Abstract Most studies of the families of people suffering from psychosomatic disorders can be seen to reflect the perspective of first-order cybernetics. In this the focus is on interaction within families. If a shift is made to the more modern perspective of second-order cybernetics, the emphasis changes to fall on the autonomy of various levels of system. In this paper, psychosomatic symptoms are described and illustrated as the expression of ideas aimed at the conservation of autonomy, both at an individual and a family level. The implications of such a changed perspective for the treatment of psychosomatic disorders are highlighted.