Structural Family Systems: Crash Course

my name is oliver and i'm a family therapist here in los angeles i love working in family systems thinking and family systems and teaching people about family systems i've been working with families and teens for most of my career mainly in residential treatment settings but also here in my private practice most recently i was the clinical director of an adolescent treatment center and i developed this program that uses systems perspectives to help the families and teams that we were working with using family systems for me has been a game changer not only in the results

that i delivered the families that i work with but also in my confidence and my abilities to help families so whether you're new to working with families or you just need a refresher on how to think systemically hit subscribe come join an alliance with me and let's talk family systems one of the reasons why i'm drawn towards structural family systems is that it gives me this awesome tool called family mapping to help visualize what is going on in the family and for me when i can see what is going on when i can sort of

map it out either physically or in my head then it gives me so much more confidence to know what i'm doing and it gives me direction on how to handle things in the case so hopefully i'm not the only one with this kind of weird brain and you find it useful because i'm going to demonstrate what i mean and i would love for you to come along and see what i'm all about i want to start off by mapping out what is going on between me and you right now because you're on youtube there's a

barrier between us a real emotional distance i never get to know who you are i don't know how many times you've seen this video i don't know if you're going to come back and there's there's a real emotional distance there that i'm going to represent on my diagram there's also other kinds of distancing factors between us as well i'm recording this in august but it could be december or january when you watch this we've got a chronological distance between us and a geographical distance between us i'm based in west hollywood right now but you could

literally be anywhere in the world family mapping is simple insofar as people are just boxes or squares so unlike genograms which are a bit more complicated and have a sort of key that you have to remember all you have to remember for family mapping is boxes so i'm going to draw me like this and then when it comes to you there's a couple of things i want to discuss there's one more element that we need to factor into this diagram and it's very important to remember this in family work and couples work and that is

power we could argue that you have a lot of power in that you can turn off and find another video at any time this is true but for the sake of this argument let's pretend i'm the only video there is on structural family systems or you're a captive audience in which case i have i have considerable more power or influence right now and that is because i've got something that you hopefully want some knowledge or um ideas uh i might also be i might also have more experience than you i might even have set myself

up at the start to be an authority on the subject all of these things as well as the lack of interaction that youtube provides us means that i've got a bit more power than you so i'm going to draw you as a smaller box and no offense is meant here um and hopefully i've got more than six people watching this video so i'll add a few next to you to represent the other people that have watched this now you might disagree entirely with what i'm doing right now and that is fantastic and fine and encouraged

unlike genograms which are all fact-based and data-driven family mapping allows more of a subjective experience to come through so maybe you don't experience me as having more knowledge than you in which case your diagram is going to look very different from mine the only person that this has to make sense to is you and you have to be able to explain it as well so for that reason i love how creative family mapping is and later in this video i hope you get to see how useful it is as well as personal another element that

i want to capture in this diagram is uh boundaries one of the reasons why i chose to use teaching as an example to highlight family mapping is that there's so many juicy rules of engagement here and boundaries at least in structural systems represent who's in what group and what the rules of engagement are teaching has these sort of very implicit rules that we're all aware of but probably never actually think about so what i mean by that is no matter what the teaching event is we're going to follow the same cultural rules and that is

the understanding that the teacher is going to have more to say than us so they talk more we're more quiet in some situations we're going to put the teacher on a pedestal literally like on a stage or raise them or elevate them somehow we might even shine some spotlights on them even aliens visiting from another civilization would be able to go oh that person doing the talking with the lights on him is in a different category from the people in the dark who are listening or not saying as much how i represent that in my

visualization is by the use of lines that represent boundaries and where there's a very clear or harsh boundary i'm going to use a double line so on in this youtube example teaching over youtube i'm going to make sure that it's very clear that i feel very disconnected from you by using two lines at some point in the future i'm going to be doing a live version of this for therapists at evolve treatment centers and insight iop quick side note these are excellent resources to have if you are looking for intensive outpatient treatment centers or residential

treatment centers for teenagers i put the links in the bio below they're excellent highly recommend them both the visualization of the map of this arrangement is going to be very different from the one that i just did on youtube physically i'll be closer to them i'll be in the same room there's going to be more interaction between us so i'm going to change that boundary a little bit to be more healthy i still have some influence or power as a teacher and somebody with experience so i'm going to retain that but i tend to see

them as colleagues versus students and i think the size of the boxes is going to change to represent that i'm going to give you one more example so we've got three ideas to compare two and this last one is my nightmare class in grad school where the teacher would show up and say hey kids what do you want to learn today there was a 90-minute class that was chaos of people talking over each other there was no direction there was no sort of learning objectives it was a nightmare to be fair it was a lot

of fun but i don't think i learned a lot from it so the diagram that i draw for this is going to be different again it was very casual those boundaries were very different the power was off as well the hierarchy wasn't nearly as clear as it has been in some of the other diagrams what we're talking about is how structure and organization of a group impacts its performance so in terms of getting the task done yes you can you can learn some stuff off youtube but it's probably not quite as good as in person

and for me at least a very informal structure of a class just didn't work there's no one right way of doing it all of these different versions of delivering a class work for some people but in general we all agree that there needs to be a bit of organization a bit of a hierarchy and some boundaries and rules and the whole point of this is the same is exactly true for families without structure without organization without boundaries rules hierarchy leadership and power family doesn't do so well and when it doesn't have these elements in place

then we start seeing dysfunction and symptoms showing up and then the family comes to us so an organization might have a goal or a purpose of treating teenagers or saving pandas or making shampoo families purposes are a little more nebulous but they do they do have a task and that is simply to get them through the life cycle stages and to adapt to change um as it comes up the founder of structural family systems is self-redomination and his whole idea was that a family needs some structure some organization some leadership in order for it to

be healthy and whenever we see dysfunctional symptoms show up in a family it's because one of these things is off some aspects of structure and organization that we know to have an impact on performance are things like um leadership hierarchy roles communication and support hierarchy in place that someone's in charge um and that there are people in roles below them and that also implies that there's somebody who's got a leadership role whose vision we're following or somebody who is taking on more responsibility than others um a ceo is a great example of a leader without

oprah there is no harpo productions and within a company there are roles there's jenny in accounting mark and finance communication needs to occur between people on in the same sub-system as well as up and down the hierarchy a company needs to provide support whether it's emotional financial benefits and this again the same is sort of true for a family right you know in reverse order we need to feel support from our family we need to feel loved and wanted and included we need to have good communication within families and you know this is a big

one for us therapists obviously we're looking at the ways people communicate roles in a family are important um and we'll go into this later but we don't want to get stuck in a role i'm in a role right now of teaching but i don't want to be a teacher when i go home at the end of the day we need to be able to move in and out of roles when we get stuck that's when symptoms start showing up and dysfunction occurs with regards to leadership and hierarchy there's just one basic rule and that's that

we don't want kids in a leadership role above adults and we don't want them too far up the hierarchy where they're making decisions and influencing the family in age inappropriate ways so when i was in grad school i think i got these concepts right i think i understood about hierarchy and family mapping and boundaries and things like that but it was only when i started working with families and seeing families that did not have these things in place did it all start making sense so i want to spend a few minutes discussing what it looks

like or what in my experience what it looks like when a family shows up in your treatment room without leadership or with poor communication leadership is usually divided between two parents but sometimes and depending on culture and circumstances isn't always the case and of course there are plenty of single parent households with one leader that are very successful i would highly encourage you to assess for leadership which we'll get to in a minute because there may well be a grandparent or an aunt that is the leader of the family that doesn't live with the people

in the room with you and you need to determine if they are needed in treatment too which they probably are i tend to think of leadership as being the glue that holds a family together and what i see sometimes in a family that lacks a leader is an increase in emotional distance it's like the family sort of disintegrates a little bit without a leadership there are quite a few families that i've worked with who have not had a leadership position in the family and it seemed that the symptoms of the ip who was a teenager

had the function of bringing the family together so it's like the teenager's symptoms were doing the job of what a leader who's an adult or a parent should be doing and in another family that i worked with there was so much emotional distance and silence in the room that it felt like um you know they might be living in the same house but they may as well be sleeping in different cities or if they were a zoo they'd all be in different enclosures it was a really sad um disconnected feeling that i got as part

of my counter transference salvador mnuchin and his team had very specific thoughts on what the hierarchy of a family should look like and 60 years later you know it hasn't changed too much although i think today we are very cognizant of co-creating that ideal hierarchy for a family to respect you know cultural and religious beliefs which is so important the idea of going in with um what we know best is very different from any other modality that i work in and can be a bit jarring to some therapists but all we're saying really with this

ideal hierarchy is that we prefer adults to be in charge and kids to not be in charge so what we're looking at here is a family of four and you'll notice that the parents are in two subgroups and we separate out subgroups for the parents to account for their adult relationship and their roles as parents this is really useful when you're working with blended families or families in which maybe grandma or an aunt is very involved in parenting what i see in the room when the hierarchy is off is a lot of acting out behavior

that can include anything from running away to sometimes self-harm to taking drugs using um oppositional behaviors and when the kids symptoms are going outwards that's an externalizing symptom and for me that's always an indicator that there is something off in the hierarchy another family that i work with told me that their nine-year-old still sleeps in the same bed as them at night and maybe that's appropriate in some cultures and certain socioeconomic conditions but generally that's not developmentally appropriate and sure enough this kid was acting out both at home and in school so in this case

you can imagine this nine-year-old had left the sibling subgroup and gone all the way up to the adult sub group and so that's what i mean by a hierarchy disturbance you can move these kids up and down and that's what was going on we'll see more in a bit roles are meant to be fluid and to change with time and if a family is to get stuck in roles it means that they haven't successfully adapted to some change internal or external that's going on and if you remember the task of a family or the purpose

of a family one of one of those components is to actually adapt well to changes so some dysfunctional symptoms will show up when um people get stuck in roles some of the issues that i see in families is where children have become adultified or parentified so they've been put into a role that they are not equipped for and there's some dysfunction and symptoms as a result one of the kids that i'm thinking of came in very very depressed having been adultified for a number of years looking after their younger siblings when a parent gets stuck

in the role of being the super parent or you know the helicopter parent i tend to see a lot of built up resentment and frustration in them and they are usually so fixed on being the best parent that they can be that they often struggle to see things systemically which can be particularly challenging for therapists when a family comes to me and tells me that they have issues with communication they would like to work on i think to myself that they're really asking for help around conflict and conflict resolution family that is saying that communication

is off is saying really that they don't know how to repair relationships they don't know how to work through conflict in a healthy way this is particularly evident in high conflict families they just don't have the tools to work through or communicate what's going on and it results in hurt feelings and then those hurt feelings produce more conflict and that conflict produces even more her feelings because there's no repair this is just an endless cycle and resentment builds and builds and builds so this is um you know family that's really prickly and explosive before we

dive into making a family map i want to distinguish the differences between genograms and family maps and i love a good genogram i'm often sketching one out in my intakes just to collect all of the data in one place i find them extraordinarily helpful they are very different from family maps though so although family maps do contain some data and information in it genograms are data and information heavy it is all about collecting dates who got divorced when who died when how old is the step cousin and you know it's it's data and the idea

of genograms is analyzing data from previous generations so we're looking for generational patterns a family map is less concerned with data although it is part of a family map and more concerned with dynamics around a problem right now it's only really about the immediate family members and the interactions that go on between them often a family map is about a specific symptom or problem in the family whereas the genogram is much broader and could go in any number of different directions collecting generational data on triangles or conflict or cut-off there's very little room in a

genogram for the therapist subjective experience it's more about numbers and data i think family maps have much more room for my experience what i felt in the room and i'm going to look at that and determine how much of it is my personal stuff and how much of it is objective counter-transparent so um it is more data and um quantitative more quantitative quantitative quantitative it's more to do with numbers although i'm a huge fan of family maps it's not without its limitations family map lacks detail it's very generalized um it's static and doesn't really account

for change over time that being said i think it's a great tool for capturing family dynamics in the moment especially the ones that you want to work on in therapy i know i run the risk here of confusing the hell out of everyone because i use family maps in three different ways i use them for my own conceptualization which is what we're talking about mainly here and all you need for that is just pen and paper i also use them in group supervision when i'm supervising therapists and i want them to present a family so

well i'll have them present using a family map and the final way that i use a family map is actually as an intervention with a family i get them to create their own family map it works so well i find that teenagers and kids love being able to show what they feel over using their words and so given the opportunity they will jump on trying to show you where mom and dad are on their map or where um they are what i'm showing you on the screen now are the instructions that i use for group

supervision and if you download the handout that accompanies this as mypeoplepatents.com forward slash family systems i'll give you all the different variations of instructions so you have everything i throw in a couple more things to make it more exciting for families and sometimes group supervision to save me time i've got these colored envelopes that i use that are really helpful the instructions are pretty simple they um have a coffee table in my office and families move things around on the coffee table until it feels right for them we've already covered that squares are people but

you can also use triangles triangles represent places institutions or things one example that we'll look at later where one of the triangles we used was for success this family had a lot of connection to success i've used different colored pieces of card or different colored pens or different color envelopes in this case and sometimes it's useful to sort of process why they chose red for dad or blue for themselves you can get more out of it if you can process these things which is what we're here to do i try and give a variety of

sizes of these squares and triangles because i want to give my clients in the room or therapists in the room with me freedom to express themselves fully so i will tape up two envelopes together cut them in half fold them up whatever i need to do to be able to give people um the tools to express how they're feeling or how they visualize what's going on another layer that i use is bits of string to mark boundaries the final piece is connections between people and i use bits of tape for that i'm pretty sure by

now you know exactly how to make a family map but let's look at how to use them clinically in the first session so that it can potentially inform your treatment plan and directors for the family after the first session before meeting the family for the first time a structural therapist uses all the information they have to form a pre-session hypothesis and the idea is that when you start working with a family you can't ask them what their structure is it's not like a family will say oh we need help because our hierarchy is inverted we

need to get asking the right questions putting together a hypothesis and then testing that hypothesis out is how you get to the correct family structure so gathering as much data as possible right from the start is really important and needs to be a priority i love going into my first session with a plan and that is one of the main benefits of coming up with the pre-session hypothesis it guides my questions in the first session it prepares me so that you know my time is spent effectively and because i've not met the family yet i'm

more willing to throw it away if i'm wrong that's really the zen of hypotheses you try something if it sticks great and if not you go back to the drawing board collecting information for your pre-session hypothesis starts with the first phone call and if you're in residential or an iop you have this much easier because you get given an intake sheet with all of this information on however if you're just working from private practice like me that first phone call is really important for you to get as much information as possible ages names dates where

people live who's in the household what the problem is i create a genogram on the first call to consolidate all of the information that i get in one place so the mother called in this particular case she's in her late 40s there's a father who's in his mid 60s and they have two kids a boy who's 14 and a girl who is 20. i find out on the call that the sister is normally out of state at college but she's back for the summer and the main problems are with the male child who's 14 he's

been smoking weed missing curfew and getting into a lot of conflict with mom after the call i'm gonna think about what my pre-session hypothesis is and i ask myself a bunch of questions like who called what was the narrative of the problem going to think about family life cycle stages ages of their family members and most importantly i think perhaps is why are they calling now why what happened recently a lot of this information goes in my bubble and if you don't have a bubble you need to get one mine is bright pink and it

is where i store information that may or may not be necessary at some point um and i'm going to pull things down out of the bubble as i play with things in my mind until i come up with the hypothesis so the symptoms of this child are acting out we've got drug use missing curfew and conflict with mum and whenever there's acting out i'm thinking of the hierarchy and what the imbalance is and just to clarify when a teenager acts out with behavioral issues we call that externalizing and when they keep their feelings inside like

depression maybe that would be an internalizing problem when it comes to hierarchy problems one of the most common things you'll see is a soft hard split so one parent is good cop or the pushover and the other one is the tough mean cop and a quick look at the genogram shows that mum and the ip have a lot of conflict so i'm gonna guess that mum is bad cop my family map already has a lot of information that i want to capture if mum and dad are on different pages one being good cop the other

being bad cop there's distance between them that i want to represent i'm also going to put the ip closer to dad further away from mom to represent him feeling closer to the good cop i'm curious to know what is going on between mum and dad and why they're not on the same page whenever there's a soft hard split like this with one parent being good cop and the other being bad cop it could be a result of there being some conflict in their parent subsystem so mum and dad just aren't on the same page with

parenting rules and consequences or it could be something going on in the adult subsystem something in their marriage that they aren't discussing that keeps them on opposite pages like this so it would be important for me to explore which one of these it is whether it's just a parenting thing or something deeper in their relationship when you've got so much distance between two parents it's impossible for them to keep healthy boundaries between the parent subsystem and the sibling subsystem in order for you to provide healthy boundaries you've got to be on the same page you've

got to be talking to each other you can't have that distance so healthy boundaries would mean a united front a slightly alternative version of depicting this would be to have rigid boundaries between mum and the ip and more porous boundaries between dad and the ip that would make sense to me as well either way though there are some porous boundaries here and whenever there are porous boundaries a kid or a child can rise up into the paranor adult subsystem and if that goes on for too long that's when you get an inverted hierarchy the kid

is ruling the family and they're not equipped for that they just don't have the tools or skill to be able to lead a family so they rule by using the only tools that they have which is usually a lot of shouting yelling bribing blackmailing threatening so going back to my hypothesis one of the questions that i'm asking myself is about the age and the life cycle i noticed that dad is a bit older than mum and i'm curious about that is he retired is he still working and how did that impact everything that we've talked

about so far my hypothesis so far is that there's a bit of an alliance or a coalition between dad and the ip and that might be because he's the youngest son it might be that that's retired and has more time to spend with him we're not quite sure but it doesn't matter because it's just a hypothesis that we're gonna check out in the future my family map is gonna include the conflict between mom and i'm drawing her a little bit bigger than dad because that's so far not really in the picture i haven't heard a

lot about him and mom is the one that calls she seems to have a lot of power and she's the one butting heads with her son and i'm not including the sister because i don't really know where she fits in yet okay this is how i know i'm a family systems nerd because now i'm super excited for my first session i've got a whole bunch of information and a lot of questions that need answering so this is where angela caldwell one of the great family systems teachers in la tells us to put our lab coats

on so as well as being therapist we have to be observing the behaviors of the family as if we were scientists in lab coats so the first session comes and i'm armed with this idea of what i think is going on and i have questions that i need to ask to fill in the gaps the first thing i'm going to notice is how do they enter the room are they nervous are they quiet are they loud are they on time are they late this is all information that might help me factor in how to change

my hypothesis or if i'm sticking with it structural family therapists pay a lot of attention to where people sit because the understanding is that the family is going to show us their structure in unconscious ways so i'm paying attention to where people sit on these sofas if the eyepiece sits in between his parents that's very different from sitting alone on a sofa by themselves this were a real case and i felt confident in my hypothesis i would bet money on the fact that dad and the ip would sit next to each other often people in

a coalition or an alliance sit next to each other away from the person that they're sort of turning against still don't know what's going on between mum and dad so i'm going to pay attention to how they interact and one of the easy ways to do this is to think of the john gottman four horsemen of the apocalypse and i'll be looking for stonewalling content criticism and defensiveness there's all kinds of things i don't know about power in this family as mum got it as the ip got it i'm not sure i'm going to be

paying attention to behaviors in the room if the ip's got the power in the family he's probably going to be sulky and drawing attention from me mum and dad if it's mom she might be running the show assuming that one of the parents in the room has the most power it's important to spend time building an alliance with that person because they write the checks and decide if they're coming back or not the following week i'm definitely assessing a family for enmeshment and i've got eight signs of enmeshment that i'm looking for in the room

when i'm working with the family for the first time you can download it at mypeoplepatterns.com forward slash family systems the most common signs of enmeshment that i see are people speaking on behalf of each other so a parent jumping in to answer a question that i aim at the ip and using we versus i so parents saying we feel that this is a great match for us when actually i want them to speak for themselves and i'll correct them and ask them to do that i think you guys are more than ready now to create

your own family map so what we're going to do is watch a scene from the incredibles 2 where the family has dinner together and i found the interactions that they have so realistic it's perfect for family systems training go grab pen and paper and watch the clip and create a family map based on the scene on the other side of the video i'll show you what i did and you can sort of follow along and see where you're at a little side note on enactments watching a family interact like this as if we're not there

is called an enactment and we would try and recreate something like this in therapy with an activity or a discussion topic or just watching the family do their thing there were three standout moments in this clip that made me think of family systems and i could already like envision the family map as i was watching this viola asked her brother a couple of times in a couple of different ways to wash his hands and that made me think of her as being a parentified child and if she's not parentified she is certainly overstepping her mark

as a sibling because that sounds an awful lot like what a mom should be saying and remember a family isn't able to tell us their structure we're inferring the structure from interactions just like this there's a bit of a familiar dynamic now in the next clip and i can see there being a lot of conflict between mom and dad taking violet's side a lot this is going to show up in my map in terms of the relationship lines violet's basically getting dad to side with her against mom in this this is quite a common dynamic

that really makes a hierarchy imbalanced so i'm going to put violet closer to dad and dad and violet against mom the fact that dad didn't take mum's side means that there's some boundary issues again that allows violet to have more power than she should as mom and dad are not on the same page with regards to the superhero thing and it clearly is a parenting issue and an issue between them personally so there's conflict in the adult and parent sub-system i think this is something that violet exploits so this was not a good idea to

have that conflict in front of her because she's going to take advantage of that whenever she can so based on just a two-minute viewing of this family you can already get a lot of information to put in your family map you need to sort of watch them over time obviously to make sure it's right but when you compare it to the ideal family map putting the two side by side gives you an outline of what the work is in treatment so to work out the treatment plan all you have to do is figure out the

things you need to do to get from one image to the other some of the things that stand out to me are violence central role hierarchy stuff the parent conflict boundaries and you know getting violet and dad a little less enmeshed with each other this is looking dangerously like a transgenerational coalition against a parent i know there are signs that dad and violet are in a coalition against mom now this is particularly dangerous to families and there's some empirical evidence out there that supports the idea that the teen in this situation is more likely to

become a substance user so i want to jump on this straight away if this family were my clients there might be some signs that there's this soft hard split between mum and dad again so i would want to address that by getting mom and dad on the same page with regards to their parenting of violet and they're in desperate need of a conversation to get on the same page about this whole superhero thing i'd also help them see the systemic pattern that goes on when one parent is easy on a kid the other one makes

up for it by being tougher and this repeats the cycle i'd want to help the family toughen up their boundaries so that the hierarchy gets a bit clearer so if i was in a session with this family one of the structural techniques i would use would be to block or restrain violet from acting like a parent in front of me and i would highlight this to mom and dad in an attempt to get them to see that it's not healthy when a kid acts like a parent all right i hope that gave you a great

insight into family mapping and if you want to know more sign up for our mailing list and i will keep you in the loop every time i put a new systems training video up and i look forward to hearing from you