being communicated to the daughter, who then had to choose whether to respond to the verbal message (e.g., “We love you and accept you the way you are”) or the nonverbal message (e.g., “What is wrong with you and why won’t you change?”). The daughter’s typical response at such times was to look confused and stare into space.


At other times, the messages exchanged between the mother and father seemed to present a mix of ‘I’ve got your back’ teamwork and overt hostility. The daughter seemed unsure what to do when such conflict occurred between her parents, and the younger brother sometimes stepped in with a convenient distraction (e.g., restlessness or some other behaviour requiring attention).


The whole family seemed caught in the same trap, unsure how to respond to one another when conflict or mixed communication occurred.


So how did the daughter’s schizophrenia fit into all this? I never got to find out exactly, but it was interesting to note that the onset of her symptoms had coincided with other developments that put a lot of strain on the parents’ relationship.

The family therapy field originated with situations very much like this, back in the early 1950s and 60s. Psychiatrists noticed that patients who were hospitalized often became very upset, often for days, after a family member came to visit, and so they began to invite family members into the hospital to observe their interactions more closely. That led to some very useful and exciting discoveries about how family communication works.


Often, psychiatrists discovered that a patient who could not be ‘cured’ in individual psychiatry did become well when the family as a whole changed its communication patterns. When the family learned to communicate differently, or when the family reorganized itself in some way, the symptoms of the ‘patient’ disappeared.


Often, psychiatrists discovered that a patient who could not be ‘cured’ in individual psychiatry did become well when the family as a whole changed its communication patterns.

Starting in the 1960s, discoveries like this dovetailed neatly with an emerging field called “general systems theory.” Working with whole family units as interactive “systems”—rather than merely as collections of individuals who are related to one another—gave therapists a whole new perspective and a whole new set of tools for helping people.

A “system” is basically a group of interacting, interdependent parts that form a complex whole. An example from the biology field is a living cell, which contains a variety of subcellular organelles interacting with one another in complex and interdependent ways within the confines of the cell membrane.


But in the therapy field, my favourite definition of a system is this: “two or more communicants in the process of, or at the level of, defining the nature of their relationship.”1 That definition is insightful because as research has shown, if we are connected and interdependent upon one another, we are always to some degree in a process of defining our relationship whether we know it or not. Sometimes this interaction is obvious and sometimes it is far from obvious, but it is at the heart of a lot of useful therapy work.


There are times when family therapy is far more useful than individual therapy, and naturally there are many situations in which individual therapy is the only way to go. Sometimes therapists work with parts of a family and then bring the whole family together when everyone feels ready. This step-by-step way of doing things is often necessary, especially if there is too much conflict for people to feel safe in the same room right away.


...if we are connected and interdependent upon one another, we are always to some degree in a process of defining our relationship whether we know it or not.

There is much more to be said about family therapy, of course, and there can be many questions (and logistics) to consider. If you’re interested in looking into the therapy options that might work best for you or your family, it makes sense to take the time to inquire with our office.

1. P. Watzlawick, J. H. Beavin, & D. D. Jackson, Pragmatics of Human Communication: A Study of Interactional Patterns, Pathologies, and Paradoxes (New York, W. W. Norton, 1967, p. 121).

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