Family Therapy: A View

1983

Reflections on Therapy and Other Essays represents the cumulative work of one of family therapy's pioneer thinkers and provocateurs. The papers in this volume are classics and belong in every family therapist's library. Many of the papers are essential to a full understanding of the history of the field as well as the evolution of some of the central debates within family therapy. Jay Haley has never been shy about his opinions, and this collection gives the reader a comprehensive view of his thoughts on the subject of therapy. The 13 essays are characteristic of Haley's unique style and are published and distributed by Haley's own agency, The Family Therapy Institute of Washington, D.C. All of the essays are beautiful examples of his clever, precise way of capturing the essences of contexts. Included are such classics as "Towards a Theory of Pathological Systems," "The Family of the Schizophrenic: A Model System," "The Contributions to Therapy of Milton H. Erickson," "Why a Mental Health Clinic Should Avoid Family Therapy," and "Fourteen Ways to Fall as a Teacher of Family Therapy." All the essays appeared in other publications but are brought together for the first time in this book. The papers can be divided into three categories reflecting Haley's various facets. The first third of the volume relates to his contribution to the project on schizophrenic communication. The second group presents Haley's views on the therapy of Milton Erickson and Don Jackson and essays on child and behavioral therapies. The final group comprises Haley's classical, satirical essays on the practice of family therapy. Haley's excellent essays on "Behavior Modification" and "In Defense of Child Therapy" highlight the differences between systemic and other therapies, as well as their areas of overlap and the limitations of the various therapeutic models. All of these essays, along with his own reflections on master therapists, make this a satisfying glimpse into issues of therapy. Papers on the wisdom of his mentorsGregory Bateson, Don Jackson, and Milton Ericksonall portray Haley's respect and appreciation of their subtle artistry. On the other hand, his satirical essays reveal a deep cynicism about clinical practice. The passion of Haley's belief in the creative genius of our masters, side by side with his disbelief in our ability to practice the art, makes an intriguing paradox. Clöe Madanes, Haley's wife as well as a respected family therapist, writes in her introduction to the book: The Haley connoisseur will find this book is a new treat, that, throwing a different light on many issues could encourage him to re-read Haley's other books. Those who read Haley here for the first time will be provoked to think about human interaction and about therapy in new and unusual ways.

Journal of Family Therapy, 1989

Family therapy: the rest of the picture Nick Child* The specialist literature on family therapy naturally tends to focus only on the special features of what is a much larger body of skills and knowledge. To redress the balance this paper outlines the rest of the picture in various ways. About 90 separable component parts offamily therapy are described. Some implications of this analysis are identified.

Family Process, 1983

From Psyche To System: The Evolving Therapy of Carl Whitaker, by John R. Neill and David P. Kniskern, New York:, Guilford Press, 1982, 409 pp. $24.50 cloth. This collection of Carl Whitaker's writings makes an important contribution to the literature of psychotherapy, and family therapy in particular. From Psyche To System offers the reader a unique opportunity to examine the evolution of a creative and controversial therapist and to understand both his approach and how it relates to his personal philosopy.

1983

This book by Andolfi and his colleagues at the Rome Family Therapy Institute joins an emergent genre in family therapy literature, the integration of theoretical schools and therapeutic styles. This integration is often around a particular theme, and for Andolfi and the Rome group the focus is rigid or "monster" families such as those with schizophrenic and anorectic index patients. The process of seeing such families as a team for eight years is the crucible in which their viewpoint developed. Two themes run through the book. The first theme is the importance of the individual's attempts to define a personal identity and personal space within the context of a relational system. Emphasis on the individual is more pronounced here than in most family systems literature and reflects the group's roots in psychoanalysis. Their language is complex and sometimes stilted, making for difficult reading in places. In a recent conversation about the book, Anna Nicolò-Corigliano said to me, "This is a very dangerous book to read in beddangerous to the book." I'm sure she was referring to the first two theoretical chapters, which are probably best reread after finishing the rest of the volume. Its many clinical examples will make the opening section more understandable the second time around. The authors' second theme is their emphasis on a central metaphor for each family; this is the fulcrum around which the therapist operates. "It is precisely through countering the image furnished by the family with an alternative that the therapist is able to release the tension which sustains the therapeutic process" (p. 17). The authors emphasize that the metaphor emerges from the family and is reworked by the therapist to create an alternative image. The primary therapeutic goals of alternative metaphors are (a) to emphasize the centrality of the patient in maintaining the system, while (b) portraying the symptomatic behavior as voluntary rather than involuntary. This specificity of goals is, in itself, a major contribution to understanding the use of metaphors. The authors also emphasize the importance of making powerful therapeutic moves quickly, before the therapist's role can be neutralized by the system. On the other hand, they note that this may increase the risk of early termination; more discussion of this point would have been welcome. Chapters 4 and 5 are the heart of the book. They delineate the role of the strategic therapist in providing a homeostatic anchor that permits the family to start changing. These chapters also describe predictable stages in the middle sessions of strategic therapy requiring an initial restraint from change and a gradual disengagement from the therapist. The authors show the importance of a powerful relationship between the therapist and the family, and demonstrate the intensity of affect that flows from effective strategic intervention. This is doubly welcome in view of the customary emphasis on technique alone in publications on strategic therapy. This book is not for the beginner. It assumes a strong theoretical background and focuses on the most difficult treatment populations. Andolfi's therapeutic style and that of the group reflects the influence of Whitaker and of the more provocative, experiential therapists. They neglect to note, however, that their ideas may also be implemented in less flamboyant style. They also omit what would have been a useful discussion on applying their approach to less rigid families. In summary, this is a useful and thoughtful contribution to the emerging integrationist literature. It is worthy of both the reader's perseverence and of the eight years of team work that went into its creation.

Family Systems Medicine, 1987

Family Therapy Skills and Techniques in Action, 2017

or other means, now known or hereafter invented, including photocopying and recording, or in any information storage or retrieval system, without permission in writing from the publishers. viii Preface ix 1 Introduction: setting the scene 2 Family therapy: listening to the orchestra 3 Assessment: finding out what we need to know 4 Integrative family therapy: a contemporary practice 5 Structural family therapy: creating a new dance with families 6 Strategic family therapy: making language therapeutic 7 The Milan and Post-Milan approach: changing rules and meanings in family life 8 Narrative therapy: interpreting the story 9 Working systemically with individuals: opening up a different view 10 Systemic supervision: reflective practice to enhance outcomes Epilogue: destination or starting point? Index Contents We would like to acknowledge the generosity of many people in the development of this book. First, to Karon Oliver for her efforts, ideas, collaboration and contribution to this work. Second, to all the publishers and family therapists who have given photographs and permission to re-publish their work. We want to give special thanks to Laura Fruggeri, Giuliana Prata and to Matteo Selvini for their contributions in Chapter 7. Third, to the actors and to John Buchmüller and Thomas Bowes without whom this project would never have happened. And finally, to all the families and students who have enriched our practice over the years. This book has been germinated, cultivated and harvested because of you. Context makes the mystery of human relationships more understandable. This is one of the primary lessons of family therapy. Therefore, understanding the context of this book may contribute to an ongoing relationship between reader, writer, therapist and family. Psychological therapies in the UK and Europe are undergoing a renaissance. In the UK, the seeds of past movements that challenged a purely biological understanding of psychological suffering and that championed consumer voices, have matured into pressure to widen access to a growing array of psychological therapies. With this growth comes a need to find new ways of teaching these therapies that takes them out of the exclusive 'institute' and into the everyday world of social workers, counsellors, mental health nurses and support workers. These clinicians want to learn skills and techniques; they need these skills to complement rather than supplant their current skill base; and they require models of learning that accord with contemporary 'YouTube' styles of learning. This book, with its accompanying films, aims to satisfy this new interest specifically in family therapy. Although this book is a response to a very new demand, it is also a poem to the past. As new generations of clinicians and family workers emerge, the knowledge about where this or that technique comes from fades. It is true that this book is founded on the idea that the application of a technique is as important as its origins. Yet history has its value. Sometimes digging in the past unearths hidden gems. Family therapy, in both its evidence-based and social-constructionist formats, has moved away from this history. We hope therefore that this book will serve as a reminder that demonstrates that many of the techniques that grew from the fertile soil of family therapy are eminently practical and applicable in contemporary family practice.

Journal of Strategic and Systemic Therapies, 1985

Journal of Adolescence

American Journal of Psychotherapy, 1987

The first one-way mirror used to observe families should be preserved in the Smithsonian Institution. This simple invention has catalyzed revolutionary developments in family therapy, enabling supervisors and consultants to be actively involved in implementing change. Cloë Madanes is a recognized master in this method of training. Behind The One-way Mirror presents her thinking about problems and their solution in her role as a family therapy supervisor. She guides the reader, as she does the trainee, in formulating hypotheses and in testing strategies of intervention. This volume extends the work presented in Madanes's earlier book (1). She proposes a strategic, problem-solving model of therapy based on ideas about the use of metaphor, planning, and hierarchy in families. Through case studies, she presents a step-by-step process of assessment and intervention. Madanes attends to the metaphorical sequences of interaction involving symptoms, to the planning ahead by family members that is attempted through symptomatic behavior, and to the power imbalances that necessitate the symptoms. A specific strategy is designed to shift the family organization so that the presenting problem is resolved. In this volume, Madanes focuses on indirect intervention strategies, which she finds are often necessary in difficult cases. The book is organized into five chapters. The first presents Madanes's conceptual frame for understanding relationships and for planning strategies for change. Chapter 2 explores the possibility that relations between two individuals are dependent upon involvements with a third person, who functions as a metaphor for covert conflict. Issues of hierarchy and power are discussed in regard to relationship contracts. Chapter 3 presents the novel approach of influencing parents through their children, strategically reversing the generational hierarchy by putting the children in charge of their parents' well-being; this is done in order to provoke the parents to take responsibility for change. Chapter 4 discusses the use of humor in therapy, and the final chapter presents eight dimensions therapists may use to conceptualize problems. Madanes briefly describes paradoxical strategies that might be selected according to the therapist's conceptualization. Madanes's creativity shines most brightly in her many case studies, which reveal the novel ways she recasts problems and the highly inventive strategies she fits to particular situations. Her originality in the construction of playful metaphors, fantasies, and make-believe interventions is a highlight of the book. From my own work (2) with severely dysfunctional families, I share her conviction that families struggling unsuccessfully with difficult problems respond well to interventions that lighten and transform their hopelessness and sense of failure. Such playfulness, if employed without sensitivity, could run the risk of cleverness that is fun only for the therapist. Madanes, however, demonstrates both sensitivity and caring in the cases presented here. The case illustration "Pretending to Be Nurses" (p. 7) is a gem. Here Madanes addresses the problem of a mother's neglect in the care of her daughter's diabetes. She recognizes that the needs of the mother have also been neglected; mother suffers from diabetes herself, was abandoned by her husband, and lacks economic and social supports. Madanes calls attention to a common issue in cases of abuse and neglect: that the parents feel abused and neglected by authorities, in this case medical. An indirect strategy of intervention puts the mother benevolently in charge of her daughter without exercising authority over her. To accomplish this, the therapist asks mother and daughter, each in turn, to pretend to be a nurse to the other, even adding the theatrical touch of donning nurses' uniforms when they do so. The rationale for the strategy is well presented, and the planning of each stage of therapy is clearly described. The follow-up information confirms the effectiveness of Madanes's unique approach. Madanes writes in a straightforward, pragmatic way, and seems to assume that the reader has a basic knowledge of family systems theory and of strategic family therapy. There is, however, some conceptual unclarity and inconsistency. The most serious problems occur in the overuse of the term metaphor and in related assumptions about causality. Every presenting problem is viewed "as a metaphor for and a replacement of" some other (covert) relationship problem. In one case example, the therapeutic strategy is based on the hypothesis that the presenting conflict between a dysfunctional son and his father was a metaphor for, and replaced, an avoided conflict between the father and another son. The son is even referred to as "a metaphor for someone else: his brother" (p. 40). The second relationship is hypothesized to be the "true source" of the first conflict. The therapeutic goal, then, is to "take the problem back to where it originated" (p. 40) so that it can be discussed, thereby freeing the symptomatic son from replacing his brother. Even the chapter title, "Discovering the Source of the Conflict" suggests that there is always a covert source, or origin, of presenting problems that is the "real" problem and the "true" meaning and "cause" of symptoms. Such linear-causal terms and references scattered throughout the text are inconsistent with the systems paradigm of circular causality on which family therapy is based. Such assumptions need to be better thought through lest they slide into the sort of inferential, deterministic interpretations that systems theorists have rightly attacked.

1981

The Family's Construction of Reality, by David Reiss, Cambridge, Mass., Harvard University Press, 1981, 426 pp. $26.00 cloth.