Systemic Constellations: A New Approach to Psychotherapy
Master of Psychology course
There are currently hundreds of different therapies being practised by psychologists today (Gurman & Messer, 2003) - some of them mainstream and others more controversial. One approach which differs from conventional psychotherapy, yet still draws on decades of psychotherapy theory and practice, is Systemic Constellations, or Constellation therapy. Relatively little-known and perhaps somewhat unusual therapy, it emphasises the experiential method of inquiry and takes inspiration from family systems theories, transgenerational approaches, and even tribal customs and eastern philosophies.
This essay aims to explore the theory and practice of Systemic Constellations through an interview with Alemka Dauskardt, a psychotherapist who has been in practice for 25 years, providing mental health services to women affected by family violence, refugees and victims of torture and trauma. She now runs her own practice, drawing on several different approaches but mainly working with Systemic Constellations, having both undertaken and led many workshops in this approach since she came across it in 1994. This essay will provide a brief overview of the history of Systemic Constellation work, followed by examples of specific strategies and outcomes. The theoretical underpinnings of this therapeutic approach will then be examined, followed by a discussion of future directions in this field.
Systemic Constellations: A Brief Overview
The Systemic Constellations approach (or Family Constellations, as it was originally known) was developed in the late 1970s by Bert Hellinger, German psychotherapist, author and philosopher. Now in his eighties, Hellinger continues to be a leading, if somewhat controversial, voice in psychotherapy internationally. Despite the fact that apparently Hellinger did not initially publish on Constellation work, intending to keep it away from mainstream psychotherapy and academia, word about this new approach spread through Europe and the world, and continues to do so. Although it remains little-known in the psychological community, this new therapeutic approach has already been practised in countries all over the world. There are now numerous organisations dedicated to furthering the practice of Constellation therapy, such as the International Systemic Constellations Association and the International Forum for Systemic Constellations in Organisations. Hellinger’s seminars, several of which Alemka has attended, have drawn audiences of thousands, and many books on the theory and practice of Systemic Constellations have now been published by Hellinger and others (Hellinger, 2001, 2003; Hellinger & ten Hövel, 1999; Hellinger, Weber, & Beaumont, 1998).
Constellation therapy is short term, often single session, solution-focused therapy which can be applied to any emotional or psychological problem. This includes issues as grief, addiction, substance abuse, family or relationship difficulties, physical and mental illness, eating disorders, somatisation disorders and trauma. When asked about whether there are specific issues this approach is most appropriate for, Alemka replied that Constellation therapy is particularly successful in examining issues which are systemic and transgenerational in nature, and which often lie out of the client’s conscious awareness. According to Alemka, it “works best for issues which have their root cause in something from our family history, something which maybe occured few generations ago and which we have no awareness of”. There must also be an important presenting issue, something which is posing difficulty for our present functioning, usually in the area of our relationships, she says – it cannot be done out of simple curiosity or just a desire for self-exploration.
Constellation therapy can be applied individually, but is most effective in groups of 10 to 30 people, and it is this group approach that will be focused on here.
Constellations take a perspective which goes beyond the level of personal history - that of “invisible bonds” or “systemic entanglement”, which is at an unconscious level for the client. Following is an example of the way this therapy works.
The method of classic family constellations, Alemka explains, is actually quite simple. In a group setting, a person (anyone from the group who volunteers to be the “client”) identifies an issue, a problem, or a symptom, and describes what he wants a resolution for. The therapist, or facilitator, asks some basic facts about the important people and events in the person’s life to determine family history. On the basis of this information, the facilitator develops a hypothesis about the family dynamics involved, which she then tests in a “constellation”. To do this, the client chooses group participants to represent important family members, including a representative for themselves, and sets them up around the room in a spatial relationship to one another, intently and carefully, guided only by their “inner image” of the dynamics and relationships between the family members. That person then sits next to the facilitator and observes.
Alemka goes on to describe that as soon as this is done, the energy of the particular family that has been set up “comes to life”. The representatives begin to experience bodily sensations, feelings and thoughts of the persons they are representing, often without knowing anything about them. Representatives then provide verbal feedback about their moment-to-moment sensations to the facilitator, who then gets a clear, well informed picture of the dynamics that are operating in this particular system. Obviously, the facilitator needs to undertake training and have sufficient experience in this approach to be able to read relationship dynamics from simple spatial orientations and positioning. She then confirms or changes her initial hypothesis on the basis of this feedback from the representatives.
Once the facilitator has “read” and understood the dynamics at play in this system, she begins with interventions designed to “bring the system to order”. She might move some representatives, add an additional representative, or she may ask representatives to speak certain sentences or complete certain rituals - for instance, bowing in gratitude or saying “Thank you” or “I am sorry”. All this is done to help the client - and everyone else in that system - to move toward a resolution. This resolution, when reached, can be expressed by representatives in the constellation in myriad ways - as feeling good, feeling as though they have found the right place for themselves in the family constellation, tears of joy, relaxation in the body. When the solution or resolving image has been found, the person whose constellation it is – the client - takes his place in it. Many constellations, Alemka reveals, lead to insight about dynamics in a family which are having a negative effect on a person’s health and well-being. Some lead to an image of a resolution that brings immediate physical and emotional relief to all representatives, as well as the client. Surprisingly, Alemka reveals that in some instances, these changes are also felt by the family members who were represented but did not attend the workshop, or indeed, did not know about it at all.
When prompted further about how she knows a constellation has “worked” for a particular client, Alemka responds by saying that there may be immediate feedback from the client after a constellation. In Alemka’s experience, at the end of a constellation, clients often report that they feel lighter, relieved, more relaxed or that the original feeling of fear or anger or grief or abandonment has gone. There may be a visible difference in the person’s body - at the end of a constellation, she says, a person’s face relaxes and they often look quite different. Sometimes, she explains, she has seen the same people again later on, and they have reported to her about the events in their life after a constellation. They may say that they finally managed to end that troublesome relationship, or that they have a much better relationship with their father or that their symptoms of asthma disappeared completely or that they finally got a long awaited promotion at work. Sometimes, if a constellation was about estrangement - with a father for example - the contact has since been re-established. “Even though”, Alemka adds, “I have no proof that these changes happen as the result of a constellation, they happen with such regularity that it is hard to attribute them to coincidence alone. I also know about the effects from personal changes I have experienced through constellation work.”
Theoretical Origins of Systemic Constellations
Family Systems Theory
The Systemic Constellations approach is an eclectic therapy, drawing from many theories since its beginnings in the 1970s. As the name implies, it was most heavily inspired by family systems theory, and many parallels can be drawn between the two therapeutic approaches. Both are based on the premise that to understand an individual’s behaviour, it is necessary to look further than the traditional psychoanalytic field of inquiry and examine the client’s role within their family (Stevens, 2001). As a result, strong emphasis is placed on obtaining the client’s family history – in family therapy approaches this is often achieved through the use of a genogram (Carlson, Sperry, & Lewis, 1997). In a Systemic Constellation, this can be done via a simple verbal description given by the client, looking back several generations (how many will depend on the client’s presenting issue) at the main events in the family, and how these impacted the members involved. The facilitator has an important role in prompting for this information. For instance, Alemka tells me, the facilitator might ask about who belongs to the family system, whether anyone died young, whether anyone in the family had a particularly hard life, or whether some injustice was done.
The practice of Systemic Constellations was inspired in no small part by Satir’s technique of sculpting. This technique uses body postures, gestures and spacing as an expression of one’s family system. In Satir’s method the client becomes the ‘sculptor’, and asks other group members to take up a specific body position and expression to represent the client’s family. This results in a three-dimensional “sculpture”, an arrangement of people which symbolically represents family members’ relationship to each other (Carlson, Sperry, & Lewis, 1997). The client can then remove him or herself from the arrangement to gain an objective understanding of the situation, thus opening up the possibility for new insight and awareness (Satir & Baldwin, 1983). While Satir’s method of sculpting was developed in the 1960s, this work has been expanded upon greatly and since used in many other psychotherapies (Satir & Baldwin, 1983), including Systemic Constellations. Indeed, the technique of using representatives to symbolise a family system forms the basis of Constellation therapy, but as we shall see, the practice of Systemic Constellations takes this concept further by developing the phenomenological and spiritual dimensions of the therapeutic work.
The experiential method of inquiry, or phenomenology, is another critical ingredient in the practice of Systemic Constellations. It can be defined as “acknowledging what is” without judgement or prejudice, recognising and accepting what is being experienced in the here and now (Germer, Siegel, & Fulton, 2005). While mindfulness has been present in Buddhist practices for the last 2500 years, it has recently begun to show potential in enhancing psychotherapy, and is now being incorporated into many different therapeutic approaches (Germer, Siegel, & Fulton, 2005). Virginia Satir has also commented on the importance of being aware of one’s body in therapy, and to try and educate clients to become more aware of theirs (Satir & Baldwin, 1983). Similarly, a vital component of Constellation therapy is the need for representatives in a constellation to be aware of sensations in their bodies. This bodily awareness allows the representatives to provide the feedback which will drive the therapeutic process to a resolution. However, this process is much simpler than that involved in mindfulness techniques. Alemka explains that this method does not require particular concentration, meditation, or the focus required in mindfulness from representatives. Participants must simply be aware of physical sensations in their bodies, which they can then report on. As an example, Alemka describes an experience she had when being a representative in a constellation:
I was representing a woman – a grandmother of a client. As soon as I was put in the spot, I felt this terrible pain in my stomach, and I just folded over. The facilitator said, ‘What’s happening with you?’, and I said ‘I can feel pain in my stomach.’ And the person whose family that was, she said, ‘Oh yes, my grandmother died of stomach cancer.’
The Systemic Constellations approach has been enriched by transgenerational perspectives on family functioning, which emphasise the way that certain behaviours continue from generation to generation, for better or worse. The overarching principle of Systemic Constellations is this: each member of a family holds a special place and has an equal right to belong to the family system. In other words, no one can be excluded; no one can be taken out of the family system. A member who is lost from the system still has an effect on it. This includes stillborn, aborted or adopted-out babies who were never spoken about, or family members who have been excluded for any reason. Common examples of exclusion from the family system, says Alemka, include not remembering those who died, treating family members and their role with disrespect, or for example a second wife who refuses to acknowledge her husband’s first wife. Exclusion from the family system is considered one of, if not the primary, underlying cause of dysfunction according to Systemic Constellations. The theory states that if a family member is rejected, disrespected, forgotten, or in some way treated as not belonging, someone in a later generation may repeat the individual’s fate by sharing a similar misfortune. In this way, family members can “take on” destructive familial patterns such as depression, anxiety, alcoholism, dysfunctional relationships and even physical illness, and these patterns can be repeated through many generations. For instance, younger generations may unknowingly take on the burden of previous family members who have suffered or been excluded, out of an unspoken, and often unconscious, loyalty to that family member.
The description of this phenomenon can be found already in the work of Ivan Boszormenyi-Nagy, an influential family therapist who identified repetitions of family events in relationships. A key mechanism of this transmission of dysfunction is what he termed “invisible loyalties”, ties that people feel to their families of origin which may prevent them from living freely (Boszormenyi-Nagy & Spark, 1984). For instance, individuals may be unable to break dysfunctional family patterns because this is “the way things are” in their family. The Systemic Constellations approach have taken this a step further, determining that family patterns can be unconsciously transmitted through many generations, and are largely out of awareness of the individual client who carries them. Alemka gives an example of this dynamic in a client of hers:
A young woman came complaining of feelings of not belonging, abandonment and inexplicable grief. The grief she connected with the death of a friend and had tried to work through in previous therapy without much success. We set up the constellation (she had never done it before) and through the process, on the basis of information I got from the set up as well as from reading the overall energy field of the constellation, I had a hunch about a lost sibling. I asked her about it but she knew nothing and maintained she was the only child. The next week she came back and told me she was astonished to find out about an adopted out sibling upon asking her mother. In her case, she not only carried the feelings of the adopted out sibling, but also carried her mother’s feelings of grief about the forced adoption that her mother could not allow herself to feel. So my work with her centered around dissolving the unconscious identification with this sibling and also involved ‘handing back’ the grief feelings to the mother, where they belonged. This is what resolved her starting presenting issue of experiencing feelings of inexplicable grief. It also unearthed the longstanding family secret, which only could have had the positive impact on the future functioning of the family.
Alemka explains that because this first child was a part of this family’s system and it was excluded, not only through adoption but by being kept a secret, the family “recruited” another (usually a younger) member of the family to represent that child, and the second child developed inexplicable feelings of abandonment and not belonging. This is what is called “entanglement” in Constellation work. The solution in this example, reveals Alemka, involved the second child being told about the first child. Family secrets, Alemka strongly believes, have devastating effects on families. She says, “It really is not true that ‘what you don’t know can’t hurt you’. It is really the opposite. It is precisely what you don’t know that hurts you.” In this example, the second child had to face the first one (in a constellation with a representative for the first child) and to say: “I can see you now. You are my sister/brother. You are the first and I am the second. I am sorry about your destiny. Even if I have never seen you, I give you a place in my heart.” Saying these words resolves the issue of entanglement in the family constellation and frees the second child.
Brief and Solution-Focused Approaches and the Stance of the Therapist
The Systemic Constellations approach is aimed at resolutions. “Our focus”, Alemka says, “is always on the solution, never on the problem.” It is also extremely brief in comparison to other psychotherapies. Most issues can be dealt with in a couple of sessions, often in one session only, making it a highly efficient form of therapy. The growing trend toward efficiency and brevity in psychotherapy (Hoyt, 2003) may serve to fuel the development and acceptance of this approach.
One other significant aspect of Constellation work is that the therapist is much “smaller” than in other types of therapy. As Alemka puts it,
We believe that the therapist comes last to the family system and as such occupies the lowest position - she facilitates the process for a short while and then completely withdraws without imposing any expectation of change, without taking any credit or responsibility for anything that happens with that family later. So the position of the therapist or facilitator is very low, humble and non-attached, which is seen as essential in entrusting the full potential for healing and change to the family in question. As a therapist I find that immensely freeing and helpful.
Mechanisms of Change: An ‘Unsolved Mystery’
The forces at play in Constellation work – those that enable representatives to channel the energies of the family system - remain very difficult to define. They have been described in various terms: energy fields, the consciousness of space, intuition, morphogenetic fields, the Knowing Field. A number of books have been written describing and attempting to make sense of this phenomenon (Sheldrake, 1988, 2003). Experiments have also been informally conducted, for instance, to test people’s ability to recognize the energy in the field which is not bound by space or time or any physical form of transmission, like for example knowing when they are being stared at (Sheldrake, 2003). However, these experiments were not scientifically rigorous and were conducted by biased investigators. Indeed, the concept of these energy fields is, by its very nature, almost impossible to research empirically and describe concretely. When asked about her take on the underlying mechanisms at work in Systemic Constellations, Alemka claims that this, understandably, tends to be the first question people ask upon reading or hearing about the work. Her reply to this question is that exactly how it happens is unknown, and practitioners of this approach, including Bert Hellinger, have for now had to content themselves with the success of the therapy and put aside the question of “How?”
From the western scientific perspective, this is not an easy thing to do. To work in this way, Alemka says, “You have to abandon most current scientific paradigms as well as notions of control, individualism, supremacy of the rational mind, and the belief that everything can be known, proved, measured and explained”. In addition, Constellation therapy is so variable and individualised in its application that it does not lend itself to being systematically evaluated, and can only be defended from a phenomenological approach. Many practitioners and individuals who have witnessed and experienced Constellation therapy have strongly attested to its success. Additionally, pilot studies have recently attempted to empirically assess the effectiveness of Systemic Constellations. Preliminary results show that this method has been quite successful in resolving emotional problems (Thomas, 2010), improving relationships (Sethi, 2009), and transforming the way illness is perceived (Descleves, 2008). A large-scale effectiveness study is also being conducted by the International Systemic Constellations Association. At present, however, effectiveness research on Systemic Constellations remains scant.
There has certainly been criticism levelled at this therapeutic method, stating that representatives in the constellation may be merely projecting their own intuitions and experiences into the process, or acting out of a desire to create healing or a resolution for the client. To this, Alemka replies that the best way to understand the approach is to participate in a constellation workshop and experience the effect of the work for oneself. Being a deeply experiential approach, she admits, the process is difficult to explain with words only. At present, it is unclear whether the processes behind this therapy will ever be fully understood, and conjecture regarding the effectiveness and underlying mechanisms of this approach is sure to continue.
Future Directions for Systemic Constellations
Constellation therapy draws on many ideas and theories preceding it, yet combines them to create a unique therapeutic approach. It is certainly not a therapy that will be accepted by everyone, and it remains unknown whether it will ever be accepted by mainstream psychology. This, admits Alemka, “would require some major shifts in currently accepted notions, beliefs and values within the psychology profession, such as a move away from western notions of individualism toward an acknowledgment of the forces that are bigger than us.”
When asked about whether this approach may not be compatible with the sceptical, empirically-trained psychologists of tomorrow, Alemka replied that her concern would be “the other way around: that the psychologists of tomorrow are not going to make themselves compatible with this truly beautiful, powerful and effective approach just because it cannot be fully understood within the current psychology paradigms.” Certainly, for psychologists trained in western societies, the concepts behind the Constellation method sound strange. In addition, the work is not easy to describe and is highly experiential in nature, which will undoubtedly result in confusion and scepticism for many psychologists. This essay has only touched on the vast array of stories that have been shared by the individuals and therapists who have experienced this therapeutic method at work. However, at present, the body of evidence remains largely anecdotal. Until research has confirmed the effectiveness of and shed light on the mechanisms at work in Constellation therapy, it is likely that this therapeutic method will not be wholly accepted by today’s scientifically driven, empirically-based psychology.
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