The Transformative Power of Questions in Psychotherapy

''Words arranged differently have different meanings, meanings arranged differently have different effects'' — Blaise Pascal (Pensées)

In the field of psychotherapy, the role of the question is often underestimated. While statements and reflections certainly have their place, the power of questions lies in their ability to open up new perspectives, challenge assumptions, and ultimately catalyse meaningful change.

Circular questioning, an approach rooted in systemic family therapy, stands as one of the most powerful tools in the therapeutic process. This method invites clients to explore their thoughts and behaviours on an issue as well as those of others within their relational system on the same issue. Observing the dynamics at play through circular questioning can shift entrenched relational patterns and pave the way for new ways of interacting (Gibson, 2021; Brown, 1997; Tomm, 1988).

The Foundation of Circular Questioning

Circular questioning emerged from the Milan systemic therapy approach, which is grounded in the understanding that problems do not exist in isolation (Gibson, 2023). Instead, issues can be seen as being perpetuated through ongoing cycles of interaction between individuals, especially in the context of family lives (Salvini Palazzoli, Boscolo, Cecchin, & Prata, 1980). This contrasts with the traditional linear view of causality, whereby a problem is attributed to a specific cause or individual, as in psychopathology (Gibson, 2024; Nardone and Portelli, 2004). Circular causality, by contrast, sees behaviours and responses as interconnected, with each person’s actions influencing—and being influenced by—others in a continuous loop (Penn, 1982).

The purpose of circular questioning is twofold: to create differences and to draw connections. The questions aim to broaden a client’s understanding of a problem by highlighting contrasts and drawing attention to the relationships and interactions that sustain the issue. Through this process, clients are encouraged to see the problem from new perspectives, leading to greater insight and, often, significant breakthroughs (Fleuridas, Nelson, & Rosenthal, 1986).

Types of Circular Questions We Can Use

1. Problem Definitional Questions. Questions focus on clarifying the nature of the problem from various angles—past, present, and future. By asking clients to define the problem in specific terms, the therapist encourages a more nuanced understanding of the issue and how it has evolved over time (Penn, 1982).

For example, a therapist might ask, “What was the main concern in your family five years ago, and how is that different from now?” This question highlights the temporal evolution of the problem, allowing clients to see how their current circumstances may be rooted in past experiences. By exploring the issue in different time frames, problem-definitional questions invite clients to reflect on how the problem developed and how it might change in the future. Such reflections are invaluable in moving beyond the present and considering both the history and potential trajectory of the issue (Tomm, 1988).

2. Sequence of Interaction Questions. The sequence of interaction questions aim to trace the chain of events that occur during problematic situations. They help clients see how their behaviours trigger responses in others, which in turn influence further actions, creating a circular pattern of interaction (Salvini Palazzoli et al., 1980).

For instance, a therapist might ask, “When your son refuses to do his homework, what happens next? How do you respond, and what does your spouse do?” This question helps to uncover the sequence of actions and reactions, revealing the systemic nature of the problem. These questions are particularly effective in making clients aware of how they contribute to the maintenance of the problem, often without realising it. By illuminating these interactional patterns, a sequence of interaction questions lays the groundwork for clients to consider alternative ways of responding (Penn, 1982).

3. Comparison and Classification Questions. Comparison and classification questions encourage clients to compare themselves or other family members, often prompting them to rank behaviours, emotions, or relationships. The questions are designed to uncover differences that may not have been previously recognised and to bring to light patterns of similarity that may have gone unnoticed (Brown, 1997).

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For example, a therapist might ask, “Who in the family gets the most upset during arguments, and who stays calm?” The question helps family members see how their emotional reactions differ, which can lead to a deeper understanding of their relational dynamics. By inviting comparisons, the questions highlight both diversity and commonality within the family system, revealing insights that can shift the family’s approach to a problem. Such questions are particularly useful for identifying previously unnoticed behaviours that contribute to the overall dynamic (Fleuridas et al., 1986).

4. Interventive Questions. Interventive questions are forward-looking and are designed to prompt family members to imagine how things might change if certain behaviours were altered. The questions encourage clients to consider alternative futures, often sparking the possibility of change in previously entrenched dynamics (Tomm, 1987).

An example of an interventive question is, “What do you think would happen if your partner stopped working such long hours? How would that affect your relationship?” This kind of hypothetical questioning encourages family members to explore how modifying certain behaviours could lead to different outcomes. Interventive questions are particularly powerful because they challenge the family to envision new possibilities. By encouraging them to think creatively about potential changes, the questions can inspire hope and motivate action (MacKinnon, 1988).

Creating Difference

At the core of circular questioning is the idea of creating difference. This is a key concept in systemic therapy, where therapists seek to shift the way clients perceive their problems by highlighting contrasts. Such differences can exist across time, between people, or even within a single person’s emotional landscape (Penn, 1982).

For example, when a client says, “Things have always been this way,” a therapist might respond by asking, “Has it really always been this way, or were there times when things were different? Can you remember when things started to change?” This type of questioning challenges the client’s assumption that the problem is fixed and unchangeable. It introduces the idea that problems evolve and are influenced by various factors, both internal and external, in the family system (Tomm, 1988).

Similarly, creating differences between people allows family members to see how their experiences of the problem differ. A question like, “Who in the family is most affected by this issue, and who is least affected?” can reveal that while one person may be deeply troubled by the problem, another may not see it as significant. This discovery can be eye-opening and can lead to more empathic conversations within the family (Penn, 1985).

Connection

While creating difference is a fundamental goal of circular questioning, so too is drawing connections. Systemic therapy emphasises the interconnectedness of family members, and circular questions often aim to reveal how each person’s behaviour influences others (Salvini Palazzoli et al., 1980). For instance, a therapist might ask, “When your daughter feels anxious, what does your partner do? And what do you do in response?” This question shows how each family member’s behaviour is connected to the others', helping them see that the problem is not just an individual issue but a relational one (Penn, 1982).

Drawing connections between behaviours, emotions, and interactions helps family members understand the systemic nature of a problem. Such insight can lead to greater empathy and collaboration in finding solutions (MacKinnon, 1988).