Illness and Physical Symptoms

This post is a subject assignment submitted by a trainee for Foundation Training 2015, Johannesburg. It has been included here as a resource for student and graduated facilitators:

Family Constellations: Physical Symptoms and Illness



 This being human is a guest house.

Every morning a new arrival.


A joy, a depression, a meanness,

some momentary awareness comes

as an unexpected visitor.


Welcome and entertain them all!

Even if they are a crowd of sorrows,

who violently sweep your house

empty of its furniture,

still, treat each guest honorably.

He may be clearing you out

for some new delight.


The dark thought, the shame, the malice.

meet them at the door laughing and invite them in.


Be grateful for whatever comes.

because each has been sent

as a guide from beyond.


— Jelaluddin Rumi,


This Rumi poem came to mind when thinking of the importance of inclusion within any system. The inclusion within our internal home, made up of our physical, psychological, emotional and spiritual parts; then inclusion of these parts of others within our family system and the inclusion of all members of the family, living or dead.

When any system is in healthy balance, a flow of communication and vitality exists. The difficulty comes in when there is an imbalance somewhere in the family system or the system within ourselves; where a part has been excluded.

When looking at what is excluded in the family system, this excluded part can be an emotion that belongs to someone in the family or a family member. According to a basic systems theory concept, the system will work to restore that equilibrium in one way or another. This means that the more vulnerable members of the system who haven’t yet developed strong enough ego defenses (particularly children and grandchildren) would be the likely ones who would inevitably carry “the unlived pieces of their parent’s and grandparent’s lives.” – (Meyburgh page7) The rejected part therefore can become internalized by the more susceptible members and manifest itself in the form of similar symptoms or an illness. “The symptoms often seem to follow an embodied creative adjustment to some relational family dynamic out of awareness.” (Hausner 2011:xi)


According to Hausner, one of Bert Hellinger’s first students, the system is influenced by one of the two forces that are playing on us all the time. “One is the force of love, generativity, healing; the other is the force for regression, attachment or loyalty to old, often distorted, imbalanced relationships of the past. Many of these later forces were set in motion by unresolved woundings or traumas to generations before our own.” (Hausner 2011:ix)


In relation to the latter it is important to look at the notion of ‘patterns of fate’ (Carl-Auer 2006). As human beings we repeat patterns and stories. These are learned patterns and stories either passed down to us from previous generations or learned by us as a result of experience. And these patterns and stories are inextricably linked to the survival of the system.


With love as a driving force, when a family member dies, the pain of this loss and the guilt of one’s survival can become unbearable. This can lead to an entanglement when we take on the pattern of fate of family members who have gone before us. According to Hellinger, as written by Carl-Auer (2006:143), love, guilt and atonement lie behind the dynamic of repeating patterns of fate. The desire to follow a loved one to the death can be internalized and a physical, emotional, psychological or spiritual movement towards ‘death’ can occur. This ‘death’ can manifest physically in the form of illness or physical symptoms.

Carl-Auer refers to the fact that this pattern of fate can be repeated, for example, by a mother who has lost a child; or by another child who repeats this pattern of fate on behalf of his/her mother.


Family Constellations offers many insights into what causes sickness in families and what heals. Constellations can enable a healing movement by interrupting the pattern of fate, enabling the individual to take a step back and see what is going on. This includes facing the pain and grief that is there and acknowledging that, in fact, this was all in service of love.


Illness or physical symptoms may come about due to an entanglement in the family system, where someone has been excluded or as a result of a disruption to the natural family order that involves ranking according to time. “When certain actions or attitudes are disrupting one of these fundamental orders, illness may call a halt to the process.” (Hausner 2011:23)


How to set up the constellation focusing on illness and symptoms:


“In constellation work with those who are ill, it is often helpful to set up someone to represent the patient’s illness or symptoms. To maintain the holistic approach and to try to avoid symptom displacement, I, personally, rarely use a representative for an isolated, single symptom.


We have observed that a representative for an abstract structure, such as an illness or a symptom cluster, generally stands in resonance with an excluded family member or relevant family issue, often one that is taboo.


At times it appears as though the symptoms reflect the ill person’s attempt to preserve the memory of an excluded family member. The patient is still connected in love, whereas other members of the family are holding back or denying the person love and recognition. Setting up the illness or symptoms in relationship to the patient or his or her family often serves to reveal these connections, which usually exist at an unconscious level.” (Hausner 2011:24 – 25)


What is important when working with illness in constellations is that the illness is seen as serving a function as well as representing an attempt to find a resolution. Therefore it is helpful for the constellation leader to look towards the underlying dynamics and forces that have lead to the illness (Hausner 2011:35)


When a healing movement happens within a constellation, this movement helps the soul to calm, and the resulting peace may have a healing effect on the body.


Guiding principles when working around illness and symptoms


The following aspects interact and have a resulting effect on the client’s health:

  • A person’s readiness to say yes to life and to assume consequent responsibilities

This involves saying ‘yes’ to ones parents and family of origin and then to one’s own life and fate. “The sense of connection to family and ancestors gives us the strength to look at what is difficult and, consequently, also to face illness.”

  • Children’s core love for their parents and their longing for closeness with them
  • the patients’ or families’ exclusion of persons and/ or issues relevant to the system.

(Hausner 2011:39)


Running the risk of moving away from Hellinger’s original model of Family Constellations, I wish to share another approach to thinking about illness and symptoms and propose using a constellations approach as a means of understanding illness and what lies behind it.


The Director of the Sesame Institute and Drama Therapist, Mary Smail, in her article entitled Soul and Sesame from the Sesame Autumn Journal (undated) speaks of illness as the soul’s way of organizing healing.

Smail refers to James Hillman’s description of how an inner soul purpose is asking for recognition and does this by arranging the falling-apart of the ego defenses, in the form of illness and symptoms. With the ego defenses down, the individual has the opportunity to listen to the ‘soul’s call’.


From this response, I am interested in exploring the use of constellations initially and setting up one representative for the illness/ symptoms and one for the soul’s purpose to work towards understanding what lies beyond this illness and what the illness may be in service of communicating. What would ne interested from there is to then perhaps work with movements of the soul and allow the client to experience being with and moving with the representative for the soul’s purpose so that this relationship can be further felt and explored.


In conclusion I wish to share the wisdom of Hellinger from Carl-Auer’s book No Waves Without an Ocean, which perhaps connects back to Rumi’s poem and the importance of inclusion. The core principle of this work for me is around inclusion:
“It is also not always true that we must combat illness no matter what. Behind that idea lies the curious assumption that life is the highest good. Health is then included with life and it is taken for granted that they must both be safeguarded regardless of the price. I find that strange. Life absolutely cannot be the highest good because it emerges from something and sinks back into it… [Life] only attains its greatest movement and strength when in harmony with the flux of emergence and sinking… The person who is in tune accepts life and death, health and illness as all of equal worth, each with its significance. From this ‘being in tune’ he can bear the one or the other, submit and grow.” (Carl-Auer 2006:143-144)

Please note:

It is important to remember that Family Constellations is not a substitute for psychotherapy or medicine. It is used in conjunction with other methods of treatment.






Carl-Auer (2006) No Waves without the Ocean, Der Deutchen Bibliothek

Hausner, S. (2011) Even if it Costs Me My Life, New York, GestaltPress.

Smail, M. Sesame and Soul. Sesame Journal, Autumn edition.

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