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On Families and Systems: Who is in the Room?

My personal definition of family has always included grandparents, aunts, uncles and cousins. This is because of how I grew up; I was born in a joint family system, which meant that my parents lived with my father’s parents, his siblings and their kids, all under one roof. Although I didn’t spent my entire life growing up in that system, my early childhood experiences of close connections with my relatives have had a profound impact on how I understand family dynamics. Whether we grow up in a nuclear family system with parents and siblings, a joint family system with other relatives, or a separated family system (divorced, geographically distant, or emotionally cut off), the connection or lack thereof shapes how we interact with others. Attachment doesn’t solely exist between parent and child; it can exist amongst siblings and also other caregivers. We are meaning-making creatures and understanding our stories and the stories of our ancestors can help define our purpose, our legacy, and our narratives about who we are as a person. 

In the medical field, asking questions about family history is standard practice; for example “Who in your family has a history of diabetes and cholesterol?” or “Is there any one else in your family with heart problems?” are often part of the intake process. In the world of psychology, asking questions about family history can sometimes open up doors people have tried to keep shut. Some times my clients come in wanting to talk about their family, at other times, they ask me why I need to know about their parents or even grandparents.  I explain that in order for me to have a context of who they are, it’s helpful to know where they come from.  I subscribe to Urie Bronfenbrenner’s bioecological systems theory, which highlights a person’s systems such as family, community, and other external environments and how our relationships to these systems change and evolve over our lifespan. Bronfenbrenner defined these as five systems; the microsystem (siblings, parents, family, teachers and peers), the mesosystem (the interaction between relationships in the microsystem, such as the parents and school), the exosystem (such as neighborhood, community, mass media), the macrosystem (culture, socio-economic status, ideaology and ethnicity), and lastly the chronosystem (socio-political environment at the time, historical events). Moving from the most intimate microsystem of family and school to the larger macrosystem of cultural factors and ethnicity, this model provides a holistic approach to understanding the multitude of dynamics in the systems that develop our personalities and shape our thoughts and behaviors. 

I find that one of the most practical elements to this approach is that not all behaviors, patterns, or problematic structures need to be altered in order for change to occur. Rather, small amounts of change in families are often sufficient to prompt more dramatic changes in family interactions and structure. For example, encouraging family members to talk about the problem allows me to assess the family’s typical interaction patterns and hierarchy, which alone has the potential to create change, particularly if the family does not typically communicate about the problem. As a feminist family therapist, I recognize how sexism in society impacts cis-gender men and women in what systemic therapists call the “relational dance”. My experiences in working with diverse clients from all walks of life allow me to see the family as more than an interactional unit; it is a political institution that reflects the culture in which it is immersed. Gender roles and socialization affect each individual in the family and perpetuate “fixedness” in interpersonal relationships in the system. Not only do gender roles affect relationships between the family and society, but they also impact the therapeutic alliance. I find that regardless of age and/or gender, folks are able to explore less rigid gender arrangements within their families when invited to do so in a collaborative, respectful manner.  Even if I’m working with a client for individual therapy, exploring their family dynamics and history allows us to see everyone who is ”in the room”, contributing to both the challenges and resilience faced by the person across from me on the couch.  Whenever possible, I encourage my clients to bring in their family so that we can go beyond just talking about what needs to happen in their family relationships, but actually find ways to enact new ways of communicating and relating that may not have been possible before. 

Dr. Ammara Khalid 

Licensed Clinical Psychologist 

CORE – Center of Relational Empowerment, P.C 

[email protected]

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