Handing it on: family constructs, symptoms and choice

We suggest that pathology exemplifies a form of conscious or unconscious 'choice'. Each individual's potential choices of action are delineated by a network of shared options representing the family construct system. Over several generations, a tradition of permissible options is transmitted with a reshuffling and some change at each generation. Thus, both ordinary and problematic actions are based on a limited set of options. This view integrates the systemic emphasis on circular processes associated with problems with an explanation of the content or types of pathology that is presented. In a given family, the type of pathology shown is seen to be a result of a choice at a particular time from a permitted set of options. Some implications of such a view for the process of therapy with families are discussed.