Systemic Therapy: Understanding Relationships, Understanding Yourself

 

Systemic therapy is a psychotherapeutic approach based on the assumption that an individual's psychological difficulties arise and are maintained in a relational and social context – that is, not "within the person themselves," but in the interactions that surround them. Therefore, systemic therapy focuses precisely on these relationships and communication patterns that people create together. It developed in the second half of the 20th century from family therapy and found inspiration in the systems theory and the development of cybernetics. Today, this psychotherapeutic approach is used in individual, couple, and family therapy, and its effectiveness has been confirmed across different age groups.

Basic principles of systemic therapy

Systemic therapy is based on several basic principles that help therapists understand their clients' needs. These principles are based on modern systems theory, communication approaches, and many years of experience in family and couples therapy.

Humans as a part of a system

Systemic therapy views people as part of a broader system—a family, couple, group, or work team. An individual's behavior cannot therefore be assessed in isolation, but only in the context of the relationships that shape it and that they themselves influence. The system is a living whole, where a change in one place always causes changes elsewhere.

Circular Causality

Many of us have a habit of thinking about what causes negative events in our lives and "who is to blame." Systemic therapy tries to prevent this mindset and instead of this linear causality, it uses the principle of circularity. This tells us that no phenomena have a clear cause and effect, but rather are mutually reinforcing interactions that retroactively influence the person who triggered them.

Language and communication

According to the systemic approach, reality is created not only by our behavior, but also by how we talk about problems and how we understand them. Language can fix problems ("he's just problematic") or, conversely, open up new possibilities ("he sometimes reacts more sensitively when he feels insecure"). That is why systemic therapists place great emphasis on questions, clarifying meanings, and seeking different perspectives.

Focus on solutions and resources

A typical and unique feature of systemic therapy is that it focuses not on the problem itself, but on its solution. The therapist often works with what already works for clients. So instead of asking, "Where is the problem?", they ask, "When does the problem disappear?" Each of us already has the necessary resources within us, and through systemic therapy we can learn to activate and strengthen them more easily.

Therapist Neutrality and a Multi-Perspective View

A systemic therapist does not seek to be right, but rather strives to understand different perspectives, i.e., each family member and the broader context as a whole. Neutrality does not mean indifference, but rather the ability not to favor one version of the story over another. This opens up space for new understandings and greater flexibility.

Structure and course of therapy

Systemic therapy has a relatively flexible framework, but, as with other psychotherapeutic approaches, certain elements are repeated throughout the course of therapy to help the therapist guide the sessions. During the first meeting, the so-called "therapeutic contract" is usually formulated, i.e., what the client needs from therapy and what the desired change will look like. Once the client has defined the problem and set the goal of therapy, the therapist uses several key aspects to guide the therapy. These include, for example:

• facilitation of dialogue – the therapist creates a safe space for open communication between members of the system and promotes mutual understanding
• circular questioning – helps the client see the situation through the eyes of others and shows how members of the system influence each other
• reframing – serves to find meaning in what at first glance appears to be a problem
• working with hypotheses – the therapist continuously creates hypotheses about how relationship patterns work, and the client can then confirm or refute them

The form of the meeting may change over time. The therapist sometimes works individually, sometimes includes couple or family sessions, or combines different forms of work depending on where the difficulties are most apparent.

Where systemic therapy can help and why it is effective

The effectiveness of systemic therapy has been repeatedly confirmed by numerous studies and meta-analyses. Research shows that it is effective in treating a wide range of mental health issues, including depressive disorders, anxiety and obsessive-compulsive disorders, eating disorders, addictions, and schizophrenic and psychotic disorders (von Sydow et al., 2024). It also produces good results in psychosomatic disorders and in clients whose difficulties are closely related to family or partner relationships (Rambo et al., 2010).

The effectiveness of systemic therapy is mainly due to the fact that it focuses not only on the symptoms of the individual, but also on the relationship patterns that maintain these symptoms. The emphasis on communication, cooperation, and activation of the resources of both the individual and the system supports the long-term strengthening of clients' competencies and ability to cope with future challenges – which research ranks among the main reasons why systemic therapy leads to more lasting results than interventions focused exclusively on the individual.

Systemic therapy at PSYMED clinic

The expert in systemic therapy at the PSYMED clinic is MUDr. Ondřej Masner, who specializes in individual and family systemic therapy. You can learn more about his professional focus, education, and approach on his profile.

If you are interested in systemic therapy and would like to learn more about it or arrange an initial consultation, please do not hesitate to contact us.

 

About author: Jana Felklova Jana is a first-year master’s student in the Theoretical and Research Psychology program at Charles University in Prague. She views her work at Unicare Medical Center as a valuable opportunity to gain hands-on experience in the field of psychology while pursuing her studies.

 

References:

von Sydow, K., Beher, S., & Retzlaff, R. (2024). Systemic psychotherapy: An introduction to its theoretical foundations and clinical practice. Deutsches Ärzteblatt International, 121(23), 783.

Rambo, A., RHOADES, E., BOYD, T., & Bello, N. (2010). Introduction to Systemic Family Therapy. available online at: RamboRhoades2010IntroSystemicFamilyTherpay.pdf (accessed June 13, 2023).

European Institute for Systemic Development. (n.d.). ISystemic – Systemická psychoterapie a vzdělávání. Retrieved January 15, 2025, from https://www.isystemic.eu/