The family is not just a collection of individuals. It is a whole larger than the sum of its parts.

The family structure is the first element of the family systems theory. It includes the dimensions that make every family unique such as:

• family size
• family form
• cultural background
• geographic location

Other factors that shape the family structure have to do with the holistic health status of its members, the way the family copes in moments of stress and crisis, and when there are special needs in the family, the nature of the disability.

All family members have a stake in maintaining the delicate balance in their relationship patterns. The action of one member affects all others, and that member is in turn affected by the reaction of others. This can be seen at times of change when the established balance is threatened.

Something as seemingly simple as a change in working hours can have implications for the relationships of everyone in the family. For example, a father is suddenly changed to the day shift on his job after working for years at night. What happens when he is there in the evening to interact more closely with the other family members? Will the children see his increased attention as interference in their established patterns? If they object to this change, he may interpret it as lack of respect or rejection.

On the other hand, the father may see problems that he has not noticed before because he was home during hours that the children were in school. His wife may have become involved in evening activities that she may not want to give up to be with him. She may resist his involvement with the children after enjoying a “power” position over the years. He might decide that it would be best to immerse himself in TV or outside activities as a way of avoiding some of the issues that the increased opportunity for closeness with the family present.

A change in the family situation means readjustment of the total system and can pose problems and challenges for every single member.

When individuals live together in an intimate environment, such as a family, they begin to set limits on each other. There is a range of behavior that is acceptable and a certain amount of deviation that is tolerated. When individual behavior threatens to violate the limits that have been agreed upon, members respond by trying to reestablish the limits and to preserve the stability of the family system.

All members of the family system participate in this process of maintaining stability. For example, a child, upset after witnessing the fighting of his parents, may begin to have problems in school. He notes that when his parents focus on his problems, they spend less time fighting. In a sense, the child is able to unite them in concern over him. Even though they may eventually express anger towards him, absorbing their anger is better than having them separate. The parents, too, may take note of the fact that they get along better when the child is having problems and may begin, at some level, to reinforce the child’s difficulties.

Though this sequence is dysfunctional for the child, it is functional for the continuity of the system. It keeps the family together, and all of the family members are invested in maintaining it. Typically, in such a family the child experiences a problem at times when he perceives that there is trouble between his parents. It is also possible that one of the parents, feeling anxiety over marital strife, could trigger this pattern by interpreting the child’s behavior as problematic, even though that behavior might be judged quite “normal” by an outside observer. This process is not conscious. The individuals do not plan it. The pattern evolves and persists to serve the positive function of maintaining the stability of the family system over a period of time. Mother, father, and child all participate in the pattern.

When the family is viewed in this way, it becomes impossible to think of family assessment as arriving at a separate diagnosis of each individual family member at a particular moment “frozen” in time. Rather, focusing upon understanding the nature and the quality of the interactions among family members over time becomes essential. And, while family systems tend to maintain stability, they are not rigid and unchanging. A family must be prepared to respond to the changing needs of its members over time, to unpredictable events that involve family members, and to pressures that come from outside family boundaries.