Families can be a source of great happiness, warmth, and love, but they also suffer from trauma and conflict, resulting in damaged connections and broken relationships.
Family constellation therapy helps clients identify, understand, and reconcile events that have led to breakdowns within the family “constellation” (Konkolÿ Thege et al., 2021).
It involves individuals from the therapy group acting as stand-ins for a client’s existing and past family members, then using their position and feedback to work through and ease tensions.
This article explores the constellation approach’s theory, practice, benefits, and disadvantages and suggests learning opportunities for new and existing therapists.
“Family/systemic constellation therapy is a short-term group intervention aiming to help clients gain insights into and then change their inner image of a conflictual system and finally change their behavior in relation to that same system” (Konkolÿ Thege et al., 2021, p. 409).
It is a healing process that makes the unconscious dynamics of a family system visible by using the embodied experience of each member to understand what is out of balance and what is needed to restore harmony (Longo-Lockspeiser, 2018).
Ultimately, “it is a way of healing the individual soul by aligning it in the right relationship to the family soul” (Longo-Lockspeiser, 2018, p. 89).
Family constellation therapy is typically offered in a group setting of 15–30 people meeting over several days. Each group member volunteers to “place” their existing (or earlier) family constellation by sharing (Stiefel et al., 2002):
Who belongs to the system (family)
Any significant events that impacted the family
Whether anyone died young
Previous partners or children of the parents
The client asks individuals from the group to stand in for each family member (including themselves) and provide feedback, describing their “here and now” experience in relation to other replacement family members.
For example, the individual would describe whether they feel hot or cold, comfortable or uncomfortable, or in physical pain.
The client repositions the replacements, considering where they face or how they stand in relation to other “family members” until a good constellation is reached (Stiefel et al., 2002).
It can take several feedback cycles and multiple repositioning layouts before a successful resolution is achieved.
Having successfully arranged family members to ease the tensions, the client replaces their stand-in and allows themselves to be affected by the experience. It may be accompanied by a therapeutic ritual such as an embrace or repeating a sentence (Stiefel et al., 2002).
In recent years, elements of family constellation therapy have moved out of a group setting to include individual therapy and organizational consulting, revealing and initiating shifts in the dynamic nature of human systems (Cohen et al., 2019).
Where did family constellation therapy come from?
The approach was first developed in the 1980s by German psychoanalyst Bert Hellinger as a way of “dealing with processes that are beyond the spectrum of traditional therapy” and relies on the “immediate processing of nonverbal experience” (Stiefel et al., 2002, p. 39).
Sitting within the phenomenological framework proposed by Edmund Husserl and others, its goal is to act as a living map to support the healing of intergenerational wounds often obscured or lacking clarity from the client (Longo-Lockspeiser, 2018; Stiefel et al., 2002).
Is Family Constellation Therapy Evidence Based?
While there is limited research into family constellation therapy, it has received some support from several well-thought-out studies (Cohen et al., 2019).
Weinhold et al. (2013, as cited in Cohen et al., 2019, p. 1040) confirmed its ability to improve an individual’s “experience in their personal social systems, especially the experience of belonging, autonomy, accord, and confidence.”
A 2021 review of existing research also found support for family constellation therapy as a short-term group intervention helping clients “better understand and then change their conflictive experiences within a social system (e.g., family)” (Konkolÿ Thege et al., 2021, p. 409).
Nine studies out of the 12 showed significant improvement in clients post-intervention, and the authors concluded that while the quantity and quality of evidence are low, family constellation therapy appears to offer a positive intervention with mental health benefits for the general population (Konkolÿ Thege et al., 2021).
Though limited, research suggests constellation therapy is a potentially effective treatment for clients, helping them gain deeper insights into themselves, their relationships, and their shared past (Konkolÿ Thege et al., 2021).
Changing a client’s image of a conflictual system can lead to behavioral change in relation to that system, whether a family or otherwise (Konkolÿ Thege et al., 2021).
Common Criticisms of Constellation Therapy
While family constellation therapy has many benefits and some research-based support, it has its critics.
Challenges are typically based on the outdated beliefs held by Hellinger and captured in his family constellation theory, including (Hellinger, 2000; Blackbyrn, 2023; Hellinger & Ten Hövel, 1999):
His highly patriarchal view, often blaming the wife rather than the husband for (heterosexual) marital breakdown
The incorrect and unhelpful belief that homosexuality is an illness to be treated and causes family breakdown
The risk of re-trauma because of the reenactment of past events and conflicts
Claims that Hellinger held antisemitic views
How to Practice Family Constellation Therapy: 8 Steps
Family constellation therapy can benefit various individuals and groups, including (Blackbyrn, 2023; Konkolÿ Thege et al., 2021):
Families experiencing interpersonal conflicts, unresolved issues, and communication difficulties
Couples facing relationship challenges, such as communication breakdown, trust issues, or recurring conflicts
Parents with neurodivergent children, helping them navigate the unique challenges they face and promoting family cohesion
Individuals and their loved ones dealing with the emotional impact of illness, fostering understanding, and enhancing coping strategies
Several techniques and approaches are available, and not all apply to every situation.
However, the following is a typical set of steps involved in the process of family constellation therapy (Cohen et al., 2019):
A family constellation therapist leads a group that is initially unknown to one another.
Each member is asked, in turn, to pose a question or a statement to the group to “constellate” (the act of performing constellation therapy).
After a brief interview, the member (client) chooses group members to represent people within their family system.
“The client guides each person to a particular position, facing in a specific direction. The spatial configuration reflects the client’s current experience of his or her family” (Stiefel et al., 2002, p. 39).
Once set up, the group remains silent and still. Each member is asked to sense the thoughts, emotions, and physical sensations of the family member they represent.
Next, the facilitator adds an additional group member to represent multiple family generations.
Empty spaces in the constellation are clues to a missing or excluded family member.
When the facilitator fills each space with a representative, the other members feel a physical sensation of relief.
Once complete, the facilitator suggests to the group that the constellation is in order.
The client and representatives are given an opportunity to “speak the essential truth of entanglements or issues to bring resolution and a compassionate restoration of balance to the system” (Cohen et al., 2019, p. 1040).
3 Ancestral Healing Interventions
“The representatives of the dead often bring a kind of energy into a constellation that makes us consider whether there may be more powerful forces at work than we normally consider” (Schneider, 2007, p. 65).
While ancestral consciousness has applications in cross-cultural settings, there are few examples in the academic literature.
We offer the following examples of interventions associated with ancestral healing.
Including ancestral representatives
In a 2018 research study, group therapy members were asked to “facilitate a connection to the extended and collective family soul (ancestors),” involving them in choosing group members to represent their maternal and paternal relatives (Geils & Edwards, 2018, p. 225).
Each group member represented and responded as an embodied experience of the ancestor to help the client (or “descendent”) form a deeper ancestral connection (Geils & Edwards, 2018).
Open-ended questions
In the same study, participants were prompted by open-ended questions to reflect on their connection to their ancestors (Geils & Edwards, 2018):
Did you experience a connection to your ancestors? How was the connection experienced?
Practicing forgiveness
A 2021 study explored ancestral spiritual healing and recognized the importance of forgiving past transgressions, potentially over several generations within (or outside) the client’s family (Dennison & Powell-Watts, 2021).
The client reflected on the trauma caused upon themselves or their ancestor by an individual (or group, identifiable or unknown) and practiced forgiving the transgressor.
Such an activity can be particularly healing and transformative for the children of those who witnessed racial, ethnic, or gender-based trauma (Dennison & Powell-Watts, 2021).
3 Family and Systemic Constellation Books
Family and systemic (working within families as systems) constellations are fascinating therapeutic approaches that can be incorporated into your existing treatments (Cohen et al., 2019).
The following therapy books help teach the theory and practical steps required.
1. Systemic Constellations: Theory, Practice, and Applications – Damian Janus
In this book, Damian Janus explores the theory and history behind systemic constellation treatments before delving into several case studies.
The reader is also introduced to Hellinger’s approach to psychotherapy in solving mental health issues in clients, couples, groups, and organizations.
2. Systemic, Family Constellation: Core Principles and Training Practices – Netra Chou
As the first person to introduce family constellation therapy to Asia, Netra Chou has combined over 20 years of teaching experience into this valuable and extensive book on systemic family counseling therapy.
The subjects covered are far reaching and include the background, theory, practices, models, and skills needed to become a successful constellation therapist.
Several training options are available for those interested in learning more about practicing family constellation therapy. We have included three of our favorites.
In the United States
Hellinger Institute – Training in family constellation is available in person and online for those wishing to pursue a career using this therapeutic approach.
By completing 12 modules of training, interested students can learn practical facilitator techniques and form a deep theoretical understanding of the treatment.
In Europe
The Centre for Systemic Constellations offers multi-level learning styles and ongoing personal and professional development in systemic constellation therapy.
The courses are valuable for anyone interested in resolving personal, family, and social issues through forming and healing deeper and far-reaching connections.
Online
Family Constellation Virtual – This powerful virtual training covers the theory and practical aspects of constellation therapy.
Through a series of videos and online material, learners are given the opportunity to learn the therapy skills needed to host individual and group sessions while also receiving individual coaching.
Best Resources From PositivePsychology.com
We have many resources available for therapists providing support to individuals, couples, families, and groups to address relationship issues or strengthen emotional bonds.
Why not download our free positive relationships pack and try out the powerful tools contained within? Some examples include:
Connecting With Others by Self-Disclosure
Being understood, accepted, and cared about is crucial to our happiness and overall wellbeing. This exercise helps the client learn how to practice self-disclosure and strengthen new and existing connections.
The Sound Relationship House Inspection
Relationships require nurturing to grow and progress; otherwise, they can falter and fail. This exercise uses a house metaphor to review client relationships.
Other free resources include:
Mind the Gap
The Mind the Gap worksheet looks at what we aspire to be (or aspire our children to be) versus what we do within the family unit.
Recognizing Family Narratives
Use this worksheet to acknowledge the narratives that explain and justify the structure and interactive patterns that exist within the family.
Family Strength Spotting
Understanding each family member’s strengths can help us build appreciation for one another and get the best out of our relationships. Try out the following four steps:
Step one – Each family member completes the VIA Inventory to identify their strengths.
Step two – Compare the strengths of each family member and consider the following questions:
What strength patterns can we find within our family? Are there specific virtues that are represented more than others? Do you possess a strength unique to you in your family (that no one else has)? Are you surprised by any of your family members’ strengths? If so, why? How can you combine all your strengths to make a tighter, more cohesive family?
Naikan Reflection Naikan therapy is a structured self-reflection method and encourages kindness and gratitude within relationships.
Ask yourself the following questions:
What have I received? What have I given? What troubles or difficulties have I caused?
Reflect on the answers and experience gratitude for what people have done for us and the positive emotions associated with what we have given to others.
In addition to these free and subscription resources, the following articles might pique your interest too:
If you’re looking for more science-based ways to help others build healthy relationships, check out this collection of 17 validated positive relationships tools for practitioners. Use them to help others form healthier, more nurturing, and life-enriching relationships.
17 Exercises for Positive, Fulfilling Relationships
Empower others with the skills to cultivate fulfilling, rewarding relationships and enhance their social wellbeing with these 17 Positive Relationships Exercises [PDF].
Family constellation therapy complements techniques from other therapeutic models.
It provides a short-term group intervention to help clients better understand their family and its conflicts and change their behavior toward other members (Konkolÿ Thege et al., 2021).
Ultimately, it is a healing process that relies on the therapy group adopting representative positions within a “living map” and then reflecting upon what is out of balance to identify what is needed to restore harmony (Longo-Lockspeiser, 2018).
The client places themselves within the map to encourage the healing of intergenerational wounds and improve their experience of belonging, autonomy, and confidence (Cohen et al., 2019).
While research is limited, existing studies suggest that constellation therapy offers a potentially effective treatment for clients. It provides clients unique opportunities for powerful emotional releases, positive behavioral change, and deep insights into themselves, their relationships, and their shared past (Konkolÿ Thege et al., 2021).
Family constellation therapy has its critics. And yet, it appears to offer healing opportunities for individuals, families, and other groups that can easily be combined with existing therapeutic approaches to heal enduring relationship wounds.
Family constellation therapy has shown positive results in helping individuals gain insights into their family systems and change their behavior in relation to those systems (Konkolÿ Thege et al., 2021).
What is an example of a family constellation?
An example of a family constellation in therapy is when the client and other group members represent family members and recreate the dynamics of the client’s family system to reveal unconscious dynamics and imbalances (Stiefel et al., 2002).
Can constellation therapy be used to treat addiction?
Constellation therapy has helped treat addiction by addressing underlying family trauma and dynamics issues. However, more research is needed to establish its efficacy in treating addiction specifically (Blackbyrn, 2023; Konkolÿ Thege et al., 2021).
References
Blackbyrn, S. (2023, February 28). Family constellation therapy: The definitive guide. Coach Foundation. Retrieved May 22, 2023, from https://coachfoundation.com/blog/family-constellation/.
Cohen, D. B., Blefeld, E., & Krost, B. (2019). Family constellation enrichment croups. In J. Lebow, A. Chambers, & D. C. Breunlin (Eds.), Encyclopedia of couple and family therapy (pp. 1039–1041). Springer.
Dennison, A., & Powell-Watts, L. (2021). Ancestral healing in psychotherapy. Spirituality in Clinical Practice, 8(3), 188–194.
Geils, C., & Edwards, S. D. (2018). Extended family constellations workshop efficacy on intuition measure and experience. Journal of Psychology in Africa, 28(3), 224–228.
Hellinger, B. (2000). Der Schaffensprocess [The Creative Process]. Praxis der Systemaufstellung, 2, 11–18.
Hellinger, B., & Ten Hövel, G. (1999) Acknowledging what is: Conversations with Bert Hellinger. Zeig Tucker & Theisen.
Konkolÿ Thege, B., Petroll, C., Rivas, C., & Scholtens, S. (2021). The effectiveness of family constellation therapy in improving mental health: A systematic review. Family Process, 60(2), 409–423.
Longo-Lockspeiser, L. (2018). Meaning making through family constellation work. In D. Trimble (Ed.), Engaging with spirituality in family therapy: Meeting in sacred space (pp. 89–106). Springer.
Schneider, J. R. (2007). Family constellations: Basic principles and procedures (C. Beaumont, Trans.). Carl-Auer-Systeme Verlag.
Stiefel, I., Harris, P., & Zollmann, A. W. (2002). Family constellation: A therapy beyond words. Australian and New Zealand Journal of Family Therapy, 23(1), 38–44.
About the author
Jeremy Sutton, Ph.D., is an experienced psychologist, consultant, and coach. Jeremey also teaches psychology online at the University of Liverpool and works as a coach and educator, specialising in positive psychology, performance psychology, sports psychology, and strength-based psychology.
Families can be a source of great happiness, warmth, and love, but they also suffer from trauma and conflict, resulting in damaged connections and broken relationships.
While there is limited research into family constellation therapy, it has received some support from several well-thought-out studies (Cohen et al., 2019).
While family constellation therapy has many benefits and some research-based support, it has its critics.
