History of family constellation therapy

What is an example of a family constellation in therapy?

Here’s a hypothetical example illustrating how a family constellation might be used in therapy:

The client (known as a “seeker” in the terminology of Family Constellation Therapy) is a man who has reported persistent feelings of apathy and depression. In interviews with the therapist, he reports that he has a difficult relationship with his father, marked by a feeling that nothing he did was ever good enough to earn approval. 

Further discussion of the family dynamic reveals that the seeker’s father lost his own parents at an early age, and had very few memories of them. He regarded them as distant, minor presences in his own life.

A family constellation might be brought together to represent the members of the family, with volunteers taking the places of the seeker, his father, and his grandparents. At first, all members present would likely remain silent, trying to get an intuitive sense of the emotional tensions between them. 

After a while, the “father” might feel an urge to start roaming around the room, as though searching for something. Eventually, the “grandparents” might get the sense that they should reach out to him because he couldn’t find them on his own. After exchanging words of love with the “father”, the grandparents might turn him to face his “son”. The seeker and volunteer might then feel able to address the difficult feelings between father and son with some specific affirming phrases.

[These specific actions are not necessarily universal — it’s just one example of how a family constellation might play out in practice.]

Based on the theory of Family Constellation Therapy, this emotional psychodrama might result in an emotional catharsis that could help the seeker let go of the feelings of inadequacy that were driving his depression. Alternatively, it might give him important insights into the roots of his behavior and symptoms.

What do you learn about family systems in Family Constellation Therapy?

Family Constellation Therapy aims to help clients learn and understand how their psychological difficulties are intertwined with larger patterns of emotional needs, wounds, and conflicts within their family. In many cases, these patterns are understood to stretch back across multiple generations. Often, the difficulties are conceived of as related to issues in which family members feel rejected or out of place.

How effective is Family Constellation Therapy?

Because of the limited empirical research on Family Constellation Therapy, it’s difficult to give precise estimates of its effectiveness. There is still debate within the psychological community about whether it can work at all. The studies that have reported positive results of Family Constellation Therapy generally estimate its effect size as moderate. 

Though that might not sound particularly encouraging, it’s similar to the reported effect sizes for many widely prescribed SSRI antidepressants. This is not to suggest that these treatments are equivalent — there is a much more robust body of evidence backing SSRIs than there is for Family Constellation Therapy. However, a treatment method with a moderate measured effect size may still provide substantial relief for some people. 

What is the purpose of family therapy?

There are many types of family therapies, and individual clients may have very different reasons for seeking treatment. In general, though, the goal of these treatments is to help clients achieve better mental health, healthier patterns of behavior, and mutually fulfilling relationships with their loved ones. 

Family therapies are generally based on the assumption that mental and behavioral health conditions are affected by interpersonal dynamics rather than being purely individual difficulties. They usually aim to assess how relationships between family members contribute to dysfunctional behavior patterns, assisting the clients to achieve healing together.

What does constellation mean in therapy?

Within the framework of Family Constellation Therapy, a “constellation” refers to a representation of a family group intended to analyze, confront, and explore the tangled relationships between them. 

This often takes the form of emotionally intense group reenactments in which volunteers stand in for members of a client’s family. The process typically begins when the participants are arranged to stand or sit in meaningful patterns that represent their family dynamics. This may be done with input from the client. 

Next, participants will usually stand in silence, attempting to intuit the feelings between the people they’re representing. Then, they generally attempt to act out scenes based on what they feel.

Family constellations can also be created in the context of individual therapy. A client might be asked to create a drawing or painting representing their feelings about the dynamics within their family. They might also arrange objects in symbolically meaningful patterns to explore their complicated relationships.

What are the healing sentences of the family constellation?

“Healing sentences” are meaningful phrases spoken by participants within a family constellation that may provide a sense of closure or transformation. The exact sentences will generally be different for every group. They’re usually crafted to represent the specific emotional needs of the seeker. Often, healing sentences are supposed to bring about a mental reconciliation between the client and their family members.

Possible examples of healing sentences could include:

• “I forgive you.”
• “Please help me.”
• “I’m sorry for what happened to you.”
• “I accept you as my mother.”
• “Your strength inspires me.”

How is family constellation therapy different from internal family systems?

While Family Constellation Therapy seeks to address breakdowns in relationships between family members, Internal Family Systems is generally used to analyze an individual’s psychology. Different aspects of a patient’s personality are conceptualized as members of an “internal family”. The therapist and client work to find ways that these different facets of the individual can “work together”, enabling a balanced and grounded approach to life.

Internal Family Systems therapy generally takes the form of one-on-one conversations between therapist and client rather than the spontaneous group dramas enacted in Family Constellation Therapy. In many ways, it’s more like other forms of talk therapy such as Cognitive Behavioral Therapy, involving techniques such as journaling, meditation, and behavioral self-assessment.

Can you do a family constellation by yourself?

Some techniques of Family Constellation Therapy can be practiced on your own. For example, you could try creating a “family map” to assist you in thinking through the complex web of relationships within your family of origin. 

A family map can be very simple, consisting of shapes or names representing specific individuals, with lines between them to represent their relationships. Two people with a strong bond might be linked with a thick, bold line. You could represent a turbulent, hot-and-cold relationship with a zigzagging line and a weak or distant one with a dashed line. Getting creative as you construct your map may help you express and face your difficult feelings about your loved ones.

This map can be used in a variety of ways. You might look over it and use it as a springboard for journaling about your relationships with siblings and parents. Or you could recreate it using figurines or other objects that you can move around on a table, exploring your emotions through creative play. Alternatively, you could simply look at your map and reflect on the thoughts that arise.

What are the benefits of Family Constellation Therapy?

Though it may not be effective for everyone, many people who participate in Family Constellation Therapy report beneficial outcomes including:

• Reduced symptoms of mental health conditions such as depression
• Improved interpersonal relationships
• Increased psychological well-being
• Greater confidence and self-efficacy
• Feelings of happiness
• Improved coping skills
• A more optimistic outlook
• Better quality of life

Why is family therapy better than individual therapy?

Family therapy is not necessarily superior to individual therapy for everyone. However, there may be some circumstances in which it’s the better option.

In many cases, an individual’s mental health difficulties may be caused or reinforced by unhealthy patterns in their close relationships. There could also be factors about their home environment that would make it difficult to make meaningful gains in individual therapy. For instance, if someone was trying to work through anxiety resulting from trauma but their relatives repeatedly triggered them, their difficulties might be more effectively addressed in the context of their family. 

Other scenarios in which family therapy may work better than individual therapy include:

• Substance use disorders
• Mental health troubles involving children or adolescents
• Relationship challenges such as infidelity or marital discord
• Eating disorders

Even in cases like those described above, family therapy may not always be the best choice. It’s often best to discuss the possibility of family therapy with a mental health specialist to see whether it should be a part of your treatment plan.