The counsellor frequently has a family group in the consultation, a nuclear family, an extended family or multigenerational. The counsellor's practice will be enhanced by an understanding of how ‘the group’ is a unit to be thought of as a whole, yet made up of interacting parts. This chapter presents the core features of systemic thinking and its application to genetic counselling. It integrates this way of thinking with that of the earlier chapters, in particular attachment theory, in order to provide a consistent theoretical base for working in genetic counselling.

The clinical practice of genetic counselling includes in its orbit the psychosocial context of the family history of relationships and looks at how individual members of a family interact together and mutually affect one another. It looks at the communication patterns of particular members of a family, their emotional links and how the story of the gene is spoken about in the family life cycle. This immediately introduces systemic thinking, yet with notable exceptions (Eunpu, 1997), it has not been widely used in genetic counselling. Indeed some counsellors are rather intimidated by systemic theory which can at times be complicated and philosophical in its discussions and seem far removed from the distressing problems experienced by families.