Contextual Family Therapy: Meet Ivan Boszormenyi-Nagy

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Creator of Contextual Therapy

Ivan Boszormenyi-Nagy, renowned psychiatrist and family therapist, is most well-known for being the creator of Contextual Therapy (Boszormenyi-Nagy, 1987; Wilburn-McCoy, 1993; Nichols, 2007; Watson, 2007). Boszormenyi-Nagy was born in Hungary, and later immigrated to the United States (Watson, 2007). According to Wilburn-McCoy (1993), Boszormenyi-Nagy was educated as a psychiatrist and started researching more effective ways to treat schizophrenics and their families at the Eastern Pennsylvania Psychiatric Institute in 1957, and remained on staff for twenty years (Watson, 2007). He later coauthored Invisible Loyalties (1973) along with Geraldine Spark. This demonstrated contextual theory the idea of a person’s indebtedness to his or her family of origin, the influence of one’s biological relations, and concepts such as the consequences of ethical and unethical relating. Nagy and Spark purported that an intergenerational ledger existed in families, binding them together.


Serving from 1976 to 1994, he was Chief of the Family Therapy Section in the Department of Psychiatry at Hahnemann University, now named Drexel University (Watson, 2007). Furthermore, Boszormenyi-Nagy founded the Institute for Contextual Growth to provide training in the Contextual Therapy approach. Cotroneo (2007) made the following statement about Boszormenyi-Nagy:

Ivan saw himself as a contributor—a constructive giver—and his work as a contribution and a resource, not only to family therapy but also to the whole of psychotherapy and the realm of all human relating regardless of context. At the same time, like so many of our elders, he was a complicated person. The almost single-minded commitment to developing his concepts probably contributed to the isolation of his work from the mainstream of our field. However, it also fueled his rather remarkable intuition about the future of therapy. His body of work on relational ethics stands as a beacon for those who understand the essence of therapy as healing that strives to maintain the integrity of one’s relational world. (p. 269)

Clearly, Boszormenyi-Nagy made unique contributions to the field of marriage and family therapy.

Mason (2010) offered some insights into his life through her direct communication with his wife, Catherine Ducommun-Nagy. Mason wrote:

Boszormenyi-Nagy took his struggle [separation from his father] and turned it into a strength and a base for a therapy model that inspires others to search within themselves and their families for those things in life that really matter, and therefore, build life on a foundation that one can be proud of and pass on to future generations. Cherish, love, hope, and live, for nothing is promised in our tomorrows. Boszormenyi-Nagy lived according to this stance and functioned by this creed. (p. 78)

Mason further stated, “Dr. Catherine Ducommun-Nagy believes Invisible Loyalties serves as one of the best literary examples of Boszormenyi-Nagy’s impact on the field of MFT” (p. 80).

Boszormenyi-Nagy later died of complications related to Parkinson’s disease (Nichols, 2007). Watson (2007) wrote, “Dr. Ivan Boszormenyi-Nagy passed away peacefully at his home in Glenside, PA, with his devoted wife, Dr. Catherine Ducommun-Nagy, by his side, on January 28, 2007” (p. 289). After his death, Ducommun-Nagy has continued to make professional contributions to marriage and family therapy (Ducommun-Nagy, 2009).

What is Contextual Therapy?

The following narrative is a brief overview of Contextual Therapy. As previously mentioned, Ivan Boszormenyi-Nagy is considered the originator of Contextual Therapy (Boszormenyi-Nagy, 1987; Nichols, 2007; Watson, 2007; Wilburn-McCoy, 1993).

Contextual therapists emphasize the ways in which generations are inherently bound to each other, while also considering intrapsychic and interpersonal elements (Boszormenyi-Nagy & Krasner, 1986). As a therapist considers these pieces, they contextualize their client’s difficulties and have a fairer and more balanced understanding. According to the Contextual Therapy model, people cannot be removed from their generational rootedness. They bring invisible loyalties extending across generations, even when starting a new family unit (Boszormenyi-Nagy & Krasner, 1987).

Unlike many other treatment modalities, contextual therapists consider relational ethics, or fairness in hammerrelationships (Boszormenyi-Nagy & Krasner, 1986). Every relationship has a ledger of indebtedness and entitlements. The ledger is balanced when the relationship is fundamentally built on equitability. The ledger includes both legacy, acquired by family dynamics and experiences, and the record of an individual’s accumulated merit by contributing to someone else’s welfare. Legacy can be understood as continuing one’s role from their family of origin in their new relationships, whether healthy or not. In order for a relationship to become increasingly trustworthy, each party must deal with both indebtedness and entitlements. Trust is essential in healthy relationships.

Also, parent child relationships are initially asymmetrical as an infant is incapable of contributing to the welfare of another. These relationships should gradually shift to a more equally balanced ledger as the child grows older. Children should also not be required to sacrifice loyalty to one parent in order to remain loyal to the other, also called split filial loyalty. Contextual therapy uses the concept of a revolving slate to describe how a legacy is repeated across generations despite attempts to change. Considering pathology, Boszormenyi-Nagy and Ulrich (1981) wrote, “the breakdown of trustworthiness of relationship through disengagement from multilateral caring and accountability sets the stage for symptom development” (p. 171). Reflecting on the importance of Contextual Therapy, Horowitz (2009) wrote:

Drawing on the philosophical, ethical, and psychological wisdom of the Western World, the work [Contextual Therapy] of Ivan Boszormenyi-Nagy, M.D., a founding father of family therapy and the originator of the Contextual Therapy approach, remains as illuminating and applicable today as ever. (p. 231)

In summation, Contextual Therapy represents an important contribution to marriage and family therapy and the helping field.

To our psychotherapy professionals, are any of your influenced by Contextual Therapy?  Please, take a moment to leave a comment below.


  1. Boszormenyi-Nagy, I. (1966). From family therapy to a psychology of relationships: Fictions of the individual and fictions of the family. Comprehensive Psychiatry, 7, 406-423.
  2. Boszormenyi-Nagy, I. (1987). Foundations of contextual therapy. New York: Brunner/Mazel.
  3. Boszormenyi-Nagy, I., & Krasner, B. (Eds.). (1986). Between give and take: A clinical guide to contextual therapy. New York: Brunner/Mazel.
  4.  Boszormenyi-Nagy, I., & Spark, G. (1973). Invisible loyalties: Reciprocity in intergenerational family therapy. New York: Harper & Row.
  5.  Boszormenyi-Nagy, I., & Ulrich, D. (1981). Contextual family therapy. In A. S. Gurman, P. Kniskern (Eds.), Handbook of family therapy (pp. 159-186). New York: Brunner/Mazel.
  6. Boszormenyi-Nagy, I., Grunebaum, J., & Ulrich, D. (1991). Contextual therapy. In A. Gurman and D. Kniskern (Eds.), Handbook of family therapy (Vol. 2, pp. 200-238). New York: Brunner/Mazel.
  7. Ducommun-Nagy, C. (2009). Forgiveness and relational ethics: The perspective of the contextual therapist. In A. Kalayjian, R. F. Paloutzian (Eds.), Forgiveness and reconciliation: Psychological pathways to conflict transformation and peace building (pp. 33-54). New York, NY: Springer Science + Business Media.
  8.  Mason, N. (2010). In remembrance of insoo kim berg and ivan boszormenyi-nagy: A look into the conceptual frameworks and major contributions of two international marriage and family therapists whom the field “lost” in 2007. (Unpublished doctoral dissertation), The University of Louisiana at Monroe, Monroe, LA.
  9. Nichols, W. (2007). In memoriam. Contemporary Family Therapy: An International Journal, 29(1/2), 3-8.
  10. Watson, M. F. (2007). Ivan boszormenyi-nagy, MD: A testimony to life. Journal of Marital and Family Therapy, 33(3), 289-290.
  11.  Wilburn-McCoy, C. (1993). Rediscovering nagy: What happened to contextual therapy?. Contemporary Family Therapy: An International Journal, 15(5), 395-404.

Check out Summit Family Therapy in Peoria, IL to learn more about Dr. Courtney Stivers’ professional work. 


About Courtney Stivers, PhD (25 Articles)
Courtney Stivers, PhD, LMFT, is a subject matter expert in Marriage and Family Therapy. Her professional experience includes residential addiction, school-based therapy, community mental health, teaching, research, public speaking, professional consultation, and several administrative roles. She is currently the Executive Director of Summit Family Therapy in Peoria, IL. Please learn more on her practice website,

4 Comments on Contextual Family Therapy: Meet Ivan Boszormenyi-Nagy

  1. Courtney, I enjoyed your lovely summary of Dr. Nagy, his life and his gift of Contextual Family Therapy. I had the pleasure of studying with him in forty years ago. At the Family & Play Therapy Center we have spent many years offering post graduate training courses in CFT and are reviving a once a month course for 2022/23. We welcome on Zoom all from around the globe and offer generous discounts that match the country’s economy.
    Dottie Higgins Klein, in Philadelphia

  2. Bart Hendriks // November 19, 2016 at 9:07 am // Reply

    Like your brief overview of the contextual therapy. I’m registered Contextual therapist and Psychotherapist in The Netherlands, working in the field of domestic violence and abuse. Still wondering why this helpful and grounded vision on human beings is not more widespread. It is a very workable therapy for many fields. And lest not forget its philosophical stance based on the thoughts of Martin Buber

    • Bart, thank you for your post. I have enjoyed learning more about Contextual Therapy during my graduate studies. I had a friend who interviewed his wife after Boszormenyi-Nagy passed away. He contributed so much to our field.

  3. Very good article!
    I am an acupuncturist and teacher of Chinese medicine behavior change (qigong).
    From my perspective, Dr. Nagy’s theory on destructive entitlement, and emphasis on context is a beacon; An absolute treasure that of it’s own accord offers functional clinical wisdom for those that have ears to hear. His contributions are applicable on SUCH a broad scale.

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