A therapeutic approach rooted in the ethics of the bond

The contextual approach was conceived in the 1950s by Ivan Boszormenyi-Nagy, a Hungarian-born psychiatrist based in the United States. At a time when family therapy was beginning to take shape, he proposed a deeply humanist and integrative vision, influenced by Ferenczi’s psychoanalysis, Martin Buber’s dialogical philosophy, and also by the emerging systemic approach.

What fundamentally sets this approach apart is its determination not to separate individual psychology from the ethical and intergenerational dimensions of human relationships.

Five inseparable dimensions in every relationship

For Nagy, every human relationship rests on five fundamental dimensions.

The emotional account: a central metaphor

In this vision, every relationship works like an emotional current account: we record, often unconsciously, what we give and what we receive. This is what Nagy calls the family ledger, a hidden slate present in all our relationships.

When the account is balanced, the relationship is experienced as fair and trust circulates freely. But when someone gives without return, or receives without being credited, a sense of injustice sets in — and with it, sometimes, psychological or relational symptoms.

Constructive or destructive entitlement

According to Nagy, two forms of entitlement can emerge from relational history.

Someone abandoned in childhood may thus seek, as an adult, unconscious repair for that wound from their partner, who then becomes the bearer of a debt they never contracted.

Invisible loyalties: unconscious allegiances

A key concept of this approach is that of invisible loyalties. These loyalties are often unconscious and involuntary, yet powerful. They bind us to our family of origin, even when the bonds are painful, conflictual or broken.

A classic example: someone who had an alcoholic parent may develop, years later, a problematic relationship with alcohol. This can be understood not as simple repetition, but as an unconscious attempt to understand, to draw closer to, even to forgive that parent, by exposing oneself to the same vulnerabilities.

Giving, receiving… and being recognised

The contextual approach insists on one essential point: children need to give as much as they need to receive. It is by giving — attention, support, love — and by being credited for their gifts that they build their self-esteem and their sense of usefulness and competence.

But when a child is forced to give at the expense of their own needs, we speak of parentification. The child then takes the parent’s place, becoming their emotional support, sometimes even their carer or confidant. Contextual therapy then aims to validate the child’s gifts, to recognise them without stripping away the function that shaped them, while relieving them of the burden.

The therapist’s role: directional multipartiality

The contextual therapist’s stance is demanding. It rests on a central principle: directional multipartiality. The therapist does not remain neutral. They engage in turn with each member of the family, including those who may have caused an injustice. They do not look for culprits, but for shared responsibilities, accounts to be balanced, gifts to be recognised.

This can give rise to powerful questions.

• Who gave without return?
• Which debts have gone unacknowledged?
• Where was trust damaged?
• What would it take for it to be reborn?

A resolutely reparative approach

Contextual therapy is both individual and collective: it can be practised in individual sessions, with couples or with families. Its aim is not to point to moral responsibility, but to restore balance, rebuild trust and make relational repair possible.

It is a deeply committed approach, one that takes seriously the ethical, transgenerational, cultural and emotional dimensions of psychological care.

A compass for damaged bonds

In an era when family bonds are sometimes broken, when intergenerational wounds struggle to be spoken, the contextual approach offers a precious compass. It reminds us that healing does not come from understanding alone, but also from recognition, from justice, and from respect for the gifts received and offered.

The full presentation of this approach — in French — can be watched below.