Mental disease and health definition in Systemic Therapy


In systemic therapy, mental disease is not seen as a personal characteristic of a human (“I have a gastric ulcer”), and the person will not be reduced to one dominant attribute (“I am a person suffering from anxiety neurosis”). Symptoms and suffering of involved persons are considered as “a part of a bigger, depending on the perspective, disturbing or disturbed interaction where one or more individuals suffer so much that they are labelled as having a disease.” Symptoms can arise on the physical level in the biological system, on the psychological level in thoughts or emotions, and on the social level in communication. Diseases also are “results of social decisions about what should be labelled as sick”.

dreamsIn systemic therapy, the client himself defines the need of treatment and agrees on therapy goals with the therapist at the beginning of treatment. The therapist takes into account the client’s individual way of life, remains open-minded for his personal perceptions, and respects his limits because the client is the expert for his goals and his life. The basic attitude in therapy is resource-based, which is why building up general psychic health is seen as the most effective way of treating a disease. Four essential requirements for emotional health are having a personal meaning in life, counting on a social network, feeling control over one’s own life, and comprehending major parts of personal life experiences and life events. Resources are all capabilities of an individual that are available for shaping his life and his identity, such as personal competences, values, life experience, reference persons and networks, hopes, or self-esteem raising activities. “Health or successful life management as a norm does not exist”, the generation of health is seen as a dynamic process.

J.Schweitzer / A. von Schlippe: Lehrbuch der systemischen Therapie und Beratung II. Das störungsspezifische Wissen
G. Schiepek: Die Grundlagen systemischer Therapie