See discussions, stats, and author profiles for this publication at: https://www.researchgate.

net/publication/348631899

The Science of Family Systems Theory

Book · January 2021

DOI: 10.4324/9780367854591

CITATIONS READS

12 10,870

1 author:

Jacob Priest
University of Iowa
41 PUBLICATIONS 509 CITATIONS

SEE PROFILE

Some of the authors of this publication are also working on these related projects:

Learning Emotionally Focused Couple Therapy: Four Therapist Perspectives View project

All content following this page was uploaded by Jacob Priest on 25 January 2021.

The user has requested enhancement of the downloaded file.

“This book is balanced and captivating. It guides the reader through
a clear, comprehensive, and grounded review of the knowledge and
practices in the area of family systems. A great resource for family
researchers, educators, and clinicians seeking to advance their work.”
— Sesen Negash, PhD, LMFT, associate professor and director,
Marriage and Family Therapy Program, San Diego State University

“In The Science of Family Systems Theory, Dr. Priest provides a cohesive
guide to understanding and applying general systems theory with
increased clarity and purpose. From describing the minute details of cells
and DNA within the body to explaining systemic oppression in broader
sociocultural systems, the author provides the reader with an opportunity
to see how comprehensive general systems theory can be in explaining so
many processes in the universe. The book also provides examples of how
to make clear connections between scientific observations and family
systems theory.”
— Daniel Hubler, PhD, CFLE, associate professor,
Child and Family Studies, Weber State University
The Science of Family Systems
Theory

This accessible text examines how the science of autonomy and adaptation
informs all family therapy approaches and discusses how clinicians can
use this science to improve their practice.
Uniquely focusing on how to integrate science and theory into clinical
practice, the book provides an overview of science from multiple domains
and ties it to family systems theory through the key framework of autonomy
and adaptation. Drawing on research from genetics, physiology, emotion
regulation, attachment, and triangulation, chapters demonstrate how a
comprehensive science-­informed theory of family systems can be applied
to a range of problematic family patterns. The text also explores self-­
of-­the-­therapist work and considers how autonomy and attachment are
connected to systems of power, privilege, and oppression.
Supported throughout by practical case examples, as well as questions
for consideration, chapter summaries, and resource lists to further
engage the reader, The Science of Family Systems Theory is an essential
textbook for marriage and family therapy students as well as mental
health professionals working with families.

Jacob B. Priest is an associate professor in the couple and family therapy

program at the University of Iowa. He received a PhD from Florida State
University and has a private practice at the Counseling Center of Iowa City.
The Science of Family
Systems Theory

Jacob B. Priest
First published 2021
by Routledge
52 Vanderbilt Avenue, New York, NY 10017
and by Routledge
2 Park Square, Milton Park, Abingdon, Oxon, OX14 4RN
Routledge is an imprint of the Taylor & Francis Group,
an informa business
© 2021 Jacob B. Priest
The right of Jacob B. Priest to be identified as author of this
work has been asserted by him in accordance with sections 77
and 78 of the Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this book may be reprinted
or reproduced or utilised in any form or by any electronic,
mechanical, or other means, now known or hereafter
invented, including photocopying and recording, or in any
information storage or retrieval system, without permission in
writing from the publishers.
Trademark notice: Product or corporate names may be
trademarks or registered trademarks, and are used only for
identification and explanation without intent to infringe.
Library of Congress Cataloging-­in-­P ublication Data
Names: Priest, Jacob Bird, author.
Title: The science of family systems theory / Jacob B. Priest.
Description: New York, NY : Routledge, 2021. | Includes
bibliographical references and index. |
Summary: “This accessible text examines how the science
of autonomy and adaptation inform all family therapy
approaches and discusses how clinicians can use this
science to improve their practice. Supported throughout
by practical case examples, as well as questions for
consideration, chapter summaries, and resource lists to
further engage the reader, The Science of Family Systems
is an essential textbook for marriage and family therapy
students as well as mental health professionals working with
families”— Provided by publisher.
Identifiers: LCCN 2020043550 (print) | LCCN 2020043551 (ebook) |
ISBN 9780367427160 (hardback) | ISBN 9780367427184
(paperback) | ISBN 9780367854591 (ebook)
Subjects: LCSH: Systemic therapy (Family therapy) | Family
psychotherapy.
Classification: LCC RC488.5 .P75 2021 (print) | LCC RC488.5
(ebook) | DDC 616.89/156—dc23
LC record available at https://lccn.loc.gov/2020043550
LC ebook record available at https://lccn.loc.gov/2020043551
ISBN: 978-­0 -­3 67-­4 2716-­0 (hbk)
ISBN: 978-­0 -­3 67-­4 2718-­4 (pbk)
ISBN: 978-­0 -­3 67-­8 5459-­1 (ebk)
Typeset in Sabon
by Apex CoVantage, LLC
To Chelsea and Keenan
Contents

Acknowledgmentsxi

1 An Introduction to Family Systems Theory 1

PART 1
The Evidence of Autonomy and Adaptation13

2 The Genetic and Individual Systems 15

3 The Attachment, Triangulation, and Family
Systems31
4 The Sociocultural System 48

PART 2
Linking the Evidence to Theory63

5 The Family as an Autonomous System 65

6 The Family as an Adaptable System 75
7 Family Systems Theory Revisited 83

PART 3
Linking Theory to Practice99

8 The Postmodern Critique and Family

Systems Theory 101
9 Attachment Theory and Family Systems Theory 108
x Contents

10 Trauma in Family Systems Theory 117

11 Family Systems Theory and Family Therapy Models 131
12 Conclusions and Recommendations 140

Appendix A: Read Better146

Appendix B: Engage Differently158
Bibliography160
Index173
Acknowledgments

This book would not have been possible without the help and support of
many. Lorna Hecker, thank you for making the introductions and help-
ing me think this was possible. Thank you to my Editors at Routledge –
Clare Ashworth, for getting it off the ground and Heather Evans for
seeing it through the finish line. Volker Thomas, thank you for your care-
ful reading and thoughtful suggestions – the book is much better because
of it. Sarah Woods and Patricia Roberson, thank you for being sound-
ing boards and idea generators. Thank you Armeda Wojciak and Kayla
Reed-­Fitzke. I couldn’t ask for better colleagues or friends. And thank
you to the teachers, professors, mentors, and clients who have inspired
and challenged me.
My parents, Scott and Sally, and my siblings, Shanna, Brody, Eli, Sar-
ryn, and Saydie have been my champions since I entered the world of
family therapy. None of this would have been possible without their sup-
port. To the world’s best cat, Albert – thank you for keeping me company
in the office during long writing days. Finally, I am fortunate to be mar-
ried to someone who writes far better than I can. Chelsea, thank you for
being my first and best editor and for the incredible support you provided
throughout this process. I love you and I like you.
Chapter 1

An Introduction to Family
Systems Theory

When people ask me about my job, I lie – a little bit. When someone asks
me what I do, I say, “I’m a family therapist.”
More often than not, they then ask, “So, like a psychologist?”
This is when I lie. I say, “Yes, like a psychologist.”
It’s not a total lie. Like many psychologists or counselors, I do psy-
chotherapy. People come to me when issues or problems come up. They
come into my office, we talk about these issues, and we work together
to tackle their problems. But my training and way of thinking about
their problems are different. As a family therapist, my practice is rooted
in family systems theory. This theory is what sets me apart from other
psychologists and counselors. It’s what makes family therapists family
therapists.

The State of Family Systems Theory

In Family Evaluation (1988), Michael Kerr and Murray Bowen argued
that “human behavior is significantly regulated by the same natural pro-
cesses that regulate the behavior of all other living things” (p. 3). They
sought to place the human family in the context of biological science.
Throughout their book, the pair drew upon the best available research
to demonstrate how evolution and other processes had shaped the family
system and could explain the development of problems in families. This
was their basis for their family systems theory.
In laying out their theory, they acknowledged that the science of fac-
tors that regulate human behavior and the family systems was limited.
They suggested that with new knowledge, their ideas about the family
system would require adapting or amending. They saw their work as a
first step in understanding the family as a natural system, but they noted
that researchers had “barely scratched the surface” in uncovering what
shapes human behavior and family interactions.
More than 30 years later, the knowledge we have regarding family sys-
tems has grown substantially. We now understand more about biological
2 An Introduction to Family Systems Theory

processes such as evolution and genetics and their effect on family sys-
tems. We know more about the human brain and body and the role that
emotion and attachment play in families. Researchers have uncovered
factors associated with loving, committed, healthy relationships, and
we know more about how broader sociopolitical forces affect families.
If in Kerr and Bowen’s era, the science of family systems had “barely
scratched the surface,” today, we have broken through the surface and
begun to dig into the core.
But with all this new knowledge, family systems theory has gotten
stuck. Karen Wampler and her colleagues (2019) noted that the field of
family therapy is still largely reliant on the family systems proposals of
people like Murry Bowen, Salvador Minuchin, and Virginia Satir – most
are more than 30 years old. They pointed out that, to move the field for-
ward, the hypotheses that accompany family systems theory need to be
scrutinized by research. By scrutinizing these hypotheses, we may be able
to create greater innovation in systemic family therapy practice.
Theory and research are supposed to have a reciprocal relationship.
Theory drives research hypotheses. Research findings provide evidence
for or opposition to the hypotheses. Based on the evidence, the theory is
supported, adjusted, or discarded. But this hasn’t happened with family
systems theory. Though the understanding of the science of family sys-
tems has grown exponentially, this evidence we have gained hasn’t been
applied to the hypotheses of family systems theory. In other words, fam-
ily systems theory hasn’t been assessed by the new evidence.

Evidence-­B ased Practice and Practice-­B ased

Evidence
One reason that family systems theory hasn’t been updated is that
researchers, with good reason, have been focusing on family therapy
outcomes. Researchers have been seeking to answer the question, “Does
family therapy work?” This research, often referred to as evidence-­based
practice, has provided good evidence that it does. When people work
with a family therapist, they tend to get better (Shadish & Baldwin,
2003). We have evidence that family therapy works for childhood prob-
lems such as behavioral issues, emotional problems, eating disorders, and
many others (Carr, 2014a). We also have evidence that family therapy
works for adult problems, including marital distress, sexual dysfunction,
intimate partner violence, depression, anxiety, and adjusting to chronic
illnesses (Carr, 2014b). Evidence gathered through randomized control
trials has found that specific models including functional family therapy
(Sexton, 2017) or solution-­focused therapy (Gingerich, Kim, Stams, &
MacDonald, 2012) help clients reach their goals.
 An Introduction to Family Systems Theory 3

Another area of research, practice-­ based evidence, is concerned

with the question: What makes a good family therapist? The research
addressing this question has led to the development of many tools to
help therapists get better. Lee Johnson and his colleagues have developed
the Marriage and Family Therapy Practice Network (Johnson, Miller,
Bradford, & Anderson, 2017). This network provides therapists with
assessments that get client feedback and track client growth over time
with the goal of improving outcomes. Evidence suggests that when thera-
pists solicit feedback and track client progress, outcomes improve (e.g.,
Anker, Duncan, & Sparks, 2009; Shimokawa, Lambert, & Smart, 2010).
Researchers and practitioners are studying and adapting the research to
refine the practice of family therapy; helping to identify what individual
therapists bring into the room that help clients get better.
These two research areas have done a great deal to advance the prac-
tice of family therapy. Today, therapists have clear ways to improve their
practice, and most importantly, they can provide care to their clients
grounded in evidence. Though there needs to be continued improvement
in evidence-­based practice and practice-­based evidence (e.g., Dattilio,
Piercy, & Davis, 2014; Wittenborn, Blow, Holtrop, & Parra-­Cardona,
2019), the evidence we have about our models and our work continues
to advance. However, this evidence is skill-­and model-­based – it’s not
focused on supporting the proposals of a theory.
Though these avenues of evidence have added much to the field of fam-
ily therapy, there needs to be a renewed focus on family systems theory.
If we don’t continue to revise family systems theory, based on new evi-
dence, we risk the assumptions of our approaches becoming invalid. If
we aren’t keeping up on the science, we risk being left behind or not being
viewed as part of the mainstream of therapeutic practice. Though we
know family therapy works, by validating family systems theory based
on current scientific knowledge, we can do things that work better. We
may develop evidence-­based treatments that work better than the ones
we currently have, and we can spur innovation and creativity both in
individual therapists and throughout the field.

What Is Family Systems Theory?

Family systems theory is surprisingly difficult to define. If you ask ten
family therapists to define it, you won’t get a consistent answer. When
I ask my students or my colleagues to define it, I get a variety of responses.
Some have said things like, “It’s the idea that family members’ actions
and emotions are connected,” or similarly, the idea that “the whole is
greater than the sum of its parts.” Others start talking about the model
they use or their own “theory of change.”
4 An Introduction to Family Systems Theory

Family therapy researchers also don’t have a clear definition of fam-

ily systems theory. In a review of 275 family therapy research studies,
28 different theories of models were identified as used by family ther-
apy researchers (Chen, Hughes, & Austin, 2017). Some used “systems
theory,” but poorly defined it; others used models or “mid-­level theo-
ries” that are connected to family systems theory but failed to tie the two
together. The authors of this review article noted that for family therapy
researchers, “Simply stating that a study is guided by a systemic per-
spective or family systems theory overlooks an opportunity to enlighten
the reader on the nuances of theory, as well as extend the theory itself”
(Chen et al., 2017, p. 522). In other words, because family systems the-
ory is often defined poorly or in different ways, it’s hard to have a clear
definition of what family systems theory is.

Defining Family Systems Theory

So, let’s define it. To build a working definition of family systems theory,
let’s break it apart and take a look at each part individually – starting
with “theory.”
A theory is a set of testable hypotheses that explains facts about the
real world. A theory is not a “best guess,” a perspective, or a specula-
tion. It is a documented set of proposals that can be proven false. For
example, atomic theory is a set of hypotheses that predicts how atoms
interact, form compounds, and behave. Initially, atomic theory was
speculative, but as researchers tested the predictions of this theory the
evidence for these principles became apparent. Though we couldn’t see
atoms until 1981, most scientists supported atomic theory long before
that due to the vast amount of evidence supporting the hypotheses
(Coyne, 2010).
Atomic theory also underscores the close connection between theory
and research. The hypotheses of a theory are tested empirically – using
multiple research methods. If the results of the empirical tests show evi-
dence for a hypothesis, that hypothesis becomes supported. If empirical
tests of a hypothesis can be replicated over and over again, we then refer
to this hypothesis as scientific fact. But, if we test a hypothesis, and there
isn’t evidence supporting it, we must then change or discard the hypoth-
esis and its accompanying theory. In the case of atomic theory, the way it
was originally proposed is different than how we understand it now. As
researchers tested the hypotheses of atomic theory, they found evidence
for major parts of the theory, but others were not supported. As such,
atomic theory was adjusted on the basis of the new evidence.
A theory is also different from a model. Atomic theory predicts and
explains the function of atoms, yet scientists and researchers use multi-
ple models to test, examine, and manipulate atomic compounds. In the
 An Introduction to Family Systems Theory 5

same way, family systems theory is different from family therapy models.
Many family therapy models are based on family systems theory, but
they use different techniques, approaches, and interventions to manipu-
late the family system.
With this definition of theory, let’s now define “system.” Ludwig von
Bertalanffy is often considered as one of the originators of systems the-
ory. In his book, General Systems Theory, he defined systems and deline-
ated the hypotheses of systems theory. He defined a system as “a set of
elements standing in inter-­relations” (p. 55). For elements to be inter-
related, he argued, the interactions of elements within a system must be
different from interactions of elements outside of the system. He then
described the hypotheses of systems theory based on this definition. Since
von Bertalanffy proposed his theory, his hypotheses have been tested.
While many of his hypotheses have been supported, others have been
revised by the results of research. Systems theory looks different today
than it did when von Bertalanffy first proposed it.
What, then, is family systems theory? Let’s start with defining our sys-
tem of interest, the “family” system. If we draw on von Bertalanffy’s
definition of a system, the family system is a set of humans who stand in
interrelations to one another. When we talk about families, this “inter-­
relation” typically occurs through blood, mating, or adoption – though
many family systems include people who don’t fit that criterion. The
basic definition of family systems theory would then be a theory that
proposes testable predictions about interrelated people. And, to extend it
a bit more, it is a theory that predicts and explains how people within a
family system interact, and how interactions inside the family system are
different from those outside of it.

Which Family Systems Theory?

With this definition of family systems theory, we need to examine the
hypotheses of this theory. When you try to find testable predictions
regarding family systems, it can be overwhelming. Remember, family
therapy researchers have used as many as 28 different theories to explain
family systems, each having its own hypotheses about the family sys-
tem. In 2016, Alan Carr listed 20 proposals of family systems theory.
This included things like: 1. The family is a social system that supports
the survival and welfare of its members; 2. The family is a system with
boundaries and is organized into subsystems; 3. The boundary around
the family sets it apart from the wider social and cultural systems; 4. Pat-
terns of family interaction are rule governed and recursive; 5. The over-
all patterning of rule-­governed family relationships may be described in
terms of family roles, routines, and rituals; 6. Within the family there are
processes that both prevent and promote change; and 7. Patterns in the
6 An Introduction to Family Systems Theory

family system are isomorphic – patterns present in one part of the system
are present in other parts of the system.
Though this is an exhaustive list, it still ignores important hypoth-
eses like those put forward by Michael Kerr and Murry Bowen. They
proposed that the family system was governed by three other systems:
1. The emotional system – a naturally occurring system that allows all
organisms to receive, integrate, and respond to information within itself
and from the environment; 2. The feeling system – the system in which
humans experience guilt, shame, sympathy, ecstasy, rejection, or sadness;
and 3. The intellectual system – which allows humans to have the capac-
ity to know and understand. Kerr and Bowen suggest that these systems
are governed by the life forces of individuality and togetherness, which
lead to patterned behavior and emotional reactivity. The ability to man-
age individuality and togetherness in a family system is called differentia-
tion of self. Greater differentiation of self results in better relationships
and fewer clinical problems.
But why is it so hard to get a clear answer about what family systems
theory is? Why are there 28 or more theories used when doing family sys-
tems research? And why do we need more than 20 hypotheses to describe
family systems theory?
One reason for these multiple, overlapping, hypotheses is that family
systems theory and its proposals have drawn on different epistemolo-
gies. In addition to drawing on von Bertalanffy’s systems ideas and other
biological concepts, family systems theory also draws on ideas from
Cybernetics – the study of control and communication in humans, other
animals, and machines (Wiener, 1949). However, as Robert Vallee (2003)
pointed out, cybernetics and systems, though different, also share many
similarities. This is evident in the overlap we see in the hypotheses of
family systems theory. Each of these proposals is describing the processes
that create the family system. They talk about boundary making, rules,
the differentiation of subsystems within the family, and how the fam-
ily system reacts and responds to stress. If we were to examine other
hypotheses used in family systems research, we would see a similar pat-
tern. Though they might use different words or ideas to describe these
processes, they are getting at most of the same ideas.
I think good theory and good science happen when hypotheses are clear,
succinct, and testable. Good theories are logically consistent and can explain
and predict what they are intended to (White, Klein, & Martin, 2015). In
other words, I think family systems theory needs to be reevaluated. We need
clear hypotheses that can bring together the disparate research and episte-
mologies that inform family systems theory as well as refocus the disparate
models that family therapists practice (Fife, 2020). We need a consensus
about what family systems theory is, so we can refine and improve the the-
ory and thereby potentially refine and improve our practice.
 An Introduction to Family Systems Theory 7

To do this, we need to return to where we began – general systems the-

ory. Though family systems theory has drawn from cybernetics and other
areas of science, I would argue that general systems theory provides the
strongest foundation for family systems theory. General systems theory
has been used to describe multiple biological systems and has been used
to unify scientific research across many disciplines. In addition, many of
the concepts of cybernetics grew out of or can be folded into a general
systems approach (Vallee, 2003). By tying family systems theory into the
research and science of general systems theory, we can connect it to the
broader biological sciences.
Just like atomic theory and many other theories before it, general sys-
tems theory has evolved. The concepts and ideas that von Bertalanffy
originally proposed have been rigorously studied and updated. Today,
systems researchers and theorists are focused on hypotheses related to
two concepts – autonomy and adaptation. These concepts are built on
von Bertalanffy’s work; however, based on new evidence that has come
about since von Bertalanffy’s proposals, some of his original hypotheses
have been changed.

Autonomy and Adaptation

In the broadest sense, autonomy is how a system distinguishes itself from
its environment while adaptation is how a system responds to its envi-
ronment. In his book, On the Origin of Autonomy, Bernd Rosslenbroich
(2014) describes autonomy and adaptation in systems. He proposes that
living systems are autonomous when they:

(1) Generate, maintain, and regulate an inner network of interde-

pendent, energy-­consuming processes, which in turn generate and
maintain the system; (2) Establish a boundary and actively regulate
their interactions and exchange with the environment; (3) Specify
their own rules of behavior and react to stimuli in a self-­determined
way, according to their internal disposition and condition; (4) Estab-
lish an interdependence between the system and its part within the
organism, which includes a differentiation of subsystems; (5) Estab-
lish time autonomy; and (6) Maintain . . . stability (robustness) in
the face of diverse perturbations arising from the environmental
changes, internal variability, and genetic variations.

Further he discusses adaptation and its relationship to autonomy, show-

ing how adaptation is built into his ideas of autonomy.

Adaptedness is a relational property of an organism or rather a

property of the organism-­environment system. . . . [A]utonomy and
8 An Introduction to Family Systems Theory

adaption become a central pair of this system. Both are dependent on

each other: On the one hand, there is the organism, and on the other
hand is the environment. The organisms – even in its simplest form –
always establishes its life function together with the generation of a
boundary and thus produces its “being different” from the surround-
ing environment. To maintain this state, the organism not only needs
to regulatory and stabilizing functions on the one hand but needs to
react appropriately to cope successfully with the environmental influ-
ences . . . autonomy needs adaptations.
(pp. 230–231)

Rosslenbroich is proposing that systems require both autonomy and

adaptation and that the two depend on each other. Systems need the
properties of autonomy, but these properties stand in relation to and
a property of the adaptations necessary to survive in an environment.
The presence of autonomy only exists by it being distinguished from its
environment; yet the very process of distinguishing itself is an adaptation.
Similar arguments have been made by other scholars. In 2018, Anne
Sophie Meincke’s review of relevant research supported the ideas of
Rosslenbroich. She suggested:

Living systems are nested hierarches of processes which are more or

less stable depending on the time scale at which they are described,
and depending on which other processes they are comparted with . . .
Any stability to be observed in living systems is the result of continu-
ous process and change.
(p. 13)

And in 2019, she argued further:

Organisms, human and non-­human, are dynamical systems that for

their existence and persistence depend on an on-­going interaction
with the environment in which they are embedded. . . . We cannot
understand what organisms are, and how they persist through time,
if not acknowledging their genuine dynamicity, fluidity, and consti-
tutive changeability.
(p. 57)

She is arguing that autonomy and adaptation are the key organizing and
operating processes of systems. Systemic autonomy comes from the sta-
ble process that occurs across time, and at the same time, the processes
that create the system are constantly interacting with the environment
and therefore must adapt.
 An Introduction to Family Systems Theory 9

Along those same lines, Alvaro Moreno and Matteo Mossio suggested,
in their book Biological Autonomy, that:

The framework we have proposed is centered on the idea of auton-

omy. Our main claim that the distinctive feature of biological sys-
tems, which distinguishes them from any other natural system, is
their autonomy. Biological systems are autonomous, which means
that, in the most general sense, that they contribute to the genera-
tion and maintenance of the conditions of their existence. . . . As
a result of their agency, autonomous systems interact with each
other, mutually affecting their respective organization and constitut-
ing higher-­level collective autonomous organizations, without losing
their autonomy. These higher levels of autonomy can in turn gener-
ate new networks of interactions, which can possibly lead to even
higher levels of autonomy.
(p. 197)

They assert that autonomy is the core feature of any living system. But
that these systems interact and affect each other and that these interac-
tions lead to adaptations that can create new systems.
Each of these systems thinkers has reviewed the evidence and concurs that
living systems are best understood and described through autonomy and
adaptation. Autonomy and adaptation can pull together ideas from evolu-
tion, biology, and physiology to predict and describe how systems function.

Family Systems Theory Hypotheses

If we return to the summary of proposals made by Alan Carr, we can
see that they fit easily into the concepts of autonomy and adaptation.
These hypotheses describe boundary making and the internal processes
that sustain these boundaries – how family systems develop and main-
tain autonomy. It also offers proposals on rules and patterns and how
boundaries are crossed in systems – how they adapt. Similarly, Bowen’s
hypotheses describe how family systems incorporate autonomy and
adaptation – the concepts of individuality and togetherness are key play-
ers in family system autonomy. The emotional, feeling, and intellectual
systems talk about ways in which the family system responds to the envi-
ronment, and the process of differentiation describes the tension and reci-
procity between autonomy and adaptation. In other words, autonomy
and adaptation can be used to unify and clarify the many proposals of
family systems theory and their underlying epistemologies.
With this in mind, we can simplify family systems theory to just two
hypotheses. The first is that the family is an autonomous system. Family
10 An Introduction to Family Systems Theory

systems have rule-­based, boundary-­making processes that generate and

maintain the family. These processes are distinct to the family system,
occur across time, and remain relatively stable. The second is that the
family is an adaptable system. The family system responds to stress from
inside and outside of the system by making changes to its rule-­based,
boundary-­making processes. The goal of these adaptations is to help the
family maintain autonomy.
But are these two hypotheses valid? If they are, then evidence should
be available to support these assertions. This evidence should be able
to explain how these interactions create boundaries and responses, and
why these boundaries and responses are unique to the family system.
In other words, do scientific findings support the proposal that a fam-
ily is an autonomous and adaptable system? What’s more, if the family
system is autonomous and adaptable, what are the important processes,
boundaries, rules, and reactions that create autonomy while also allow-
ing for adaptation?
If we understand these things, we can then better link family systems
theory and its supporting evidence to the models of family therapy. We
may then be able to develop better evidence-­based practices. In addition,
by providing evidence for family systems theory, we may be better able to
link science and theory to our own practice, resulting in better outcomes
for our clients.

The “Why” of This Book

Family systems theory is what sets family therapy apart from other
psychotherapy approaches. Family systems theory is the foundation
of the field, and it’s the driver of family therapy models. For our field
to remain strong, we need researchers to focus on developing and
improving evidence-­based practices as well as find ways to improve
how we train therapists. But we also need a research and practice
that is grounded in a scientifically validated theory. Without a strong,
scientifically supported theory to ground our practice, we risk our
models and practice becoming outdated. Theories remain strong only
when the hypotheses of the theory are clear, testable, and supported
by evidence.
The goal of this book is to outline the science that is linked to family
systems theory. Specifically, we will explore the science relating to the
hypotheses that the family is an autonomous and adaptable system. By
examining the science of family systems, we can see if the evidence sup-
ports these hypotheses. Given the vast amounts of evidence that have
come about since the original proposals of family systems theories, it is
necessary to revisit, amend, and refocus our current understanding of
family systems theory.
 An Introduction to Family Systems Theory 11

Chapter Recap
Family systems is the foundation of family therapy practice. Since people
like Virginia Satir, Murray Bowen, and Salvador Minuchin proposed their
ideas about family systems, there has been a surge of research regarding
family relations and the processes that bind families together. But with this
new research, the proposal and hypotheses of family systems theory have
remained unchanged. Theory and research are supposed to have a reciprocal
relationship – with new evidence, the theory changes. However, this hasn’t
happened with family systems theory. Current family therapy researchers
often don’t take the time to tie their findings to family systems theory.
This has led to family systems theory becoming unfocused. To refocus
family systems theory, we need a clear definition and testable hypotheses
of the theory. Family systems theory is defined as the theory that predicts
and explains how people within a family interact, and how the interaction
inside the family are different from those outside of it. With this defini-
tion comes the two main hypotheses. First, the family is an autonomous
system. If the family is an autonomous system then the evidence would
suggest that the family has rule-­based, boundary-­making processes that
generate and maintain the family. Second, the family is an adaptable sys-
tem. If the family is an adaptable system, then the evidence should suggest
that the family responds to stress from inside and outside of the system by
making changes to its rule-­based, boundary-­making processes.

Questions to Consider

1. This book proposes that family systems theory should be built

on the research and proposals of biological systems. Do you
agree with this assertion? What might other fields, theories, or
assumptions be better suited as the foundation for family sys-
tems theory?
2. What are your thoughts on the relationship between theory
and research? How can family therapy researchers and practi-
tioners strengthen family systems theory?
3. What do you think about the description and definition of
autonomy used in this chapter? How would you define it dif-
ferently? Do you find it a useful concept? Or can you think of
a better one?
4. What do you think about the description and definition of
adaptation used in this chapter? How would you define it dif-
ferently? Do you find it a useful concept? Or can you think of
a better one?
References
Aaron, A. (2016). Why attachment theory is all sizzle and no steak. Psychol-
ogy Today. Retrieved from www.psychologytoday.com/us/blog/standard-
­deviations/201608/why-­attachment-­theory-­is-­all-­sizzle-­and-­no-­steak
Acevedo, B. P., & Aron, A. (2009). Does a long-­term relationship kill romantic
love? Review of General Psychology, 13(1), 59–65.
Afifi, T. D., Davis, S., Merrill, A. F., Coveleski, S., Denes, A., & Shahnazi, A.
F. (2018). Couples’ communication about financial uncertainty following the
great recession and its association with stress, mental health and divorce prone-
ness. Journal of Family and Economic Issues, 39(2), 205–219.
Afifi, T. D., Merrill, A. F., & Davis, S. (2016). The theory of resilience and rela-
tional load. Personal Relationships, 23(4), 663–683.
Afifi, T. O., Enns, M. W., Cox, B. J., Asmundson, G. J., Stein, M. B., & Sareen,
J. (2008). Population attributable fractions of psychiatric disorders and suicide
ideation and attempts associated with adverse childhood experiences. Ameri-
can Journal of Public Health, 98(5), 946–952.
Aggarwal, B., & Mosca, L. (2009). Heart disease risk for female cardiac caregiv-
ers. The Female Patient, 34(2), 42.
Alcalá-­López, D., Smallwood, J., Jefferies, E., Van Overwalle, F., Vogeley, K.,
Mars, R. B., . . . Bzdok, D. (2018). Computing the social brain connectome
across systems and states. Cerebral Cortex, 28(7), 2207–2232.
Aldao, A., Nolen-­Hoeksema, S., & Schweizer, S. (2010). Emotion-­regulation
strategies across psychopathology: A meta-­analytic review. Clinical Psychol-
ogy Review, 30(2), 217–237.
Amato, P. R., & Afifi, T. D. (2006). Feeling caught between parents: Adult chil-
dren’s relations with parents and subjective well-being. Journal of Marriage
and Family, 68(1), 222–235.
Amodio, D. M., & Frith, C. D. (2006). Meeting of minds: The medial frontal cor-
tex and social cognition. In Discovering the social mind (pp. 183–207). New
York: Psychology Press.
Anderson, H. (1997). Conversation, language, and possibilities: A postmodern
approach to therapy. New York: Basic Books.
Anderson, J. R. (2020). Inviting autonomy back to the table: The importance of
autonomy for healthy relationship functioning. Journal of Marital and Family
Therapy, 46(1), 3–14.
Anker, M. G., Duncan, B. L., & Sparks, J. A. (2009). Using client feedback to
improve couple therapy outcomes: A randomized clinical trial in a naturalistic
setting. Journal of Consulting and Clinical Psychology, 77(4), 693.
Apicella, C. L., & Silk, J. B. (2019). The evolution of human cooperation. Cur-
rent Biology, 29(11), R447–R450.
Bailey, Z. D., Krieger, N., Agénor, M., Graves, J., Linos, N., & Bassett, M. T.
(2017). Structural racism and health inequities in the USA: Evidence and inter-
ventions. The Lancet, 389(10077), 1453–1463.
Barnwell, A. (2019). Family secrets and the slow violence of social stigma. Sociol-
ogy, 53(6), 1111–1126.
Baumrind, D. (1966). Effects of authoritative parental control on child behav-
ior. Child Development, 887–907.
Baumrind, D. (2013). Authoritative parenting revisited: History and current sta-
tus. In R. E. Larzelere, A. S. Morris, & A. W. Harrist (Eds.), Authoritative
parenting: Synthesizing nurturance and discipline for optimal child develop-
ment (pp. 11–34). Washington, DC: American Psychological Association.
Benjamins, M. R., Hirschtick, J. L., Hunt, B. R., Hughes, M. M., & Hunter, B.
(2017). Racial disparities in heart disease mortality in the 50 largest US cit-
ies. Journal of Racial and Ethnic Health Disparities, 4(5), 967–975.
Benware, J. (2013). Predictors of father-­child and mother-­child attachment in
two-­parent families. Retrieved from https://digitalcommons.usu.edu/etd/1734/
Birnbaum, G. E., Mizrahi, M., Kovler, L., Shutzman, B., Aloni-­Soroker, A., &
Reis, H. T. (2019). Our fragile relationships: Relationship threat and its effect
on the allure of alternative mates. Archives of Sexual Behavior, 48(3), 703–713.
Birnbaum, G. E., & Reis, H. T. (2019). Evolved to be connected: The dynam-
ics of attachment and sex over the course of romantic relationships. Current
Opinion in Psychology, 25, 11–15.
Blow, A. J., & Hartnett, K. (2005). Infidelity in committed relationships I: A meth-
odological review. Journal of Marital and Family Therapy, 31(2), 183–216.
Borges, J. L. (1972). Selected poems, 1923–1967. New York: Delacorte Press.
Bowers, M. E., & Yehuda, R. (2016). Intergenerational transmission of stress in
humans. Neuropsychopharmacology, 41(1), 232–244.
Bradshaw, G. A., Schore, A. N., Brown, J. L., Poole, J. H., & Moss, C. J. (2005).
Elephant breakdown. Nature, 433(7028), 807.
Buehler, C., & Welsh, D. P. (2009). A process model of adolescents’ triangulation
into parents’ marital conflict: The role of emotional reactivity. Journal of Fam-
ily Psychology, 23(2), 167.
Buss, D. (2015). Evolutionary psychology: The new science of the mind. New
York: Psychology Press.
Carr, A. (2014a). The evidence base for family therapy and systemic interventions
for child-focused problems. Journal of Family Therapy, 36(2), 107–157.
Carr, A. (2014b). The evidence base for couple therapy, family therapy and
systemic interventions for adult-focused problems. Journal of Family Ther-
apy, 36(2), 158–194.
Carr, A. (2016). The evolution of systems theory. In T. L. Sexton & J. Lebow
(Eds.), Handbook of family therapy: The science and practice of working with
families and couples. London: Routledge.
Carr, D., & Springer, K. W. (2010). Advances in families and health research in
the 21st century. Journal of Marriage and Family, 72(3), 743–761.
Carter, R. T., Kirkinis, K., & Johnson, V. E. (2019). Relationships between
trauma symptoms and race-­based traumatic stress. Traumatology, 26(1).
Center for Disease Control and Prevention. (2019). Heart disease facts. Retrieved
from www.cdc.gov/heartdisease/facts.htm
Cerniglia, L., Cimino, S., Tafà, M., Marzilli, E., Ballarotto, G., & Bracaglia, F.
(2017). Family profiles in eating disorders: Family functioning and psychopa-
thology. Psychology Research and Behavior Management, 10, 305.
Chambers, C. (2017). Against marriage: An egalitarian defense of the marriage-­
free state. Oxford: Oxford University Press.
Chambers, J. K. (2007). Sociolinguistics. In The Blackwell encyclopedia of soci-
ology. Malden, MA: Wiley Blackwell.
Chen, E. H., Shofer, F. S., Dean, A. J., Hollander, J. E., Baxt, W. G., Robey,
J. L., . . . Mills, A. M. (2008). Gender disparity in analgesic treatment of emer-
gency department patients with acute abdominal pain. Academic Emergency
Medicine, 15(5), 414–418.
Chen, R., Hughes, A. C., & Austin, J. P. (2017). The use of theory in family
therapy research: Content analysis and update. Journal of Marital and Family
Therapy, 43(3), 514–525.
Chu, P. S., Saucier, D. A., & Hafner, E. (2010). Meta-­analysis of the relationships
between social support and well-­being in children and adolescents. Journal of
Social and Clinical Psychology, 29(6), 624–645.
Cohen, S. (2004). Social relationships and health. American Psychologist, 59(8),
676.
Conching, A. K. S., & Thayer, Z. (2019). Biological pathways for historical
trauma to affect health: A conceptual model focusing on epigenetic modifica-
tions. Social Science & Medicine, 230, 74–82.
Conger, R. D., & Elder, G. H. (1994). Families in troubled times: The Iowa youth
and families project. Families in Troubled Times: Adapting to Change in Rural
America, 3–19.
Coontz, S. (2016). The way we never were: American families and the nostalgia
trap. London: Hachette.
Coyne, J. A. (2010). Why evolution is true. Oxford: Oxford University Press.
Cyranowski, J. M., Zill, N., Bode, R., Butt, Z., Kelly, M. A., Pilkonis, P.
A., . . . Cella, D. (2013). Assessing social support, companionship, and dis-
tress: National institute of health (NIH) toolbox adult social relationship
scales. Health Psychology, 32(3), 293.
Dabla-­Norris, M. E., Kochhar, M. K., Suphaphiphat, M. N., Ricka, M. F., &
Tsounta, E. (2015). Causes and consequences of income inequality: A global
perspective. Washington, DC: International Monetary Fund.
Dalal, F. (2018). CBT: The cognitive behavioural tsunami: Managerialism, poli-
tics and the corruptions of science. London: Routledge.
Dallos, R., & Vetere, A. (2012). Systems theory, family attachments and processes
of triangulation: Does the concept of triangulation offer a useful bridge? Jour-
nal of Family Therapy, 34(2), 117–137.
Dattilio, F. M., Piercy, F. P., & Davis, S. D. (2014). The divide between “evi-
denced-based” approaches and practitioners of traditional theories of family
therapy. Journal of Marital and Family Therapy, 40(1), 5–16.
Davis, K. L., & Montag, C. (2019). Selected principles of Pankseppian affective
neuroscience. Frontiers in Neuroscience, 12, 1025.
Desmond, M. (2012). Disposable ties and the urban poor. American Journal of
Sociology, 117(5), 1295–1335.
Diamond, G., Leckrone, J. O. D. I., Dennis, M., & Godley, S. H. (2006). The canna-
bis youth treatment study: The treatment models and preliminary findings. Can-
nabis Dependence: Its Nature, Consequences, and Treatment, 247–274.
DiCorcia, J. A., Snidman, N., Sravish, A. V., & Tronick, E. (2016). Evaluating the
nature of the still-face effect in the double face-to-face still-face paradigm using
different comparison groups. Infancy, 21(3), 332–352.
DiGangi, C. (2017). This man’s ambulance ride cost $2,700: Is that nor-
mal? USA Today. Retrieved from www.usatoday.com/story/money/
personalfinance/2017/05/20/ambulance-­health-­care-­services-­costs/334338001/
Doyle, A. B., Lawford, H., & Markiewicz, D. (2009). Attachment style with
mother, father, best friend, and romantic partner during adolescence. Journal
of Research on Adolescence, 19(4), 690–714.
Duncan, B. L., Miller, S. D., Wampold, B. E., & Hubble, M. A. (2010). The
heart and soul of change: Delivering what works in therapy. Washington, DC:
American Psychological Association.
Dziengel, L. (2012). Resilience, ambiguous loss, and older same-­sex couples:
The resilience constellation model. Journal of Social Service Research, 38(1),
74–88.
Ehring, T., & Quack, D. (2010). Emotion regulation difficulties in trauma sur-
vivors: The role of trauma type and PTSD symptom severity. Behavior Ther-
apy, 41(4), 587–598.
Ellis, G., & Solms, M. (2018). Beyond evolutionary psychology. Cambridge:
Cambridge University Press.
Erwin, E. (1997). Philosophy and psychotherapy: Razing the troubles of the
brain. London: Sage Publications.
Falicov, C. J. (2012). Immigrant family processes: A multidimensional frame-
work. In F. Walsh (Ed.), Normal family processes: Growing diversity and com-
plexity (pp. 297–323). New York: Guilford Publications.
Falicov, C. J. (2014). Psychotherapy and supervision as cultural encounters: The
multidimensional ecological comparative approach framework. In C. A. Falen-
der, E. P. Shafranske, & C. J. Falicov (Eds.), Multiculturalism and diversity in
clinical supervision: A competency-­based approach (pp. 29–58). Washington,
DC: American Psychological Association.
Farr, R. H., Bruun, S. T., & Patterson, C. J. (2019). Longitudinal associations
between coparenting and child adjustment among lesbian, gay, and hetero-
sexual adoptive parent families. Developmental Psychology, 55(12).
Felitti, V. J., Anda, R. F., Nordenberg, D., Williamson, D. F., Spitz, A. M.,
Edwards, V., & Marks, J. S. (1998). Relationship of childhood abuse and
household dysfunction to many of the leading causes of death in adults: The
Adverse Childhood Experiences (ACE) Study. American Journal of Preventive
Medicine, 14(4), 245–258.
Fife, S. T. (2020). Theory: The heart of systemic family therapy. In K. S. Wam-
pler (Ed.), The handbook of systemic family therapy (pp. 296–316). Hoboken:
Wiley Blackwell.
Figley, C. R., and Figley, K. R. (2009). Stemming the tide of trauma systemically:
The role of family therapy. Australian and New Zealand Journal of Family
Therapy, 30(3), 173–183.
Fishbane, M. D. (2013). Loving with the brain in mind: Neurobiology and cou-
ple therapy. Norton Series on Interpersonal Neurobiology. New York: WW
Norton & Company.
Ford, J. D., & Courtois, C. A. (Eds.). (2013). Treating complex traumatic stress
disorders in children and adolescents: Scientific foundations and therapeutic
models. New York: Guilford Publications.
Fosco, G. M., & Grych, J. H. (2010). Adolescent triangulation into parental
conflicts: Longitudinal implications for appraisals and adolescent-parent rela-
tions. Journal of Marriage and Family, 72(2), 254–266.
Fosco, G. M., Lippold, M., & Feinberg, M. E. (2014). Interparental bound-
ary problems, parent – adolescent hostility, and adolescent – parent hostility:
A family process model for adolescent aggression problems. Couple and Fam-
ily Psychology: Research and Practice, 3(3), 141.
Fosco, G. M., Raynor, S. M., & Grych, J. H. (2004). Triangulation, apprais-
als, and adjustment: Examining the impact of interparental conflict on ado-
lescent functioning. Poster presented at the biennial meeting of the Society for
Research on Adolescence, Baltimore, pp. 614–625.
Fraser, K., MacKenzie, D., & Versnel, J. (2017). Complex trauma in children
and youth: A scoping review of sensory-­based interventions. Occupational
Therapy in Mental Health, 33(3), 199–216.
Gallese, V., Fadiga, L., Fogassi, L., & Rizzolatti, G. (1996). Action recognition in
the premotor cortex. Brain, 119(2), 593–609.
Geiger, A., Bente, G., Lammers, S., Tepest, R., Roth, D., Bzdok, D., & Vogeley,
K. (2019). Distinct functional roles of the mirror neuron system and the men-
talizing system. NeuroImage, 202, 116102.
Genetic Science Learning Center. (2018, August 7). Learn: Genetics. Retrieved
February 20, 2020, from https://learn.genetics.utah.edu/
George, M. R., Cummings, E. M., & Davies, P. T. (2010). Positive aspects of
fathering and mothering, and children’s attachment in kindergarten. Early
Child Development and Care, 180(1–2), 107–119.
Gingerich, W. J., Kim, J. S., Stams, G. J. J. M., & Macdonald, A. J. (2012).
Solution-­focused brief therapy outcome research. In C. Franklin, T. S. Trepper,
W. J. Gingerich, & E. E. McCollum (Eds.), Solution-­focused brief therapy:
A handbook of evidence-­based practice (pp. 95–111). Oxford: Oxford Uni-
versity Press.
Golds, L., de Kruiff, K., & MacBeth, A. (2020). Disentangling genes, attachment,
and environment: A systematic review of the developmental psychopathology
literature on gene – environment interactions and attachment. Development
and Psychopathology, 32(1), 357–381.
Gone, J. P., Hartmann, W. E., Pomerville, A., Wendt, D. C., Klem, S. H., & Bur-
rage, R. L. (2019). The impact of historical trauma on health outcomes for
indigenous populations in the USA and Canada: A systematic review. Ameri-
can Psychologist, 74(1), 20.
Gross, J. J. (Ed.). (2013). Handbook of emotion regulation. New York: Guilford
Publications.
Grove, D. R., Greene, G. J., & Lee, M. Y. (2020). Family therapy for treat-
ing trauma: An integrative family and systems treatment (I-­FAST) approach.
Oxford: Oxford University Press.
Grych, J. H., Raynor, S. R., & Fosco, G. M. (2004). Family processes that shape
the impact of interparental conflict on adolescents. Development and Psycho-
pathology, 16(3), 649–665.
Gunderson, J., & Barrett, A. E. (2017). Emotional cost of emotional support?
The association between intensive mothering and psychological well-­being in
midlife. Journal of Family Issues, 38(7), 992–1009.
Harandi, T. F., Taghinasab, M. M., & Nayeri, T. D. (2017). The correlation of
social support with mental health: A meta-­analysis. Electronic Physician, 9(9),
5212.
Helimäki, M., Laitila, A., & Kumpulainen, K. (2020). “Can I tell?” Children’s
participation and positioning in a secretive atmosphere in family therapy. Jour-
nal of Family Therapy. doi:10.1111/1467-­6427.12296
Hoeve, M., Dubas, J. S., Eichelsheim, V. I., Van der Laan, P. H., Smeenk, W., &
Gerris, J. R. (2009). The relationship between parenting and delinquency:
A meta-­analysis. Journal of Abnormal Child Psychology, 37(6), 749–775.
Hoffman, L. (2018). Exchanging voices: A collaborative approach to family ther-
apy. London: Routledge.
Hsieh, J. Y., Mercer, K. J., & Costa, S. A. (2017). Parenting a second time around:
The strengths and challenges of Indigenous grandparent caregivers. Grand
Families: The Contemporary Journal of Research, Practice and Policy, 4(1), 8.
Jablonka, E., & Lamb, M. J. (2014). Evolution in four dimensions, revised edi-
tion: Genetic, epigenetic, behavioral, and symbolic variation in the history of
life. Cambridge: MIT Press.
Jawaid, A., Roszkowski, M., & Mansuy, I. M. (2018). Transgenerational epige-
netics of traumatic stress. In Progress in molecular biology and translational
science (Vol. 158, pp. 273–298). London: Academic Press.
Johnson, L. N., Miller, R. B., Bradford, A. B., & Anderson, S. R. (2017). The
marriage and family therapy practice research network (MFT-PRN): Creating
a more perfect union between practice and research. Journal of Marital and
Family Therapy, 43(4), 561–572.
Johnson, S. M. (2019). Attachment theory in practice: Emotionally focused
therapy (EFT) with individuals, couples, and families. New York: Guilford
Publications.
Johnson, S. M., Makinen, J. A., & Millikin, J. W. (2001). Attachment injuries in
couple relationships: A new perspective on impasses in couples therapy. Jour-
nal of Marital and Family Therapy, 27(2), 145–155.
Kawabata, Y., Alink, L. R., Tseng, W. L., Van Ijzendoorn, M. H., & Crick, N.
R. (2011). Maternal and paternal parenting styles associated with relational
aggression in children and adolescents: A conceptual analysis and meta-­
analytic review. Developmental Review, 31(4), 240–278.
Kendi, I. X. (2019). How to be an antiracist. New York: One World, Ballantine.
Kent de Grey, R. G., Uchino, B. N., Trettevik, R., Cronan, S., & Hogan,
J. N. (2018). Social support and sleep: A meta-­analysis. Health Psychol-
ogy, 37(8), 787.
Kerr, M. E., & Bowen, M. (1988). Family evaluation. New York: WW Norton &
Company.
Kouneski, E. F. (2000). Family assessment and the circumplex model: New
research developments and applications (p. 141). Twin Cities, MN: University
of Minnesota Press.
Labrecque, L. T., & Whisman, M. A. (2017). Attitudes toward and prevalence
of extramarital sex and descriptions of extramarital partners in the 21st cen-
tury. Journal of Family Psychology, 31(7), 952.
Labrecque, L. T., & Whisman, M. A. (2019). Extramarital sex and marital dis-
solution: Does identity of the extramarital partner matter? Family Process, 30.
Ludwig, R. J., & Welch, M. G. (2019). Darwin’s other dilemmas and the theoreti-
cal roots of emotional connection. Frontiers in Psychology, 10.
Maes, M., Van den Noortgate, W., Fustolo-­Gunnink, S. F., Rassart, J., Luyckx,
K., & Goossens, L. (2017). Loneliness in children and adolescents with chronic
physical conditions: A meta-­analysis. Journal of Pediatric Psychology, 42(6),
622–635.
Magnavita, J. J., & Anchin, J. C. (2013). Unifying psychotherapy: Principles,
methods, and evidence from clinical science. New York: Springer Science &
Business Media.
Mahner, M., & Bunge, M. (1997). Foundations of biophilosophy. Berlin: Springer
Science & Business Media.
Mark, K. P., & Lasslo, J. A. (2018). Maintaining sexual desire in long-­term
relationships: A systematic review and conceptual model. The Journal of Sex
Research, 55(4–5), 563–581.
Mastrotheodoros, S., Canário, C., Gugliandolo, M. C., Merkas, M., & Keijsers,
L. (2019). Family functioning and adolescent internalizing and externalizing
problems: Disentangling between-­, and within-­family associations. Journal of
Youth and Adolescence, 1–14.
McDowell, T., Knudson-­Martin, C., & Bermudez, J. M. (2017). Socioculturally
attuned family therapy: Guidelines for equitable theory and practice. London:
Routledge.
McEwen, B. S. (2000). Allostasis and allostatic load: Implications for neuropsy-
chopharmacology. Neuropsychopharmacology, 22(2), 108.
McGoldrick, M. (2016). The genogram casebook: A clinical companion to geno-
grams: Assessment and intervention. New York: WW Norton & Company.
McNeil Smith, S., & Landor, A. M. (2018). Toward a better understanding of
African American families: Development of the sociocultural family stress
model. Journal of Family Theory & Review, 10(2), 434–450.
McNelis, M., & Segrin, C. (2019). Insecure attachment predicts history of
divorce, marriage, and current relationship status. Journal of Divorce &
Remarriage, 60(5), 404–417.
Meincke, A. S. (2018). Persons as biological processes: A bio-­processual way out
of the personal identity dilemma. In D. J. Nicholson & J. Dupre (Eds.), Eve-
rything flows: Towards a processual philosophy of biology (pp. 357–378).
Oxford: Oxford University Press.
Meincke, A. S. (2019). Human persons–A process view. In Was sind und wie
existieren Personen? (pp. 57–80). mentis Verlag.
Mikulincer, M., & Shaver, P. R. (2007). Attachment in adulthood: Structure,
dynamics, and change. New York: Guilford Publications.
Molix, L. (2014). Sex differences in cardiovascular health: does sexism influ-
ence women’s health? The American Journal of the Medical Sciences, 348(2),
153–155.
Moreno, A., & Mossio, M. (2015). Biological autonomy: A philosophical and
theoretical enquiry. Dordrecht: Springer Science & Business Media.
Neppl, T. K., Senia, J. M., & Donnellan, M. B. (2016). Effects of economic hard-
ship: Testing the family stress model over time. Journal of Family Psychol-
ogy, 30(1), 12.
Nixon, R. (2011). Slow violence and the environmentalism of the poor. Cam-
bridge: Harvard University Press.
Olson, D. H., Olson-­Sigg, A., & Larson, P. J. (2008). The couple checkup: Find
your relationship strengths. Nashville, TN: Thomas Nelson.
Olson, D. H., Waldvogel, L., & Schlieff, M. (2019). Circumplex model of marital and
family systems: An update. Journal of Family Theory & Review, 11(2), 199–211.
Ottersen, O. P., Dasgupta, J., Blouin, C., Buss, P., Chongsuvivatwong, V., Frenk,
J., . . . Leaning, J. (2014). The political origins of health inequity: Prospects for
change. The Lancet, 383(9917), 630–667.
Oyama, S., Griffiths, P. E., & Gray, R. D. (2001). Introduction: What is devel-
opmental systems theory. Cycles of Contingency: Developmental Systems and
Evolution, 1–11.
Panksepp, J., & Biven, L. (2012). The archaeology of mind: Neuroevolution-
ary origins of human emotions. Norton Series on Interpersonal Neurobiology.
New York: WW Norton & Company.
Papp, L. M., Kouros, C. D., & Cummings, E. M. (2009). Demand-withdraw pat-
terns in marital conflict in the home. Personal Relationships, 16(2), 285–300.
Patten, E. (2016). Racial, gender wage gaps persist in U.S. despite some progress.
Retrieved February 24, 2020, from http://pewrsr.ch/29gNnNA
Penninkilampi, R., Casey, A. N., Singh, M. F., & Brodaty, H. (2018). The associa-
tion between social engagement, loneliness, and risk of dementia: A systematic
review and meta-­analysis. Journal of Alzheimer’s Disease, 66(4), 1619–1633.
Perel, E. (2013). The secret to desire in long-­term relationships. Retrieved February 21,
2020, from www.ted.com/talks/esther_perel_the_secret_to_desire_in_a_long_term_
relationship/transcript?language=en
Perel, E. (2017). The state of affairs: Rethinking infidelity-­A book for anyone
who has ever loved. London: Hachette.
Piercy, F. P., & Sprenkle, D. H. (1986). Family therapy theory building: An inte-
grative training approach. Journal of Psychotherapy & the Family, 1(4), 5–14.
Pilgrim, D. (2000). The real problem for postmodernism. Journal of Family Ther-
apy, 22(1), 6–23.
Pinquart, M. (2016). Associations of parenting styles and dimensions with aca-
demic achievement in children and adolescents: A meta-­analysis. Educational
Psychology Review, 28(3), 475–493.
Pinquart, M. (2017). Associations of parenting dimensions and styles with
externalizing problems of children and adolescents: An updated meta-­
analysis. Developmental Psychology, 53(5), 873.
Porges, S. W. (2011). The polyvagal theory: Neurophysiological foundations of
emotions, attachment, communication, and self-­regulation. Norton Series on
Interpersonal Neurobiology. New York: WW Norton & Company.
Porges, S. W. (2018). Polyvagal theory: A primer. In Clinical applications of the
polyvagal theory: The emergence of polyvagal-­informed therapies (pp. 50–72).
New York: WW Norton & Company.
Priest, J. B., Roberson, P. N., & Woods, S. B. (2019). In our lives and under
our skin: An investigation of specific psychobiological mediators linking family
relationships and health using the biobehavioral family model. Family Pro-
cess, 58(1), 79–99.
Pugh, A. J. (2015). The tumbleweed society: Working and caring in an age of
insecurity. Oxford: Oxford University Press.
Ramo-Fernández, L., Schneider, A., Wilker, S., & Kolassa, I. T. (2015). Epigenetic
alterations associated with war trauma and childhood maltreatment. Behavio-
ral Sciences & the Law, 33(5), 701–721.
Rico-­Uribe, L. A., Caballero, F. F., Martín-­ María, N., Cabello, M., Ayuso-­
Mateos, J. L., & Miret, M. (2018). Association of loneliness with all-­cause
mortality: A meta-­analysis. PloS One, 13(1).
Roberson, P. N., Shorter, R. L., Woods, S., & Priest, J. (2018). How health behav-
iors link romantic relationship dysfunction and physical health across 20 years
for middle-­aged and older adults. Social Science & Medicine, 201, 18–26.
Rosenau, P. M. (1991). Post-­modernism and the social sciences: Insights, inroads,
and intrusions. Princeton, NJ: Princeton University Press.
Rosslenbroich, B. (2014). On the origin of autonomy: A new look at the major
transitions in evolution (Vol. 5). New York: Springer Science & Business Media.
Ruhl, H., Dolan, E. A., & Buhrmester, D. (2015). Adolescent attachment trajec-
tories with mothers and fathers: The importance of parent–child relationship
experiences and gender. Journal of Research on Adolescence, 25(3), 427–442.
Ryan, R. M., & Deci, E. L. (2017). Self-­determination theory: Basic psycho-
logical needs in motivation, development, and wellness. New York: Guilford
Publications.
Saban, K. L., Mathews, H. L., DeVon, H. A., & Janusek, L. W. (2014). Epi-
genetics and social context: Implications for disparity in cardiovascular dis-
ease. Aging and Disease, 5(5), 346.
Sassler, S., & Miller, A. (2017). Cohabitation nation: Gender, class, and the
remaking of relationships. Oakland: University of California Press.
Schäfer, J. Ö., Naumann, E., Holmes, E. A., Tuschen-­Caffier, B., & Samson, A. C.
(2017). Emotion regulation strategies in depressive and anxiety symptoms in
youth: A meta-­analytic review. Journal of Youth and Adolescence, 46(2), 261–276.
Spunt, R. P., & Lieberman, M. D. (2012a). Dissociating modality-­specific and
supramodal neural systems for action understanding. Journal of Neurosci-
ence, 32(10), 3575–3583.
Schnarch, D. (2009). Intimacy & desire: Awaken the passion in your relation-
ship. New York: Beaufort Books.
Schrodt, P., Witt, P. L., & Shimkowski, J. R. (2014). A meta-­analytical review
of the demand/withdraw pattern of interaction and its associations with
 individual, relational, and communicative outcomes. Communication Mono-
graphs, 81(1), 28–58.
Seccombe, K. (2002). “Beating the odds” versus “changing the odds”: Poverty,
resilience, and family policy. Journal of Marriage and Family, 64(2), 384–394.
Seikkula, J., Laitila, A., & Rober, P. (2012). Making sense of multi-actor dia-
logues in family therapy and network meetings. Journal of Marital and Family
Therapy, 38(4), 667–687.
Sexton, T. L. (2017). Functional family therapy. In The encyclopedia of juvenile
delinquency and justice (pp. 1–7). Cham: Springer Science & Business Media.
Sexton, T. L., Ridley, C. R., & Kleiner, A. J. (2004). Beyond common factors:
Multilevel-process models of therapeutic change in marriage and family ther-
apy. Journal of Marital and Family Therapy, 30(2), 131–149.
Shadish, W. R., & Baldwin, S. A. (2003). Meta-analysis of MFT interven-
tions. Journal of Marital and Family Therapy, 29(4), 547–570.
Shimokawa, K., Lambert, M. J., & Smart, D. W. (2010). Enhancing treatment
outcome of patients at risk of treatment failure: Meta-­analytic and mega-­
analytic review of a psychotherapy quality assurance system. Journal of Con-
sulting and Clinical Psychology, 78(3), 298.
Shotter, J. (1993). Conversational realities: Constructing life through lan-
guage (Vol. 11). London: Sage.
Singh, S., Lundy, M., Vidal de Haymes, M., & Caridad, A. N. A. (2011). Mexi-
can immigrant families: Relating trauma and family cohesion. Journal of Pov-
erty, 15(4), 427–443.
Sippel, L. M., Pietrzak, R. H., Charney, D. S., Mayes, L. C., & Southwick, S.
M. (2015). How does social support enhance resilience in the trauma-­exposed
individual? Ecology and Society, 20(4).
Sparks, J. A., & Duncan, B. L. (2010). Common factors in couple and family
therapy: Must all have prizes? In The heart and soul of change: Delivering
what works in therapy (2nd ed., pp. 357–391). Washington, DC: American
Psychological Association.
Spinazzola, J., Van der Kolk, B., & Ford, J. D. (2018). When nowhere is safe:
Interpersonal trauma and attachment adversity as antecedents of posttrau-
matic stress disorder and developmental trauma disorder. Journal of Traumatic
Stress, 31(5), 631–642.
Spiro, M. E. (1996). Postmodernist anthropology, subjectivity, and science: A mod-
ernist critique. Comparative Studies in Society and History, 38(4), 759–780.
Sprenkle, D. H., Davis, S. D., & Lebow, J. L. (2013). Common factors in cou-
ple and family therapy: The overlooked foundation for effective practice. New
York: Guilford Publications.
Spunt, R. P., & Lieberman, M. D. (2012b). An integrative model of the neural
systems supporting the comprehension of observed emotional behavior. Neu-
roimage, 59(3), 3050–3059.
Steele, W., & Malchiodi, C. A. (2012). Trauma-­informed practices with children
and adolescents. New York: Taylor & Francis.
Stone, C., Trisi, D., Sherman, A., & Debot, B. (2015). A guide to statistics
on historical trends in income inequality. Center on Budget and Policy
Priorities, 26.
Stringhini, S., Polidoro, S., Sacerdote, C., Kelly, R. S., Van Veldhoven, K., Agnoli,
C., . . . Mattiello, A. (2015). Life-­course socioeconomic status and DNA meth-
ylation of genes regulating inflammation. International Journal of Epidemiol-
ogy, 44(4), 1320–1330.
Thayer, Z. M., & Kuzawa, C. W. (2011). Biological memories of past environ-
ments: Epigenetic pathways to health disparities. Epigenetics, 6(7), 798–803.
Thomas, V., & Ozechowski, T. J. (2000). A test of the circumplex model of mari-
tal and family systems using the clinical rating scale. Journal of Marital and
Family Therapy, 26(4), 523.
Titlestad, A., & Robinson, K. (2019). Navigating parenthood as two women; the
positive aspects and strengths of female same-­sex parenting. Journal of GLBT
Family Studies, 15(2), 186–209.
Tronick, E., Als, H., Adamson, L., Wise, S., & Brazelton, T. B. (1978). The
infant’s response to entrapment between contradictory messages in face-­to-­
face interaction. Journal of the American Academy of Child Psychiatry, 17(1),
1–13.
Uchino, B. N., Trettevik, R., Kent de Grey, R. G., Cronan, S., Hogan, J., &
Baucom, B. R. (2018). Social support, social integration, and inflammatory
cytokines: A meta-­analysis. Health Psychology, 37(5), 462.
Umberson, D., & Thomeer, M. B. (2020). Family matters: Research on family ties
and health, 2010 to 2020. Journal of Marriage and Family, 82(1), 404–419.
Vallee, R. (2003). Cybernetics and systems, from past to future. Kybernetes,
32(5–6).
Valtorta, N. K., Kanaan, M., Gilbody, S., Ronzi, S., & Hanratty, B. (2016).
Loneliness and social isolation as risk factors for coronary heart disease and
stroke: Systematic review and meta-­ analysis of longitudinal observational
studies. Heart, 102(13), 1009–1016.
Van der Kolk, B. A. (1996). The body keeps score: Approaches to the psychobiol-
ogy of posttraumatic stress disorder. New York: Guilford Publications.
Verhage, M. L., Schuengel, C., Madigan, S., Fearon, R. M., Oosterman, M., Cas-
sibba, R., . . . Van IJzendoorn, M. H. (2016). Narrowing the transmission gap:
A synthesis of three decades of research on intergenerational transmission of
attachment. Psychological Bulletin, 142(4), 337.
Vogeley, K. (2017). Two social brains: Neural mechanisms of intersubjec-
tivity. Philosophical Transactions of the Royal Society B: Biological Sci-
ences, 372(1727). doi:10.1098/rstb.2016.0245
Walsh, F. (2016). Family resilience: A developmental systems framework. Euro-
pean Journal of Developmental Psychology, 13(3), 313–324.
Wampler, K. S., Blow, A. J., McWey, L. M., Miller, R. B., & Wampler, R. S. (2019).
The profession of couple, marital, and family therapy (CMFT): Defining our-
selves and moving forward. Journal of Marital and Family Therapy, 45(1),
5–18.
Warach, B., & Josephs, L. (2019). The aftershocks of infidelity: A review of
infidelity-­based attachment trauma. Sexual and Relationship Therapy, 1–23.
Weinberg, M. K., & Tronick, E. Z. (1996). Infant affective reactions to the
resumption of maternal interaction after the still-face. Child Develop-
ment, 67(3), 905–914.
Whisman, M. A. (2007). Marital distress and DSM-­IV psychiatric disorders
in a population-­based national survey. Journal of Abnormal Psychology,
116(3), 638.
White, J. M., & Epston, D. (1990). Narrative means to therapeutic ends. New
York: WW Norton & Company.
White, J. M., Klein, D. M., & Martin, T. F. (2015). Family theories: An introduc-
tion. New York: WW Norton & Company.
Widom, C. S., Czaja, S. J., Kozakowski, S. S., & Chauhan, P. (2018). Does adult
attachment style mediate the relationship between childhood maltreatment and
mental and physical health outcomes? Child Abuse & Neglect, 76, 533–545.
Wiener, N. (1949). Cybernetics. Cambridge: MIT Press.
Willems, Y. E., de Zeeuw, E. L., van Beijsterveldt, C. E., Boomsma, D. I., Bar-
tels, M., & Finkenauer, C. (2020). Out of control: Examining the association
between family conflict and self-­control in adolescence in a genetically sensi-
tive design. Journal of the American Academy of Child & Adolescent Psychia-
try, 59(2), 254–262.
Witherington, D. C., & Lickliter, R. (2016). Integrating development and evolu-
tion in psychological science: Evolutionary developmental psychology, devel-
opmental systems, and explanatory pluralism. Human Development, 59(4),
200–234.
Wittenborn, A. K., Blow, A. J., Holtrop, K., & Parra-Cardona, J. R. (2019).
Strengthening clinical research in marriage and family therapy: Challenges and
multilevel solutions. Journal of Marital and Family Therapy, 45(1), 20–32.
Woodhouse, S. S., Scott, J. R., Hepworth, A. D., & Cassidy, J. (2020). Secure
base provision: A new approach to examining links between maternal caregiv-
ing and infant attachment. Child Development, 91(1), e249–e265.
Woods, S. B., Bridges, K., & Carpenter, E. N. (2019). The critical need to rec-
ognize that families matter for adult health: A systematic review of the litera-
ture. Family Process, 8.
Woods, S. B., Priest, J. B., & Roberson, P. N. (2019). Family versus intimate
partners: Estimating who matters more for health in a 20-­year longitudinal
study. Journal of Family Psychology, 34(2).
Woods, S. B., Priest, J. B., & Roush, T. (2014). The biobehavioral family model:
Testing social support as an additional exogenous variable. Family Pro-
cess, 53(4), 672–685.
Yehuda, R., Flory, J. D., Bierer, L. M., Henn-­Haase, C., Lehrner, A., Desarnaud,
F., . . . Meaney, M. J. (2015). Lower methylation of glucocorticoid receptor
gene promoter 1F in peripheral blood of veterans with posttraumatic stress
disorder. Biological Psychiatry, 77(4), 356–364.
Yih, J., Uusberg, A., Taxer, J. L., & Gross, J. J. (2019). Better together: A uni-
fied perspective on appraisal and emotion regulation. Cognition and Emo-
tion, 33(1), 41–47.
Yllö, K., & Torres, M. G. (Eds.). (2016). Marital rape: Consent, marriage, and
social change in global context. Oxford: Oxford University Press.
Young, I. M. (2004). The five faces of oppression. In R. Heldke & P. O’Connor
(Eds.), Oppression, privilege, and resistance: Theoretical perspectives on rac-
ism, sexism, and heterosexism. New York: McGraw-­Hill Humanities Social.
 Yu, M., Linn, K. A., Shinohara, R. T., Oathes, D. J., Cook, P. A., Duprat, R., . . .
Fava, M. (2019). Childhood trauma history is linked to abnormal brain con-
nectivity in major depression. Proceedings of the National Academy of Sci-
ences, 116(17), 8582–8590.

View publication stats