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2, 1997
1. EARLY WRITINGS
In the 1950s the predominant models within psychiatry for psychotherapeutic
practice were based upon psychoanalysis. The psychopathology of the individual
was taken as the focus for assessment and treatment. The early pioneers of the
systemic family therapy field departed from the prevailing orthadoxy in shifting
the focus of analysis from the individual to the family. At that time there were
some attempts at translating principles and practice from individual psychoanalysis to the realm of work with families (e.g., Ackerman, 1958), with limited
success. There began a search for alternative models that might define and guide
clinical practice. The break with psychiatric thinking was given impetus by the
diversity of professional and academic backgrounds of those who took up this
task.
In 1958, Gregory Bateson, an anthropologist, together with John Weakland, Don Jackson, and Jay Haley, was conducting research in Palo Alto, California, on the communication patterns of families in which one member had
been diagnosed as schizophrenic. The following year, Don Jackson established
the Mental Research Institute (MRI) for research and treatment of families. A
year later Nathen Ackerman, a child psychiatrist, founded the Family Therapy
Institute in New York. These researchers and clinicians shared an interest in the
~The Psychology Department, Mental Health Unit, Chase Farm Hospital, The Ridgeway, Enfield,
Middlesex EN2 8JL, U.K.
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nation for the problem within the context of the family system, its presentation
at that particular time and in that particular manner. Ideas might also be generated concerning the relationship to the referrer (Selvini-Palazzoli et al., 1980).
The hypothesis guides the interviewer, enabling him or her to maintain a
systemic reality which is " m e t a " to the linear reality of the family. The therapist
asks questions concerning relationships and interrelatedness. The authors give
details of a number of categories of questions which aim to develop a systemic
map of the connections between family members and, hence, make a difference
to their linear thinking. This map may or may not substantiate the hypothesis,
and it may be that the therapist must revise his or her hypothesis in order better
to accommodate information generated by the interview. Questions are asked
roughly equally of all family members, giving the impression of impartiality or
neutrality. A break would be taken by the therapist before delivering an intervention which would seek to bring together thinking concerning the family
system and might include positive connotation, a reframing of the problem, and
a prescribed ritual. The team would have a postsession discussion.
Following the elucidation of principles of their systemic model for therapy,
the four coworkers separated in 1980. Selvini-Palozzoli and Prata moved more
into the area of research, seeking to control and manipulate therapy variables
within an empiricist tradition. Their work has not been as influential or widely
read in the field as that of Boscolo and Cecchin, who devoted their energies to
teaching and further developing their ideas.
The principles of therapy developed by the Milan group were incorporated
into the working practices of therapists around the world. Inevitably the ideas,
when translated into different settings by professionals in various fields, stimulated debate and dissent. In keeping with the theoretical diversity and eclecticism of earlier formulations, much of the impetus for change came from areas
of discourse not normally occupied by mental health practitioners. Of particular
significance was the work of two Chilean biologists, Humberto Maturana and
Francisco Varela.
2. T H E M O V E T O C O N S T R U C T I V I S M
Maturana and Varela's (1987) neurophysiological experimentation led them
to the conclusion that what is seen by an organism is determined primarily by
its internal neurophysiological organization rather than external stimuli. Within
this view an organism is an autopoetic system which may engage in "structural
coupling" with other organisms, but for which the nature of the information
derived from such an interaction is dependent less upon the nature of the stimulus
than upon the internal organization of the organism itself. Translated into human
interaction, this would mean that one person is unable to predetermine the impact
that his or her communication will have upon another person; instructive inter-
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creation of a context for change within a therapeutic conversation, but not the
creation of change along predetermined coordinates.
The nature of change itself also began to shift. Cognitive psychology had
provided some of the impetus for the move toward constructivism, and accordingly, views of what it is that changes in therapy moved from an emphasis upon
behaviors to an increased interest in beliefs, ideas, and values. Indeed, Hoffman
(1988) saw this as extending to an interest in " a shared unconscious . . .
(s)ymbols, dreams, stories, trance" (p. 124). This change of emphasis has had
two important consequences which have been taken up by writers in the field:
(i) the development of a view of systems not confined to patterns of interactions,
but including linguistic and meaning systems, and (ii) a resurgence of interest
in individual narratives within systems.
In 1991, Leppington noted the remark made by certain commentators in
the field of systemic therapy that " i f you take a tea break you're likely to miss
two paradigm shifts in the literature." Certainly there has been a good deal of
lively debate over theory and practice in the decade since a constructivist position
for therapy began to be advocated. Here, I want to indicate some of the positions
taken within this debate, which seem to me to have moved forward thinking in
the field.
The repercussions of an observing systems approach to therapy have been
considerable, and have led to suggested modifications of many of the central
principles developed in Milan. Therapist neutrality has come to be seen as
neither desirable in theory nor achievable in practice. This idea has been reframed
(or perhaps clarified) in terms of multiple-engagement, of multipartiality, and
influentially, by Cecchin (1987), of curiosity. A stance of curiosity allows the
therapist to remain engaged with, and not detached from, clients, while drawing
from them interconnecting patterns of multiple descriptions.
The inhibiting effects of holding a predetermined hypothesis have been
discussed, and such hypothesizing has been abandoned by some (e.g., Anderson, 1987) in an attempt to stay more connected to feedback from clients and
to relinquish agendas set by therapists. The need for end-of-session interventions
has been questioned: a more flexible engagement with clients has been advocated, where interventive engagements are made throughout the session and
included within the questioning (Tomm, 1987).
Tom Anderson (1987) and his colleagues in Norway have been at the
forefront of innovative developments in practice that flow from a constructivist
stance. They pioneered the idea of the reflecting team, which involves team
discussions that take place in front of family members and the therapist. This
practice completes a loop between observers and observed, positions the therapist with the family within the therapy system, and at the same time breaks
down barriers of secrecy and hierarchy between therapist and therapee.
The principal metaphors used to describe systemic work with families had
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previously been derived from machinery and cybernetics, and hence patterns of
interactions between family members were construed within physicalistic models.
These explanatory frameworks began to be seen as too objectivist, implying as
they do an "out there" pathology in need of correction (a sort of recalibration
of parts of the system which have become faulty), to be in tune with secondorder sensibilities.
The work of Harlene Anderson and Harold Goolishian (Anderson et al.,
1986; Anderson and Goolishian, 1988) has been important in bringing metaphors
derived from linguistics to bear upon thinking in the field. Their view of systems
is revolutionary in that it is predicated not upon structures within social systems,
but upon systems of language and communication within which participants
seek to construct meanings and an understanding of themselves and others.
Within this context the therapy system is a problem-organizing, problem-dissolving system, where subjective and intersubjective meanings are orchestrated
by the therapist. If analyzed in this way, the system ceases to be structurally
bound by its participants, but is inclusive of all descriptions and explanations
that have been generated in talking about the problems. The therapist creates
change through bringing forth fresh narratives within which the problems are
no longer embedded.
There is another change worthy of note that came with the introduction of
constructivist ideas. Earlier models of systemic therapy have been critiqued in
terms of their dismissal of the "felt experience" of those who seek help, in
favor of an exploration of transactional patterns between people (Treacher, 1992).
The theoretical journey from mechanical to linguistic systems has been accompanied by a fresh interest in subjective experience or personal narratives. Stephen
Frosh (1992) has described this in terms of offering a language with which to
plot the internal coordinates of change for individuals within a linguistic system.
3. F R O M C O N S T R U C T I V I S M T O S O C I A L C O N S T R U C T I O N I S M
In recent years there has been a shift in the terms of the discourse, from
constructivism to social constructionism. This shift has been only partial and
incomplete, with some writers continuing to refer to constructivist ideas, but
others citing influences from social constructionism, and still others using both
sets of ideas together or even interchangeably (e.g., Real, 1990). Possibly this
has been due to certain overt similarities between models of therapy drawing
upon constructivist and social constructionist thinking, notably with regard to a
belief in the centrality of language to the therapeutic endeavor and a disavowal
of a single objective reality. However, there are important differences. Social
constructionism sits within social psychology as a system of thought that locates
the individual, and groups of individuals (e.g., families), as formed from and
by a myriad of societal contexts, _with norms and values understood and defined
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