What is it about?

This study tells the story of one man in his forties who came to therapy in a state of profound crisis: he was on the verge of divorce and tormented by suicidal thoughts. Through a deep, mixed-methods analysis of his 10-session journey with Family Constellations therapy, we sought to understand not just if he got better, but how and why the change happened. By combining quantitative data (like depression and anxiety scales) with in-depth qualitative analysis of his own words and the therapist's notes, we uncovered a hidden connection: his drive to end his marriage seemed deeply entangled with his unconscious wish to end his life. The therapy helped to reveal and process deep-seated, transgenerational family traumas and loyalties. As these hidden dynamics came to light, the pressure on his marriage eased, and, concurrently, his suicidal ideation disappeared.

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Why is it important?

This research is important because it goes beyond simply asking "does a therapy work?" and instead explores the complex question of "how does it work?". It provides a rich, detailed roadmap of a client's journey, offering invaluable insights for other therapists working with clients in similar crises of marital distress and suicidal ideation. Crucially, our study proposes a model suggesting that for some clients, the impulse to divorce can be a symptom of deeper, unresolved transgenerational issues. It also introduces a novel concept—Idealized Sex Projection (ISP)—as a potential key to understanding certain relationship conflicts. This kind of in-depth, qualitative-rich research is vital for building a more nuanced, humanistic evidence base for psychotherapy.

Perspectives

It is a profound privilege, and a great responsibility, to accompany a client on such a deep and vulnerable journey. Our primary motivation for writing this article was to honor the complexity of that journey. We wanted to build a bridge between the sacred, non-linear space of the therapeutic encounter and the structured, linear world of academic writing. It was a challenge to translate such a profound human experience into a scientific paper, but a necessary one. Our greatest hope is that this study inspires more researchers and practitioners to embrace the power of single-case research, to not be afraid of complexity, and to continue telling the deep and meaningful stories of human change.

Jorge A. Ramos
Instituto de Ciências Integradas

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This page is a summary of: Process of change and effectiveness of family constellations: “On the verge of divorce, I glimpse my finitude.” A mixed methods single case study on suicidal ideation., The Humanistic Psychologist, August 2021, American Psychological Association (APA),
DOI: 10.1037/hum0000242.
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