The Systemic Paradigm Shift: Reframing Depression and Anxiety Through a Family Lens
From symptom to system
In a world that often views depression and anxiety as individual malfunctions, the systemic lens offers a compassionate and distinct perspective. Rather than asking, “What’s wrong with me?” the systemic paradigm asks, “What has happened in the relational field around me and how am I carrying it?”
As therapists, we’re often trained to assess and intervene at the level of the individual. Identifying symptoms, tracing cognitive distortions, or exploring personal trauma narratives.
But what happens when we widen the frame?
When we begin to see depression and anxiety not as isolated intrapsychic phenomena, but as expressions of relational and intergenerational systems.
The systemic lens invites us to look beyond the individual to the family, cultural, and social fields that shape emotional experience.
In this post, I explore how a systemic perspective can deepen our understanding of depression and anxiety and support us in offering more nuanced, compassionate, and effective therapeutic work.
What depression and anxiety might be telling us
Depression and Anxiety often seen as individual pathologies a long-standing medical model perspective.
Our experiences are often more complex and shaped by relational, familial, and cultural dynamics leading to symptomology.
A systemic lens is a paradigm shift from individualising and problematising to interconnectedness, relational influencing, and patterns over time.
Symptoms of depression or anxiety may reflect loyalty to family roles, unresolved trauma, or survival strategies.
For example:
Depression: possible expressions of entanglement, withdrawn loyalty, or systemic burdens.
Anxiety: survival strategies attuned to unstable, unsafe, or emotionally fragmented systems. Hypervigilance in a legacy of fear.
The Value of a Systemic Shift for Therapists:
Enhances our capacity to hold complexity.
Helps reduce therapist burnout by moving away from feeling the need to “fix” the client.
Fosters more enduring change by working at the level of belonging, attachment, and relational roles.
Integrating Systemic Thinking into Your Practice
Invitations: Try viewing a client’s symptom as an intelligent adaptation rather than a malfunction.
Explore relational questions in session, even when working individually.
Reflect on your own systemic positioning as a therapist: whose loyalties or roles do you hold?
Suggested reading and influences:
Bowen, M. (1978). Family Therapy in Clinical Practice. Jason Aronson.
Boszormenyi-Nagy, I., & Spark, G. M. (1973). Invisible Loyalties. Harper & Row.
McGoldrick, M., & Gerson, R. (2008). Genograms: Assessment and Intervention. Norton.