With families of adolescents that have had longstanding difficulties, there may be certain systemic constraints that have blocked family members from revealing the following: what specific past events or negative interactions are truly fueling their conflicts; are contributing to maintaining their distance in their relationships; or what specifically they strongly desire from a parent but they think based on past history that he or she is incapable of changing. One powerful question that invites the adolescent to share his or her not yet said is as follows, “What is missing in your relationship with your father that if it were present would make a big difference to you?” The answers to this question can be invaluable to a parent in guiding them on how to be different in mood, tone of voice, and specific actions the adolescent desires from the father and would help them to get along better. The latter could be reinstating an old hobby or activity they used to do together in the past or pursuing a new activity that the adolescent would really enjoy doing with the father. Once we have all the details about what specifically the adolescent desires from the father, an implementation plan can be discussed and problem-solving strategies can be put in place to manage any potential obstacles that may occur while they are trying to implement their relational changes. Sometimes all the adolescent may need from his or her parents is to be listened to and validated and this would mean the world to him or her because it had been lacking in their relationships.
Another category of systemic questions that can reveal relational constraints, conflicts, secrets, and the not yet said are what we call metaphorical questions. For example, asking a bulimic adolescent, “Has there been anything in the past or recently that happened that has been difficult for you to swallow or digest?” Often, we learn about a family member or someone from her social network that hurt or wronged her in some emotionally upsetting way. Sometimes we learn about past sexual or physical abuse that has never been talked about before. In some cases, clients’ symptoms or behavioral difficulties are a metaphor for a family relationship conflict. Asking an adolescent with chronic headaches with no physiologic basis for causation, “Who in your family gives you the biggest headache?” May lead to him or her revealing the specific family member who he or she is in conflict with, which can provide us with a target area to address directly in family therapy. Finally, both of these relational questions can be used with couples as well.