TRAJECTORIES #2: The Systemic-Relational Approach: When the symptom speaks of bonds and when the relationships heal
- Feb 23
- 8 min read
Alessia Gioia, psychologist and psychotherapist in training.
Introduction
This month, we enter as fascinating as it is everyday territory: the storyline of relationships. Those that form us, pass through us, support us, and sometimes, complicate our lives.
The systemic-relational approach invites us to look at the individual not as an island, but as part of a living network of bonds, dynamics, communications, and shared meanings. A lens that shifts focus from “what's wrong with me” to “what's happening between us”. In this issue, you will find:
A personal account of what it means to train as a systemic-relational psychotherapist; • practical tools and resources to deepen the approach;
An inspiring quote, a clinical cartoon, and a reading suggestion;
A space to participate, contribute, and grow our community.
Welcome to the world of healing relationships.
I’ll tell my world of psychology
How did my journey begin?
Development is never a linear process. It's made up of advances and stops, silent passages and moments of rupture that force us to reorganize what we thought we knew. This applies to the people we meet in our work, but also to those who choose to inhabit psychology as a profession.
Good morning, everyone. My name is Alessia Gioia, and I'm 26 years old. I qualified as a psychologist in 2023, but while I'm not practicing yet, I'm continuing my training. I currently work as a school educator, an experience I consider temporary but an integral part of my professional journey.
My journey into the world of clinical psychology began with a simple insight: people change through relationships. The more I observed family dynamics, bonds of friendship, alliances, and conflicts, the more I realized that you can't truly understand an individual without considering the system they are part of.
After graduating from my master's degree from the Catholic University of the Sacred Heart in Milan in 2023, I completed my postgraduate internship at the CTA – Centro di Terapia dell’Adolescenza, a place where relational complexity is a daily protagonist. Here, I have seen how adolescents' symptoms often speak the language of their family systems. I've learned that when a boy brings a “problem”, he's often expressing a balance that the family is struggling to maintain, and in particular how crucial it is, in the care process, to work with the entire family system.
In February 2025, I obtained my qualification as a psychologist and – after officially enrolling in the Register A of Psychologists of Lombardy - a new chapter began.
Training as a systemic-relational therapist: what does this orientation really consist of?
I am currently training at EIST – European Institute of Systemic-relational Therapies in Bergamo (a program that began in January 2025), a specialization school based on systemic-relational orientation. An approach that looks at the person not as an isolated entity, but as part of broader systems —family, relational, social— within which discomfort takes shape, but also the possibility of change.
One of the central elements of the EIST model is the work on semantics, that is, the shared meanings that circulate in relationships. Semantics are not simply the words we use, but the profound meaning we attribute to experiences: what a family means by “being strong”, “failing”, “protecting”, “loving”. They are invisible maps that guide behaviors, often unconsciously, and can become both resources and constraints. Therapeutic work, in this sense, does not consist in correcting people, but in transforming the meanings that keep certain dynamics in place.
The systemic orientation on which EIST is based considers the symptom as a form of communication: something that emerges within a network of relationships, and that has a function, a meaning, a story. Suffering is not read only in individual terms, but as an expression of family balances, evolutionary transitions, alliances, and roles that have been structured over time. In particular, great attention is given to family dynamics, not only in the small core, but also in the extended family: grandparents, previous generations, stories that continue to “speak” even when they are not named.
From this perspective, relationships are not only the backdrop to discomfort, but become an active part of the healing process. The same dynamics that contributed to the onset of psychopathology can, if reread and reorganized, become transformative resources. Therapeutic work, therefore, moves between past and present, between what has been transmitted and what can be redefined.
Another characterizing aspect of the systems model, and in particular of the EIST approach, is the use of metaphors. Metaphors allow us to approach experiences without naming them directly, offering images that make concepts more accessible and profound at the same time. Speaking in metaphors means creating spaces of understanding that do not impose interpretations, but open up new possibilities for meaning, often more respectful and less defensive.
Systemic training opens up various professional opportunities: from clinical work with individuals, couples, and families, to interventions in educational, school, and psychosocial contexts, to work with groups and teams. Specializing in this orientation means acquiring a transversal perspective, capable of adapting to different contexts, while maintaining a focus on relationships and systems of belonging.
For me, EIST represents a rich, rigorous, and profoundly human educational context: a place where we learn to read bonds, to pause in complexity, and to recognize how individual stories are always intertwined with collective ones.
My scope of work
I work in the field of clinical psychology, with a particular focus on family systems, subsystems, boundaries, communication patterns, and interactive dynamics.
In this regard, I am carrying out my specialization internship at Auxologico ICANS – Città Studi, in an outpatient clinic dedicated to eating and metabolic disorders. Here, the systemic reading becomes even clearer: the body, the symptom, and the relationship speak together.
Every eating behavior brings with it a story, an emotional context, and a series of responses learned within the most significant bonds. Working with a multidisciplinary team is teaching me how essential an integrated perspective is: biology, psychology, nutrition, family — everything dialogues.
Methods and tools of my work
In my daily life, I use tools specific to the systemic-relational approach, including:
Genogram: To explore transgenerational histories and patterns that span generations.
Restructuring meaning: To transform rigid readings that often fuel suffering.
Circular questions: To open up new perspectives and bring out unexpressed points of view.
Observation of communication patterns: To grasp what is repeated, what protects, and what blocks.
Triadic hypothesis: A hypothesis that takes into account at least three subjects, and that must be perturbed but plausible
A tip for those who want to delve deeper
If you want to enter the systemic-relational world, I suggest you start with three things:
A book | The direct experience | Curiosity about the real relationships in your life |
You can find it in the extra section | Following a therapist, attending seminars, and observing family therapy. | The systems approach is learned primarily by observing what happens between people. |
Tools and Resources
Here are some helpful resources if you want to delve into the systemic-relational perspective:
Readings
“Pragmatics of Human Communication” – Watzlawick, Beavin, Jackson: Fundamental to understanding communication patterns and levels of relationships.
Open access article: “Family Systems and Therapeutic Change”: Great for introducing the logic of systems and complexity.
Operational tools
Three-generation genogram: Useful in initial assessments and working with families, couples, or young adults.
Double Moon Test: A support for observing triangulations, alliances, boundaries, and implicit roles.
Podcast: “Systemic Thinking”: Short episodes explaining key concepts such as the life cycle, paradoxical communication, and co-construction of change.
App: Reflectly or guided journaling: Useful for helping patients observe recurring dynamics in daily relationships
Recommended books
Families and Family Therapy - Salvador Minuchin: Fundamental text for those who want to understand the family as a relational system. Minuchin clearly and practically describes how family dynamics —boundaries, alliances, hierarchies, and roles— influence individual functioning and the onset of symptoms. The book offers tools to intervene in bonds and reorganize relationships, placing the family at the center as a place of change.
Permitted Stories, Forbidden Stories – Valeria Ugazio: A fundamental book for understanding semantics and how they guide the relationships and behaviors of individual subjects, and above all, family dynamics. An essential classic for understanding family boundaries, alliances, and organization. Clearly written, full of clinical examples and practical applications.
Clinical Case
A 15-year-old girl arrives for consultation with eating difficulties. Speak
little, avoid the gaze, he just says: “I don't have hunger”. In family interviews, a very worried mother and a father
silent. The girl becomes the center
of attention, the “carrier of the symptom”.
During a session, she says, “When they argue, I don't exist. But when I'm sick,
they stop”.
Reflection:
Sometimes the symptom is a painful but effective way to restore balance in the system. Often, however, the person arriving for consultation is not the “real patient”, but the “designated patient”: that is, the person in the family who takes charge of the present problem and expresses it through a symptom, thus becoming the spokesperson for a difficulty that concerns the entire system.
For this reason, the symptom should not simply be “removed”: it must be understood, because it speaks the language of the relationship and tells something fundamental about how the family system is functioning.
Questions for the reader:
When did you hear, in your story, that a relationship changed you? What dynamic or connection taught you anything about yourself?
What is a resource —book, tool, or meeting— that has profoundly influenced the way you work?
There are thoughts that resonate louder than others. At certain moments, when words were missing, I found refuge in some thoughts that seemed written especially for me. These are phrases that have helped me look my pain in the face without being ashamed of it and understand that not everything that breaks needs to be repaired in the same way. These are the phrases that accompanied me on this journey and which, even today, remind me of the value of knowing how to listen beyond the surface. I leave them here, as small landmarks that guided my journey:
“It is not power that destroys but the idea of power.”
(Gregory Bateson)
“Continuing to repair a broken cup with invisible glue will no longer make it whole, just more fragile.”
(Guida Psicologi)
“Life is a journey and not everything deserves a place in your suitcase.”
(Guida Psicologi)
“Don't minimize your pain just because others are suffering too.”
(Guida Psicologi)
Concluding
The Value of Bonds: No One Saves Himself Alone
Relationships aren't simply the backdrop to our lives; they're the very storyline we're made of. They shape us, shape us deeply, and even when they are difficult, they accompany us on our evolutionary journey as necessary mirrors to understand who we are.
The systemic-relational approach teaches us a fundamental truth: none of us grows or heals in total isolation. We are nodes in an invisible web, and every change in one thread of the web makes everyone else vibrate. It is precisely this interconnection, this "being together," that makes our work of caring and listening so precious. It's not just about analyzing an individual, but about honoring the complex dance of bonds that made them who they are today.
Recognizing the importance of these threads that connect us to others allows us to transform the wounds of the past into bridges for the future, reminding us that, while it is true that relationships can hurt, it is equally true that it is only within new, healthy relationships that we can truly rediscover ourselves.
We have reached the end of this reflection. I thank you very much for taking the time and attention to these words of mine. Writing these lines was a way for me to sort out my thoughts and share a little piece of that journey that, deep down, we're all on: the journey toward greater self-awareness.
I hope this article has been helpful, or perhaps helped you look a little more “sweetly” at that "suitcase" you're carrying.
Thanks for walking with me a bit.
Want to share your world of psychology or share your resources? Send us an email: thedevelopmentallibrary@gmail.com — our library grows thanks to you.
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