Family Systems as Part of a Tripartite Clinical Model

Jinji Willingham

Three Foundations:

  • dharma
  • neurobiology (attachment theory and polyvagal theory: how live-streaming relationship dynamics impact the nervous system, mid-prefrontal brain, and mental health; how trauma leads to mood disorders, personality disorders, and the spectrum of self-harming behaviors).
  • family systems (systems theory applied to family dynamics).

This presentation will focus on:

  • how the three are aligned
  • how they emerge
  • how I integrate them in clinical work with clients and families
  • I share my clinical orientation with clients implicitly (embodied) and explicitly (named, described, explained) as well as in consultation with or training other psychotherapists. 

Consilience (how they aligned):

  • Dharma: interbeing, dependent co-arising, co-emergence
  • Family systems: 1+1=3, the third field of live-streaming organismic co-emergence
  • Neurobiology: dynamics of relational attachment; secure or insecure as a)anxious b) avoidant, c) disorganized

Neurobiology: A Review

Sympathetic autonomic nervous system (ANS) response to perceived threat. Dysregulation: upregulated (anxious), downregulated (depressed), vacillation (chaotic). Sympathic involuntary ANS: 

  • Fight/flight (mobilized response, up-regulated)
  • Freeze (immobilized response, can be up or down-regulated, immobilized)
  • Co-regulation maintained through attunement and repair
  • Neuroception supports state change (Porges’ Polyvagal theory)

Dan Siegel: describes the mind as an “emergent, embodied, relational process”(Dan Siegel, Mind)

  • Siegel is describing a living organismic system.
  • Not who am I and who are you (discrete, separate)
  • Not even who we are
  • But how are we relating in this live streaming third field (1+1=3) third field of organismic co-emergence.
  • The field of Neuroception (Porges) where we co-regulate
  • not “perspective change” but “state change”

Importance of Family Systems

  • Result of assessment: root of distress is systemic: family and cultural
  • family is the most basic unit but has sub-systems and super-systems
  • My own karmic lineage: my family, how I responded, how I became myself 
  • e.g., Midnight Diner (Japanese Netflix show, lots of family systems in it)

How It Often Emerges in Psychotherapy:

  • 27-year-old clients begin therapy due to current stressors/distress. They want to have enough space and time to look back and compost the residue of her karmic family lineage, in order to grow and move forward. (Family not present but focus on family system.)
  • Parents send in their adolescent clients and ask me to help them, unaware of source of distress. They often have low self-insight and don’t realize that they are ultimately involved in their adolescent’s maladaptive behaviors due to intergenerational insecure attachment. They want the therapist to “fix” their kid.
  • Individual clients inevitably talk about relationships with family members, and we often invite them it to join and participate.
  • Covid: extended time at home, whether alone or together in close proximity with family gave rise to deep reflection. Being home together is the mirror 

Perspective: it’s in relationships that most chronic trauma occurs, and it’s in relationship that we can repair and heal. 

Systems Origins:

General Systems Theory: Austrian biologist Ludwig von Bertalanffy used the term Systems Theory through his ‘Organismic Biology’ theory (1920s). We cannot understand biological organisms in parts. We must think about how interactions of different parts influence the behavior as a whole. Further developed during WWII when engineers needed to solve complex communications and control problems. Later applied to business, management, sociology, and psychology. And they realized that cause and effect is not always linear. (e.g., not: the pool cue hits the cue ball, which hits the next ball, or in relationships: “he said, she said” etc.)

Dynamic co-emergence is non-linear:

  • the third field: 1+1 = 3
  • live streaming in the moment
  • micro systemic attunement: track and respond
  • verbal and largely non-verbal (facial tone, vocal tone, body language)

Murray Bowen: 1950’s: Era of Social Science. Considered to be founder of Family Systems Therapy


  • multi-generational diagram focusing on relational dynamics. We can add major events like war, assault, trauma, suicide, addiction, incarceration, accident, illness, death, career.
  • helps with clinical assessment
  • establishes trust in therapist-client relationship
  • builds insight for client into their own suffering and how their family suffers: bodhicitta, empathy, and compassion
  • Introduced presence of subsystems and supersystems
  • recommended inclusion of at least three generations to establish intergenerational patterns

Other Contributions

  • 1st order change: incremental improvement, changing a part can change the system
  • 2nd order change: fundamental creative new thinking emerges that creates system-wide (transformative) change – more than just changing a part.
  • Emancipation: leaving home, cutting off and distancing will not necessarily lead to growth and will pass on maladaptive behaviors vs. Individuation: repair, heal, and grow into a relationally-connected individual.

Virginia Satir (1950-70’s): more experiential, explored family roles, arranged tableaus, and incorporated sculpting 

Salvador Minuchin (1970’s): more strategic and directive. It identified the patient as the symptom-holder and the key subsystem to create second order change. He re-seated and re-positioned clients to highlight the hidden dynamics: alliances, triangulated relationships. “Change the part, change the system.”

More Recently: Adverse Childhood Experiences (ACE, Assessment diagnostic). Increased awareness of the neurobiology of Developmental/Complex Trauma (family, attachment): ANS dysregulation, anxiety, depression, and self-harm. (Dan Siegel, Bessel Van der Kolk, Stephen Porges, Gabor Mate, Peter Levine, Robert Karen) Epigetics: intergenerational transmission of trauma. 

My Personal Clinical Insights From Family Work

  • Often one person in the family holds the symptoms for an entire family, usually a child. 
  • Younger, more sensitive, more empathic, more porous members often hold the distress and projections of the elders who are not looking into their own mirror.
  • Adults often don’t see or acknowledge abuse, harm, or emotional neglect/abandonment because it requires the self-regulation they lack.
  • If they cannot tolerate their own distress, they are up-regulated or down-regulated
  • Their emotionally-parentified child is left to adapt to parents’ psycho-emotional needs in order to maintain proximity and maintain connection, so they become symptom holders and their own development is compromised
  • Neuroception is not happening (over-arousal/chaotic or dissociative behavior emerges)
  • They cope (fixation, dissociation, or self-harm) and then contact me when they turn 27. (Really, most common age people begin therapy.)
  • Clinical work has focused on integrating what I love most (dharma) with the clinical relevance of neurobiology. In the last three years my work has increasingly shifted to include family systems therapy, working with multiple family members, both together and separately, focusing on raising insight and developing practical relationship skills.

Direction of my work: integrating tableau-work, archetypal choreography, sculpting, and ritual with dharma and neurobiology to effect organismic co-emergent growth.

Benefits of Family Systems: When paired with dharma and neurobiology, it yields insight, compassion, awareness of dynamics of unhealthy attachment.

What’s at Stake: If we don’t repair, heal, and grow we will:
a) internalize it and get sick or harm ourselves,
b) dissociate and isolate: we die off
c) whoever cannot face themselves in the mirror turns the mirror to someone else: projection (aggressive),
d) pay it forward: harm others, pass it down intergenerationally, ask others to carry it for us


  • Four Reminders that Turn Thoughts to the Dharma: evokes the motivation to liberate from family samsara
  • Four Noble Truths & Samsara
  • Calm abiding, insight, contemplation, awareness
  • Four Establishments of Mindfulness: body (sense perceptions, interior environment, speech, mind, meta-awareness. Meta-awareness (the 4th establishment) serves as the gap that provides access to emptiness and helps clients de-identify with personal/constructed parts.
  • Bodhicitta: empathy and compassion
  • Tibetan Lojong slogans
  • Tilopa’s Six Words
  • Four Immeasurables (brahma-vihara)
  • Loving Kindness practices
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