Every clinical approach has its stories of sudden, life-changing breakthroughs and revelations. Those are the moments every therapist hopes for: when clients, caught in a maze of self-defeating patterns and despair, make a sudden leap that frees them from the prison of their past. But a relatively obscure therapeutic school called Family Constellations, developed by a controversial former priest named Bert Hellinger, claims to have offered the key to more than its share of these transformative moments, even though they can’t be explained within the accepted notions of how therapy brings about change.
Now in his 90s, Hellinger attributes part of his approach to his time spent as a missionary among the ancestor-worshipping Zulus of South Africa, who communicate with their dead and often consult with and attempt to appease them when befallen by illness or misfortune. Hellinger went on to make it the central tenet of his therapy approach that every family has a common conscience going back generations. His goal is to help people bring to life and confront their larger family story, so that children and grandchildren don’t end up shouldering their ancestors’ pain.
Does all this sound a little out there? It may be one of the reasons that Hellinger’s influence on the therapy field has been relatively small in the U.S. But Family Constellations adherents are devoted and passionate, and can be found all over the world. One of them is Carol Heil, a psychotherapist in the Washington, DC area, who frankly admits that constellations are “definitely weird,” but nonetheless regularly uses the approach with clients who seem terminally stuck and haven’t responded to other interventions.
One of those clients is Margaret, someone Heil has been seeing for years, and who remains unabatingly anxious, dangerously anorexic, and at 42 is still living unhappily with her father in her childhood home. Each new attempt Heil makes to help her stabilize her weight or step out into the world withers into nothing. Having run out of alternatives with Margaret, who’s a frightening 81 pounds, Heil has persuaded her to attend one of her weekend Family Constellations workshops.
Participants have been asked beforehand to consider the traumas in their ancestral histories. Which relatives were likely riddled with grief or distress or met a tragic fate? Did any children die? Was a sibling rejected or disowned? Did anyone go to war or jail or emigrate under threat? Who might’ve struggled with violence, poverty, political oppression, addiction, or abuse?
In a voice so hushed the other participants have to lean in to hear, Margaret explains her family situation at the beginning of the group, and then says, “I might be an anxious person, but I want very much to be able to find a job and get out of my parents’ house.” She’s then asked to choose people, from among the room of strangers, to represent herself, her immediate family members, and her anxiety—and then to place them near each other in the center of the room in a way that “feels right.” These “reps” are told to tune into any emotional or physical resonance with the person they’re representing (what those in the constellations world call the morphogenic, or knowing, field) and are given a few moments to absorb it.
When asked how they’re feeling, “Margaret,” her “mother,” and her “anxiety” each say they’re having stomach pain. One of these reps clutches her stomach and says, “I see people all around and they look dead.” Heil adds a few reps for the dead, and each of them, without instruction, drop to the ground with their eyes open—a detail, Heil says, “that tells me they’re not at rest.” Heil is so taken by this scene that she turns to Margaret and asks her if she lost any family members in the Holocaust. Margaret shakes her head no. Moving on, Heil asks the woman representing Margaret to acknowledge the dead, and say to the others representing her immediate family, “I look at them because you won’t.”
Heil directs the Margaret rep to turn to her deceased mother, who also suffered from anorexia, and say, in the formal, ritualistic language that constellations employ, “Out of loyalty to you and the suffering in my family, I starve myself just like you. That’s my way to remember and honor you.” Then she asks the real Margaret to take her place in her own constellation and say to all the gathered reps, “I will honor you. Please bless me as I move on with my life, no longer starve, and become healthy and independent.”
In the days that follow, Margaret, who’s puzzled by the scene of the dead at her constellation, calls some of her older relatives and discovers that they’ve been hiding a huge part of their history. It turns out members on both sides of her family, children in Poland at the time of the WWII, had been victims of the Holocaust. Great-aunts died in the camps, and a great-uncle emerged starved from one when the war ended. In an effort to put the horror behind them, her grandmother said, they all chose to keep their trauma a secret.
Margaret is stunned by this revelation. Her constellation revealed a deeply felt experience that she never would’ve thought to ask her relatives about on her own. When Heil follows up with her, she reports that the new picture of her family, going back generations to the relatives who huddled together to comfort each other in their fear and despair, has contextualized and profoundly shifted her sense of herself as weak and dependent. And having the new knowledge of their experience of near starvation places her family’s relationship to food in a different light. She starts asking, “Am I really honoring the dead by suffering for them? Is this the best way to live the life they couldn’t?”
For the first time, she begins to set limits for herself in her enmeshed family and joins a group of career searchers, making friends and even going out to dinner with a few of them. In a monumental move, she sets up 24/7 care for her father. When last she and Heil checked in, she’d gained four pounds.
The Science and the Controversy
As stunning a revelation as Margaret’s constellation produced, does this sort of experience really work for every stuck client? Heil says it often does. No matter the story, there’s something about the three-dimensional, embodied experience of intergenerational influence that Family Constellations provide that she’s seen work in dramatic ways, time and again.
“At first, I was cynical about them; they’re a form of channeling, after all. But people deeply experience what’s coming up in these workshops,” she says. “Remember, we’re working with factual stuff—actual traumas, the dynamics and energy of a family—and asking everyone to tune into body and emotion. It’s powerful stuff.”
Psychologist Marla Zipin agrees. Though she doesn’t lead groups like Heil does, she’s studied Family Constellations for years, training with “constellators” from Hellinger’s native Germany, and weaving the work into her individual office sessions by substituting rocks for embodied family members.
“Maybe if you were trained analytically and don’t work systemically, Constellations would seem weird,” Zipin says. “But for those of us who do, who already know the brain remembers for three generations, it makes so much sense. You see amazing things happen in these groups. I myself was freed from persistent anxiety during a constellation that explored how my maternal grandmother’s sister perished in the Holocaust. It was a remarkable experience.”
Many therapists know their way around family systems and are well versed in the late Murray Bowen’s belief that to differentiate ourselves and truly become grown up, we need to trace the genealogy of emotional patterns in our families. Plenty of therapists also help clients better understand why their parents learned to behave as they did and how that’s shaped their relationships and emotional lives. But Family Constellations has never achieved the level of legitimacy that other multigenerational approaches have. Aside from a few studies that found it had some positive effects on psychological distress, social relationships, and motivation, it’s sometimes been derided as just a dramatically powerful, three-dimensional form of suggestion. Physicists have even called claims that Family Constellations accesses a psychic field of energy “quantum quackery.” But the therapists and the myriad groups of other healers who facilitate constellations counter that the three-dimensionality of these groups makes them an invaluable way to deeply explore, even briefly inhabit, a family history that’s rarely brought as fully to life through talk.
Hellinger himself has been a lightning rod for controversy for much of his career. He did steep himself in analytic, family therapy, and family systems training with Murray Bowen, Leslie Kadis, Ruth McClendon, and Virginia Satir. But over the years, he’s been accused of maintaining a patriarchal view of the family, engaging in mother-blaming and heterosexism in the extreme. And he’s drawn the ire of victims’ groups for his hardline stance that for his version of family work to succeed, participants must afford “due respect” to each and every member of their family, even those who’ve committed heinous acts, like murder, rape, and incest. He’s told immediate survivors that without demonstrating such “respect” to their offenders, the love within their family system will not flow freely, meaning children and grandchildren may end up shouldering the perpetrator’s pain.
With the controversy swirling around its creator, and the unconventionality of the technique, you’d think Family Constellations would remain in the fringy background of the therapeutic landscape in the States. But fascinating developments outside of therapy are giving rise to the idea that we might do well to take on the kind of active exploring of inherited traumas that’s at the core of the approach.
Researchers in the field of epigenetics are now suggesting that our cells may transmit the impact of traumas experienced by relatives and ancestors down through the generations. While it’s long been considered a scientific given that our DNA is a stable genetic code, epigenetics researchers study what happens to our genes over the course of our lives. They shine a light on the factors that can influence the instructions cells receive to turn certain genes on and off: factors like poverty or pregnancy, diet, drugs, sleep habits, and stress—as well as big emotional and physiological traumas. But how is it possible to pass a lived trauma down biologically? Rachel Yehuda, professor of psychiatry and neuroscience at Mt. Sinai School of Medicine in New York, is one of the first to try to find an answer.
The daughter of a rabbi, Yehuda had been looking into biological markers for PTSD in veterans in New York, and when she became interested in furthering her evidence, she set out for a neighborhood of Holocaust survivors in Cleveland, Ohio, where she’d grown up. After finding enough survivors in this neighborhood who showed the same markers, she created a new investigative and therapeutic clinic back at Mt. Sinai expressly for Holocaust survivors. But it wasn’t just the survivors who called her for treatment: their kids, who had their own trauma symptoms, reached out too. She evaluated them and discovered that they were three times as likely to meet the criteria for PTSD than those in their community whose parents hadn’t been through the Holocaust.
The therapy field has long had its own ideas about how parental stress gets passed down as children live it and feel it in their homes. But when Yehuda did research with mothers who’d been pregnant during 9/11, she found that if the mothers’ traumas had resulted in PTSD, then a susceptibility was passed along to their children. In 2015, she published a study noting, in her sample of Holocaust-survivor mothers and their children, a cortisol pattern in both that she’d already associated with PTSD. She also identified an epigenetic tag that lead her to conclude that the propensity for PTSD could be biologically inherited.
Yehuda likes to think her work may help put to bed the notion that trauma lives on only in the person it’s happened to and that it reflects a lack of inner strength. “We all know that there are effects of parental trauma on children—because trauma changes people and the quality of their parenting and attachment,” Yehuda says. “But it’s becoming clear that there are real biological changes that map onto parental experience. This work is painting a picture of the idea that when offspring say they’re affected by their parents’ trauma, there’s a counterpart in the body that reflects this.”
But couldn’t telling clients that their parents’ or grandparents’ trauma is baked into their own cells discourage people from believing that they can do something about it? Yehuda doesn’t think so. She’s noticed a very different reaction in the people she sees when they learn this. “In the past, mental health work had a broader approach to working with trauma. Then we got more efficient and infatuated with approaches that focus on just the individual and on the here and now, no longer taking a wider view of the problem. But now my patients report that diving back into their parents’ lives gives them an experience of healing that goes beyond symptom reduction and behavioral changes.”
There’s some argument within the scientific community that the only way to establish whether trauma is truly inheritable is to see whether its markers appear in third and fourth generations—which has been difficult to do with a human population in such a new field, since we age and procreate slowly. But animal researchers tackling this question report some provocative findings.
Isabelle Mansuy, a neuroscientist at the Brain Research Institute at the University of Zurich, has been traumatizing mother mice and their pups by separating them from each other and exposing them to added stresses—either restraining them or leaving them helpless in containers of cold water. The children of these mothers have gone on to exhibit depression, impaired social skills, changes in cognition, and a loss of behavioral control. Those changes hold for their pups and grandpups. There’s even evidence from Mansuy’s team that some, though not all, behavioral traits persisted into the great-grandpups—a potential fourth generation.
Mansuy is also doing work to reassure the public that inherited trauma can be ameliorated by a good and loving environment. “Until now, only pharmacological drugs were known to correct epigenetic alterations in a consequential way for behavior,” she writes in her study findings. “Now we know that this is also possible through environmental manipulations such as enriched conditions.”
Mansuy’s findings have been supported by the work of Emory University’s Brian Dias with multiple generations of mice. Using mild electrical shocks, he’s shown that they can pass along their fear of certain stimuli to their offspring. Even when he transferred embryos of the traumatized mice to mothers who’d never been shocked, the pups inherited the memory.
Dias isn’t only interested in legitimizing the idea of inherited trauma: his work has already highlighted subtle variations in inheritance across the generations. What was a full-on fear of a particular trigger can become just a high sensitivity in the next generation. Now he wants to see if intervening with descendants early can help prevent carrying those sensitivities into their own lived experience. In his mice and in the children of monkeys traumatized in childhood, he’s also seen evidence that with a nurturing environment filled with socializing and good food, the effects of trauma sometimes don’t manifest in the next generation at all.
Ideas about using targeted drugs and gene therapy to treat inherited trauma in descendants are regularly bandied about in epigenetic circles. But Yehuda believes the in-person work is invaluable, especially since some researchers are asking whether a portion of the biological changes related to trauma might actually be strength based. “One thing I wouldn’t want this work to do is to suggest to therapists that we need to start doing gene therapy” says Yehuda. “We wouldn’t necessarily want a medicine at this point that would alter biology when some of these epigenetic changes might be there to help!”
This raises the question of whether therapists should be intervening with the children and grandchildren of trauma survivors early on. What about populations that we know experience and may continue to experience cultural and historical trauma, like African Americans and Native peoples? Family Constellations facilitators, some of whom are organizational and community specialists, educators, and activists, are already doing such work. In these types of constellations, the client is often the community itself, and the group helps discover what painful truths have been minimized or forgotten so people within those communities can begin to heal.
A Constellation of My Very Own
Fascinated by the phenomenon of inherited trauma and Family Constellations, and plagued by what felt like sticky questions about both, I decide to shift from journalist to participant, and become a member of one of Carol Heil’s constellation groups. In the same room in Northwest DC where Margaret had her revelation, my first group experience centers on a woman named Donna, who looks to be in her early 70s. When asked why she’s come, she says that her marriage is faltering because of her emotional distance. Her hope is that if she gains a new perspective on her family history, she might be able to open up and save her marriage.
As Donna shares her family’s trauma history with the group, we learn about the suicides in her family background, the cruel and distant father with a criminal past, the desperate grandparents and great-grandparents from war-torn South American countries, a couple of whom died violent deaths.
The constellation process itself begins with Donna selecting her own stand-in. I nervously cast my eyes down, but it doesn’t work: she chooses me to represent her. Grasping me by the shoulders, she walks me to the center of the room and leaves me to stand there, alone, my hands at my sides.
“Now choose your father,” she’s told.
Donna places a young man with long red hair, friendly when we’d met at the door, a few feet away to face me. Despite our earlier warmth, I find I can’t manage to look at him now. At first, I think avoiding eye contact is just me doing my part and playing a role with Donna’s difficult “father.” But soon I’m experiencing a shockingly visceral sense of anger and resentment toward him. Though I try to shake it—this is just an exercise for someone else’s benefit, after all—the feeling doesn’t go away. Why am I so angry at this guy for hurting Donna—a woman I don’t know and one he’s never met?
Before I can make sense of it, Heil asks me how I’m feeling. What am I noticing in my body? Should I tell her the truth? That I’m inexplicably furious, and have a pressing need to flee from this guy? “I feel it in my calves,” I say, which is true. “I want to move away. Fast.”
Heil asks Donna to add her paternal grandparents to the constellation. This grandmother, we’ve learned, lost her family home and a beloved cousin in wartime. Grief-stricken, she’d had little interest in parenting her son. Like me, the woman who’s asked to take on this role won’t look at Donna’s father either. Her selected husband, in a show of support, stands beside her with an arm on her back, also ignoring his son.
As the minutes tick on and the three of us continue to ignore him, what started out as white-hot anger at the father begins to shift in me. It’s a cruel scene that I’m a part of, and out of the corner of my eye I can see the “father’s” shoulders round and sag as he looks woefully at his own dad. I start to wonder, what must it have been like to be so unloved by a mother and ignored by a father taken up with supporting his wife?
Part of me wants to help in some small way, so I take a real look at him. He’s rocking to soothe himself, eyes downcast, mumbling about needing a drink. Maybe, I think, if things don’t improve for him in this constellation, I’ll at least turn toward him.
I recognize this feeling: a familiar tension between anger and empathy that lives brightly in me with my own father. Our relationship has been marked by estrangements that follow a pattern of him raging at me with little provocation and then never making amends, resulting in months, sometimes years of disconnection.
The women in my family have all at various times explained his behavior away by reminding one another that as a child he’d been molested by a parish priest in the very Irish and very Catholic neighborhood where my parents grew up. My mother encouraged me early on to remember his trauma, accept his taciturn nature, and forgive him when he’d explode, without expectation of apology. “Try to understand, honey: men never really recover from those kinds of things,” she’d always told me.
As I stand there across from Donna’s difficult father, still quietly suffering in the constellation as his parents ignore his pain, I get a flash of my own grandmother’s face. She’s long dead, and I haven’t thought deeply about her in years, but I suddenly remember how rough she always was with my dad. She’d tell him loudly, in front of us, how much better other young men in the family had turned out. Perhaps there’d been a mix-up and one of his cousins, always so solicitous with her, was really meant to be her son?
Pieces from the past suddenly begin to come together. My grandfather was sickly from the start of their marriage, and my grandmother lived with the fear of losing him, carrying much of the weight of their relative poverty as his ability to work declined. When he died young, the church was her solace. My father couldn’t impugn it by telling the truth about his abuse, and as she’d made clear, he wasn’t worthy of help anyway.
Meanwhile, in Donna’s constellation, Heil asks the grandfather to reach out to his son, Donna’s father. He does so, tentatively at first, keeping one hand on his wife, then stretching to place the other hand on his son’s arm. Donna’s grandmother turns away as this happens. It’s a cutting rejection, and in a surge of empathy, I reach out and grab his hand myself.
The father clings to me, and we smile at one another. I can’t help it; I well up. This isn’t my own father; I get that, and who knows if I’d ever do such a thing in my own life. But for a couple of minutes, there’s warmth and understanding coursing between me and this man. I feel how lovely such a different reality might be.
In my role as Donna in this constellation, Heil brings me a heavy brown stone, which the facilitators sometimes use to close out the constellations. She tells me to hold it for a moment and then hand it to Donna’s father, saying, “I’ve been carrying this for you, but it doesn’t belong to me. I give it back to you.”
I hesitate. Donna’s father is carrying enough, I think. Can I really unload this pain on him too? What kind of daughter would I be if I wasn’t trying to ease his burden? But then he smiles and holds out his hands to take it. Heil instructs him to say, “Thank you for returning this to me. I never meant for you to carry it. This is my burden, not yours.”
She then asks the grandfather to reassure me. He says, “We will help him with this burden. He is our responsibility, not yours.”
I glance at Donna, hoping she might feel her own weight lift as I hand the rock back and both men thank me and smile. Her eyes are wet. Mine are too. Being a part of this expression of healing going back generations feels beautiful, and a transformative sense of tranquility fills the room.
It All Matters
Decades back, a journalist asked Hellinger for the theoretical underpinnings of Family Constellations. He answered her this way: “Actually the theories aren’t important to me. I can see that these things happen, and explanations after the fact don’t add anything to the practical work. Many people would be interested in an explanation of exactly what happens and how it’s possible, but I don’t need an explanation in order to work with the phenomenon.”
These are the kinds of responses that make us journalists pounce, and before I’d experienced Donna’s constellation, Hellinger’s attitude and the whisperings from therapists I’ve interviewed about his dismissive exchanges with clinicians would’ve been enough for me to weigh whether his work deserved its spot on the outer fringes of therapy.
But I can’t pretend that nothing happened to me on that Saturday, or that the experience hasn’t added a sweet note to the sour complexities of my own family drama. Have I made any radical changes to the way I approach my family? Not at this point. Do I see my father in a slightly better, gentler light? Yes. I saw and felt a new piece of his pain in the cruel way Donna’s “mother” had blatantly ignored the pain of her “son.” And the impact was different from how it might’ve been had I come to this understanding though talk. It was three-dimensional. The living memory of it now competes for space with actual remembered experiences with my own family. I can still see it vividly and feel it in my body. As I write, that same warm sense of peacefulness fills me.
Though it might not have provided me with some ready path forward with my family, it did affirm the idea that Rachel Yehuda had stressed when we talked. Maybe it’s time to rethink the way we focus on our lives as individuals first, existing, most importantly, within a present tense. If our families’ traumas live on in us, even in curious, elusive ways, then why not take some time to turn our attention back to the psychological strengths and weaknesses we’ve inherited—and plumb them for whatever lessons and revelations we can.
“Trauma is always in the narrative of every family, but there’s always variability in how each family lives with it,” Yehuda says. “For some, you can’t get away from it. For others, it isn’t discussed at all. But that isn’t necessarily better. And now it’s harder to dismiss the clinical reality of parental inheritance of trauma. For me, this work is showing us the importance of exploring where we come from culturally and ancestrally. It all matters.”
ILLUSTRATION © ISTOCK/LEONTURA
Lauren Dockett, MS, is Psychotherapy Networker’s senior writer. A longtime journalist, journalism lecturer, and book and magazine editor, she’s also a former caseworker taken with the complexity of mental health, who finds the ongoing evolution of the therapy field and its broadening reach an engrossing story. Prior to the Networker, she contributed to many outlets, including The Washington Post, NPR, and Salon. Her books include Facing 30, Sex Talk, and The Deepest Blue. Visit her website at laurendockett.com.